Moda Health. Healthcare from your head to your toes. Delta Dental | Moda Health

Managed Care Plan

Area 1 (Portland)

Prevailing Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $456 $958 $1,345 $789
25 - 29 $513 $1,076 $1,512 $887
30 - 34 $513 $1,077 $1,513 $887
35 - 39 $541 $1,137 $1,597 $937
40 - 44 $599 $1,259 $1,768 $1,037
45 - 49 $709 $1,489 $2,091 $1,226
50 - 54 $822 $1,726 $2,425 $1,422
55 - 59 $875 $1,838 $2,582 $1,514
60 - 64 $902 $1,893 $2,660 $1,560
65 and older $907 $1,906 $2,677 $1,570
Low Cost Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $387 $812 $1,140 $669
25 - 29 $435 $912 $1,282 $752
30 - 34 $435 $913 $1,282 $752
35 - 39 $459 $964 $1,354 $794
40 - 44 $508 $1,067 $1,499 $879
45 - 49 $601 $1,262 $1,773 $1,040
50 - 54 $697 $1,463 $2,055 $1,205
55 - 59 $742 $1,558 $2,188 $1,283
60 - 64 $764 $1,605 $2,255 $1,322
65 and older $769 $1,615 $2,269 $1,331

Area 2 (Eugene)

Prevailing Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $444 $933 $1,311 $769
25 - 29 $499 $1,049 $1,473 $864
30 - 34 $500 $1,049 $1,474 $864
35 - 39 $528 $1,108 $1,556 $913
40 - 44 $584 $1,227 $1,723 $1,010
45 - 49 $691 $1,451 $2,038 $1,195
50 - 54 $801 $1,682 $2,363 $1,386
55 - 59 $853 $1,791 $2,515 $1,475
60 - 64 $879 $1,845 $2,592 $1,520
65 and older $884 $1,857 $2,609 $1,530
Low Cost Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $377 $791 $1,111 $652
25 - 29 $423 $889 $1,249 $732
30 - 34 $424 $890 $1,250 $733
35 - 39 $447 $939 $1,319 $774
40 - 44 $495 $1,040 $1,461 $857
45 - 49 $586 $1,230 $1,727 $1,013
50 - 54 $679 $1,426 $2,003 $1,174
55 - 59 $723 $1,518 $2,132 $1,250
60 - 64 $745 $1,564 $2,197 $1,288
65 and older $750 $1,574 $2,211 $1,297

Area 3 (Salem)

Prevailing Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $424 $891 $1,251 $734
25 - 29 $477 $1,001 $1,406 $825
30 - 34 $477 $1,002 $1,407 $825
35 - 39 $504 $1,057 $1,485 $871
40 - 44 $557 $1,171 $1,645 $964
45 - 49 $659 $1,385 $1,945 $1,141
50 - 54 $764 $1,605 $2,255 $1,322
55 - 59 $814 $1,709 $2,401 $1,408
60 - 64 $839 $1,761 $2,474 $1,451
65 and older $844 $1,772 $2,490 $1,460
Low Cost Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $360 $755 $1,061 $622
25 - 29 $404 $849 $1,192 $699
30 - 34 $404 $849 $1,193 $699
35 - 39 $427 $896 $1,259 $738
40 - 44 $473 $992 $1,394 $818
45 - 49 $559 $1,174 $1,649 $967
50 - 54 $648 $1,361 $1,911 $1,121
55 - 59 $690 $1,449 $2,035 $1,194
60 - 64 $711 $1,493 $2,097 $1,230
65 and older $715 $1,502 $2,110 $1,238

Area 4 (Bend/Klamath Falls)

Prevailing Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $474 $996 $1,399 $820
25 - 29 $533 $1,120 $1,573 $922
30 - 34 $533 $1,120 $1,573 $923
35 - 39 $563 $1,182 $1,661 $974
40 - 44 $623 $1,309 $1,839 $1,079
45 - 49 $737 $1,548 $2,175 $1,275
50 - 54 $855 $1,795 $2,522 $1,479
55 - 59 $910 $1,911 $2,685 $1,575
60 - 64 $938 $1,969 $2,766 $1,622
65 and older $944 $1,982 $2,784 $1,633
Low Cost Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $402 $844 $1,186 $696
25 - 29 $452 $949 $1,333 $782
30 - 34 $452 $949 $1,334 $782
35 - 39 $477 $1,002 $1,408 $826
40 - 44 $528 $1,110 $1,559 $914
45 - 49 $625 $1,312 $1,844 $1,081
50 - 54 $725 $1,522 $2,138 $1,254
55 - 59 $771 $1,620 $2,276 $1,335
60 - 64 $795 $1,669 $2,345 $1,375
65 and older $800 $1,680 $2,360 $1,384

Area 5 (Coastal Areas)

Prevailing Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $442 $929 $1,305 $765
25 - 29 $497 $1,044 $1,467 $860
30 - 34 $497 $1,045 $1,467 $861
35 - 39 $525 $1,103 $1,549 $909
40 - 44 $581 $1,221 $1,715 $1,006
45 - 49 $688 $1,444 $2,029 $1,190
50 - 54 $797 $1,674 $2,352 $1,379
55 - 59 $849 $1,783 $2,504 $1,469
60 - 64 $875 $1,837 $2,580 $1,513
65 and older $880 $1,849 $2,597 $1,523
Low Cost Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $375 $787 $1,106 $649
25 - 29 $421 $885 $1,243 $729
30 - 34 $422 $885 $1,244 $729
35 - 39 $445 $935 $1,313 $770
40 - 44 $493 $1,035 $1,454 $853
45 - 49 $583 $1,224 $1,720 $1,008
50 - 54 $676 $1,419 $1,994 $1,169
55 - 59 $720 $1,511 $2,123 $1,245
60 - 64 $741 $1,557 $2,187 $1,283
65 and older $746 $1,567 $2,201 $1,291

Area 6 (Eastern Oregon)

Prevailing Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $461 $967 $1,359 $797
25 - 29 $518 $1,087 $1,527 $896
30 - 34 $518 $1,088 $1,528 $896
35 - 39 $547 $1,148 $1,613 $946
40 - 44 $605 $1,271 $1,786 $1,047
45 - 49 $716 $1,504 $2,112 $1,239
50 - 54 $830 $1,743 $2,449 $1,436
55 - 59 $884 $1,856 $2,607 $1,529
60 - 64 $911 $1,912 $2,686 $1,575
65 and older $917 $1,925 $2,704 $1,586
Low Cost Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $390 $820 $1,152 $675
25 - 29 $439 $922 $1,295 $759
30 - 34 $439 $922 $1,295 $760
35 - 39 $464 $973 $1,367 $802
40 - 44 $513 $1,078 $1,514 $888
45 - 49 $607 $1,275 $1,790 $1,050
50 - 54 $704 $1,478 $2,076 $1,217
55 - 59 $749 $1,573 $2,210 $1,296
60 - 64 $772 $1,621 $2,277 $1,335
65 and older $777 $1,632 $2,292 $1,344

Area 7 (Medford)

Prevailing Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $483 $1,015 $1,426 $836
25 - 29 $543 $1,141 $1,603 $940
30 - 34 $544 $1,142 $1,604 $940
35 - 39 $574 $1,205 $1,693 $993
40 - 44 $635 $1,334 $1,874 $1,099
45 - 49 $751 $1,578 $2,217 $1,300
50 - 54 $871 $1,830 $2,570 $1,507
55 - 59 $928 $1,948 $2,736 $1,605
60 - 64 $956 $2,007 $2,819 $1,653
65 and older $962 $2,020 $2,838 $1,664
Low Cost Benefits
Age Insured
Only
Insured &
Spouse
Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective June 1, 2013
Monthly family rates are based on the age of primary applicant

Under 25 $410 $860 $1,209 $709
25 - 29 $461 $967 $1,359 $797
30 - 34 $461 $968 $1,359 $797
35 - 39 $486 $1,022 $1,435 $842
40 - 44 $539 $1,131 $1,589 $932
45 - 49 $637 $1,338 $1,879 $1,102
50 - 54 $739 $1,551 $2,179 $1,278
55 - 59 $786 $1,651 $2,320 $1,360
60 - 64 $810 $1,701 $2,390 $1,402
65 and older $815 $1,712 $2,405 $1,411

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Hello.

We have exciting news to share. ODS is changing its name to Moda Health.

Moda comes from the latin term "modus" and means "a way". We picked it because that's what we are here to do: help our communities find a way to better health.

Together, we can be more, be better.

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