Picking the right plan

Find your perfect fit

Health plans are personal. Knowing how much you’ll pay for your premium, deductibles, copays and coinsurance — and how much coverage you need — will help you choose the one that fits you best.

We offer a variety of individual and family medical plans in Oregon and dental plans in Oregon and Alaska. Plans differ by how much they cost and how much they cover. Shop our plans to find your best match.

Medical plans

Medical plans fall into levels called metal categories: Gold, Silver and Bronze. Understanding these levels can help you choose the plan that’s right for you.

  • Gold plans cost the most, but they cover about 80 percent of the total average cost of care.
  • Silver plans sit somewhere in the middle, giving members a combination of coverage and value, with mid-range monthly premiums. These plans cover about 70 percent of the total average cost of care.
  • Bronze plans give members less coverage – about 60 percent of the total average cost of care – but have lower monthly premiums.

Each plan level meets the requirements of the ACA.

What affects your monthly premium?

A few things affect the amount you pay each month. The first is the plan you choose. Some plans simply cost more because they offer greater benefits.

The second is your age and the age of your dependents — your spouse or partner and/or children no older than 25. Your premium will go up a little each year until you turn age 65, when you’ll be eligible for Medicare. If you are covering children under age 21, they each have the same premium rate based on the plan. Child dependents age 21 through 25 have a rate based on their actual age.

Finally, the region — or rating area where you live — may also affect the cost of your plan’s premium.

Primary care providers

As a Moda Health member, you’ll get personalized, coordinated care from your primary care provider (PCP) — a professional you select to help manage your healthcare. This provider works closely with Moda and the rest of your care team to help you achieve better health and wellness. Many in-network providers in your coverage area are available as PCPs. You can choose any of these, and you can always change to another in-network PCP later.

Provider networks

Each Moda medical plan comes with a provider network. This is a group of licensed medical professionals, clinics, labs, pharmacies and hospitals that offer quality care and services to Moda Health members at an agreed-upon cost.

It's important to remember that members may pay more for services from out-of-network providers than from in-network providers.

Out-of-network providers may also bill members for the difference between the maximum plan allowance and their billed charges. This is known as “balance billing.” In-network providers don’t do this.

Need more help with picking a health plan?
Explore our frequently asked questions (FAQs).

Dental plans

Our Delta Dental plans connect you with great benefits and quality in-network dentists in Oregon and Alaska. In some Delta Dental plans, preventive care is fully covered.

With each plan, you can count on:

  • Savings from in-network or participating dentists
  • Cleanings every six months
  • Benefit estimates prior to treatment
  • Superior customer service

Differences between the Delta Dental plans we offer include the amount of per-person deductibles, the percentage members pay for covered services like fillings and space maintainers, and annual benefit maximums for members over the age of 19. An annual benefit maximum also applies for under age 19 out-of-network.   

Delta Dental networks

Each Delta Dental plan comes with a Delta Dental network. It includes thousands of dentists across the state and the country.

In-network dentists have contracted with us to help get you the best rates. Using in-network and participating dentists can help you save on out-of-pocket costs. If you see nonparticipating providers or providers outside the network, you may pay more for care.

You can enroll in a dental plan through the federal Marketplace at HealthCare.gov only if you are enrolling in a medical plan at the same time during an enrollment period.

Need more help with picking a dental plan?
Explore our frequently asked questions (FAQs).

Ready to shop plans?