You have a lot to think about when choosing the right medical benefits for you and your family. Our exclusive provider organization (EPO) plans connect you with your primary care provider (PCP), who works closely with the rest of your care team (other providers, specialists, etc.) to help you achieve better health and wellness.
Our Individual medical plans give you access to providers in the Moda Select Network. This network includes a group of licensed medical professionals, clinics, pharmacies, labs and hospitals. These providers offer quality care and services to our Individual members who live within the Hays, Travis, and Williamson service area.
Our network of healthcare providers offers you the right combination of value and service. No referrals are needed for in-network specialist care. Please note that there is no out-of-network coverage, except for services listed in the medical plan policies.
Serving Hays, Travis and Williamson counties in the greater Austin area, the network is made of a carefully selected community of PCPs, specialists and partner health systems, including:
The pharmacy network includes access to over 95% of pharmacies in Texas, plus more than 65,000 pharmacies nationwide. This means you can fill prescriptions almost anywhere, including these local and national drug store chains.
Mail-order services If you have a chronic health condition, our mail-order services via Costco and PPS may be for you.
And you can review our Texas specific formulary (list of covered prescription drugs) to see if any current prescriptions are covered in our plans.
Medicaid redetermination is when the state checks to see if you still qualify for Medicaid. Paused during the COVID-19 pandemic, redetermination now takes place annually. If you no longer qualify for Medicaid because of a redetermination, you may find affordable coverage through a subsidized ACA Marketplace plan. Visit our Medicaid redetermination page to learn more and find your state Medicaid office.