Individual and family medical plans
Better plans for the real you
Your clients have a lot to think about when choosing the right medical benefits for themselves and their families. Our exclusive provider organization (EPO) plans connect them with their primary care provider (PCP), who works closely with the rest of their care team (other providers, specialists, etc.) to help them achieve better health and wellness.
Moda Select Network
Our Individual medical plans give 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 Individual members who live within the Hays, Travis, and Williamson service area.
EPO Plans
Our network of healthcare providers offers 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 emergency medical care and retail pharmacy services, and some out-of-area children.
In network providers and health systems
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:
- Austin Diagnostic Clinic
- Austin Regional Clinic
- Capital Area Cardiology
- Capital Area Multispecialty Providers
- Capital Area Primary Care
- Capital Area Specialty Providers
- St. David's HealthCare
Pharmacy benefits
In-network pharmacies
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.
Covered prescription drugs
And you can review our Texas specific formulary (list of covered prescription drugs) to see if any current prescriptions are covered in our plans.
Ready to see plans?
Review plans we have available for your clients
Benefit Summaries for these plans