Pharmacy
Why choose Moda Health
Moda Health has the right pharmacy benefits to meet your needs with wide networks, carefully crafted formularies, online tools for members and more.
Preferred drug program
This program uses tiers to provide the right prescriptions at the right prices. Your employees and their providers can choose between value, select, preferred, non-preferred, preferred specialty or non-preferred specialty tier drugs. Each tier has a different copay or coinsurance amount, based on your benefit.
Pharmacy benefits, and then some
Pharmacy networks
Based on your plan, employees have access to one of two pharmacy networks, the Navitus network or the Northwest Prescription Drug Consortium. Employees should use their member ID card to verify which network their plan uses.
Navitus network
The Navitus Network includes access to over 95% of pharmacies in Oregon, plus more than 58,000 pharmacies nationwide. This means your employees can fill prescriptions almost anywhere, including these local and national drug store chains:
- Costco
- CVS
- Fred Meyer
- Rite Aid
- Safeway and Albertsons
- Walgreens
- Walmart
Locate a pharmacy in the Navitus network >
Northwest Prescription Drug Consortium (MedImpact)
The Northwest Prescription Drug Consortium is supported by MedImpact, a Pharmacy Benefits Manager. MedImpact operates a robust pharmacy network in Oregon and across the nation that includes both independent pharmacies and national chains.
Locate a pharmacy in the MedImpact network >
Mail-order services
If your employees have chronic health conditions, our mail-order services may be for them. This program is open to members who require ongoing treatment for conditions like high blood pressure, asthma or diabetes.
If their plan allows, they can order up to a 90-day supply of medication. To get started, just visit Postal Prescription Services (PPS) online or call for more information.
Postal Prescription Services (PPS)
Members can contact Postal Prescription Services (PPS) at 800-552-6694 or visit the PPS website.
Health support, online
Member Dashboard
Members have access to the Member Dashboard, our personalized member website. Your employees will love everything they can do at Member Dashboard, including:
- Checking medication costs
- Viewing prescription history
- Finding in-network pharmacies
- Reviewing drug interactions
Members access their dashboard at modahealth.com/memberdashboard >
Formularies and medication tiers
Group plans using the Navitus pharmacy network
For group plans that use the Navitus Network, members can search our formulary to see medications by tier and coverage level.
- Prescription drug list for large group
- Value tier medications list
- Vaccines covered at the pharmacy
- Preferred diabetes supplies & insulins
- Summary of changes for small group members
- Summary of changes for large group members
Group plans using the Northwest Prescription Drug Consortium (MedImpact)
For group plans that use the Northwest Prescription Drug Consortium, members can explore our formulary lists to see medication tiers and coverage requirements:
- Prescription drug list
- Value tier medications list
- Vaccines covered at the pharmacy
- Preferred diabetes supplies & insulins
- Summary of changes
Questions?
If you’re shopping for pharmacy benefits
Call the Moda Health Sales and Account Service team at 503-243-3948 or toll-free at 800-578-1402. Or, contact your producer.
If you want to know about your plan
To learn more about Moda Health pharmacy benefits, including formularies and medication tiers, please contact Moda Health Pharmacy Customer Service at 503-243-3960 or toll-free at 888-361-1610. Members can also access this information by visiting the Member Dashboard.
Pharmacy
Why choose Moda Health
Moda Health has the right pharmacy benefits to meet your needs with a wide network, carefully crafted formularies, online tools for members and more.
Preferred drug program
This program uses tiers to provide the right prescriptions at the right prices. Your employees and their providers can choose between value, select, preferred, non-preferred, preferred specialty or non-preferred specialty tier drugs. Each tier has a different copay or coinsurance amount, based on your benefit.
Pharmacy benefits, and then some
Pharmacy network
Navitus network
The Navitus Network includes access to over 90% of pharmacies in Alaska, plus more than 58,000 pharmacies nationwide. This means your employees can fill prescriptions almost anywhere, including these local and national drug store chains:
- Carrs
- Costco
- CVS
- Fred Meyer
- Walgreens
- Walmart
Locate a pharmacy in the Navitus network >
Mail-order services
If your employees have chronic health conditions, our mail-order services may be for them. This program is open to members who require ongoing treatment for conditions like high blood pressure, asthma or diabetes.
If their plan allows, they can order up to a 90-day supply of medication. To get started, just visit Postal Prescription Services (PPS) online or call for more information.
Postal Prescription Services (PPS)
Members can contact Postal Prescription Services (PPS) at 800-552-6694 or visit the PPS website .
Health support, online
Member Dashboard
Members have access to the Member Dashboard, our personalized member website. Your employees will love everything they can do at Member Dashboard, including:
- Checking medication costs
- Viewing prescription history
- Finding in-network pharmacies
- Reviewing drug interactions
Members access their dashboard at modahealth.com/memberdashboard >
Formularies and medication tiers
Members can search our formulary to see medications by tier and coverage level.
- Prescription drug list for large group
- Value tier medications list
- Vaccines covered at the pharmacy
- Preferred diabetes supplies & insulins
- Summary of changes for small group members
- Summary of changes for large group members
Questions?
If you’re shopping for pharmacy benefits
Call the Moda Health Sales and Account Service team at 907-278-2626 or toll-free at 888-374-8910. Or, contact your producer.
If you want to know about your plan
To learn more about Moda Health pharmacy benefits, including formularies and medication tiers, please contact Moda Health Pharmacy Customer Service toll-free at 844-235-8017. Members can also access this information by visiting the Member Dashboard.