Moda Health medical networks

You’ll be assigned to a home network based on where you reside (Oregon/SW Washington (Cowlitz and Clark Counties), NW Washington, Alaska or remote). The providers in Tier I will be the same across all 3 plans, but the Tier II providers will vary based on where you live.

View networks quick-guide PDF

Read this guide on how to search for in-network providers

 

Tier I

When you receive care from a provider in the Tier I network, you will pay the least amount. That’s because the plans pay more of the cost for Tier I providers.

This network includes:

• PeaceHealth facilities
• Peacehealth and employed professional providers
• ZoomCare
• The Clinically Integrated Network community providers
• PeaceHealth Joint Ventures*
• Slocum professional providers (the surgery center is Tier II)
• Willamette Valley Cancer Institute: Oncology Associates of Oregon
• Seattle Children’s Hospital (for Caregivers residing in Alaska and NW Washington)

PeaceHealth network Directory Link

*Joint ventures include Fresenius Kidney Care Longview, LLC, Mt. Baker Imaging, LLC, RiverBend Ambulatory Surgery Center, Southwest Washington Regional Surgery Center, Oregon Imaging Centers and Emerging Health, LLC

If you need additional help finding a Tier I provider, you can contact the Moda Health Navigators at 833-599-8602.

 

Tier II

Tier II includes more providers and health systems, so you have more choices.

When you receive care from a provider in the Tier II network, you may have higher out-of-pocket costs than Tier I. That’s because the plans will cover a lower percentage of the costs for care received from Tier II providers.

PeaceHealth partnered with Moda Health to customize the network in this Tier. Please visit the FAQs to learn more about how and why we customized these networks and to learn how to confirm if a provider is in-network.

The Tier II network includes:

• Moda Health Connexus network for residents of Oregon and Washington (Cowlitz and Clark counties)
  • Moda Health Connexus network Directory Link
  • Although the following provider groups will display as in-network in the Moda Health Connexus network provider directory,they will be in Tier III (out-of-network) in 2025 and are covered at a different benefit level for the PPO and ABHP plans; there is NO coverage for them on the EPO (unless true emergency):
    • Legacy Salmon Creek Medical Center (providers remain in Tier II)
    • McKenzie Surgery Center
    • McKenzie-Willamette Medical Center
    • Option Care at Legacy Health (home infusion)
      

       

• Moda Health Endeavor Select network with First Choice and Aetna® PPO Network through Aetna Signature Administrators® for residents of Alaska 
  • Moda Health Endeavor Select network Directory Link 
  • First Choice Directory Link
  • Aetna® PPO Network through Aetna Signature Administrators® Directory Link
  • Important Notes:
    • While you will have access to the Aetna network, the medical plan is administered by Moda Health
    • Although Family Care Network will display as in-network in the Aetna network provider directory, Family Care Network will remain not covered in 2025.
      
      
• Aetna® PPO Network through Aetna Signature Administrators® for residents outside Oregon and SW Washington (Cowlitz and Clark counties). It’s also the travel network for caregivers residing in Oregon and SW Washington (Cowlitz and Clark counties) when traveling outside of their network service area. Please note that travel benefits are available for emergency care ONLY.
  • Aetna® PPO Network through Aetna Signature Administrators® Directory Link
  • Important Notes:
    • While you will have access to the Aetna network, the medical plan is administered by Moda Health.
    • Although Family Care Network will display as in-network in the Aetna network provider directory, Family Care Network will remain not covered in 2025.

Tier III

This network includes all out-of-network providers. They have not contracted with us, so there is no protection from balance-billing. Depending on which plan you choose, you will need to pay some or all of the cost of care from a Tier III provider.

• PPO and ABHP plans may cover a small amount of provider fees
• EPO plan provides no coverage for services, unless it’s a medical emergency