Individual and family plans in Oregon
Medical and dental plan offerings
We offer individual and family medical and dental plans in Oregon. As a member, you'll enjoy a diverse provider network, friendly customer service representatives and member perks to help you stay healthy. You can access all of these from your Member Dashboard, your personalized member website.
Each Moda Health medical plan covers in-network preventive care, including women's annual exams, well-baby care, routine physicals and immunizations. Our plans also come with prescription medication benefits too.
Members
As a member, you have access to your Member Dashboard where you can:
- Find in-network providers
- Review your coverage for specific services
- Check the status of claims
- Check your annual deductible and out-of-pocket status
- Review explanations of benefits (EOBs)
- View documents about your benefits
- Download your member ID card
- Access tools to manage your care needs
- Manage paperless communication
- Pay your premiums and set up recurring payments for members on individual plans
Additional resources
- Benefit summaries - summary guides on benefits with your individual plan
- eBill - details on managing monthly invoices
- ID Card - options on how to access your ID card
- Member Handbooks - access your member handbook in your Member Dashboard, or browse the list of all Individual Plan Member Handbooks
- Provider search - access Find Care in your Member Dashboard or search for all providers in our Find Care tool
Questions?
Contact our Customer Service team. We're here to support you, every step of the way.
Impacted by Medicaid eligibility changes?
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.
Individual and family plans in Alaska
Medical and dental plan offerings
We offer individual and family medical and dental plans in Alaska. As a member, you'll enjoy a diverse provider network, friendly customer service representatives and member perks to help you stay healthy. You can access all of these from your Member Dashboard, your personalized member website.
Our Moda Health Individual medical plans, provided by Moda Assurance Company, are available to residents in the Municipality of Anchorage, Fairbanks North Star, Haines, Kenai Peninsula, Ketchikan Gateway, Matanuska-Susitna, Petersburg and Muncipality of Skagway boroughs, City and Borough of Juneau, City and Borough of Wrangell, Hoonah-Angoon Census Area and Prince of Wales-Hyder Census Area. Each Moda Health medical plan covers in-network preventive care, including women's annual exams, well-baby care, routine physicals and immunizations. Our plans also come with prescription medication benefits too.
Members
As a member, you have access to your Member Dashboard where you can:
- Find in-network providers
- Review your coverage for specific services
- Check the status of claims
- Check your annual deductible and out-of-pocket status
- Review explanations of benefits (EOBs)
- View documents about your benefits
- Download your member ID card
- Access tools to manage your care needs
- Manage paperless communication
- Pay your premiums and set up recurring payments for members on individual plans
Additional resources
- Benefit summaries - summary guides on benefits with your individual plan
- eBill - details on managing monthly invoices
- ID Card - options on how to access your ID card
- Member Handbooks - access your member handbook in your Member Dashboard, or browse the list of all Individual Plan Member Handbooks
- Provider search - access Find Care in your Member Dashboard or search for all providers in our Find Care tool
Questions?
Contact our Customer Service team. We're here to support you, every step of the way.
Impacted by Medicaid eligibility changes?
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.
Better health plans for the real you
Are you looking for an individual or family medical plan? If so, you're in the right place. Moda Health plans are designed to support the way you live.
Benefits you'll love
As a member, you'll enjoy a diverse provider network, friendly customer service representatives and our member care resources to help you stay healthy. You can access all of these from your Member Dashboard, your personalized member website.
Each Moda Health medical plan covers 100 percent of in-network preventive care, including women's annual exams, well-baby care, routine physicals and immunizations. Our plans also come with prescription medication benefits as part of our Preferred Drug Program.
Enrollment
The new open enrollment period for 2021 medical and dental plans is Feb. 15, 2021 through Aug. 15, 2021. To change your medical or dental plan or to enroll in new coverage outside of the open enrollment period, you'll have to qualify for special enrollment. Learn more about special enrollment.
Download our plans brochure and application
We provide medical plans in most counties and dental plans statewide. Depending on the county you live in, our medical plan will use one of three provider networks. Look for your county below to see the medical plans in your areas. If you don't see your county, we don't offer medical plans there. Both brochures contain our statewide Delta Dental plans.
- 2021 Oregon Beacon medical and dental brochure for Clackamas, Clatsop, Columbia, Coos, Curry, Hood River, Jackson, Josephine, Multnomah, Tillamook, Wasco, Washington and Yamhill counties
- 2021 Oregon Affinity medical and dental brochure for Baker, Crook, Douglas, Gilliam, Grant, Harney, Jefferson, Klamath, Lake, Lane, Malheur, Marion, Morrow, Polk, Sherman, Umatilla, Union, Wallowa and Wheeler counties
Questions?
Contact our Customer Service team. We're here to support you, every step of the way.
Better health plans for the real you
Are you looking for an individual or family medical or dental plan? If so, you're in the right place. Our Moda Health Individual medical plans, provided by Moda Assurance Company, give you access to quality medical services, including clinics, labs and hospitals in Alaska. Our individual medical plans are available to residents in the Municipality of Anchorage, Fairbanks North Star, Ketchikan Gateway, Kenai Peninsula and Mat-Su Boroughs, and Prince of Wales-Hyder Census Area. Our individual Delta Dental of Alaska Premier plans are available to Alaska residents statewide and our Delta Dental of Alaska PPO plans are available to members residing in the Anchorage, Fairbanks North Star Borough, or Mat-Su Valley areas.
Benefits you'll love
As a member, you'll enjoy cost-effective coordinated care, friendly customer service representatives and our member care resources to help you stay healthy. You can access all of these from your Member Dashboard, your personalized member website.
Each Moda Health medical plan covers 100 percent of in-network preventive care required under the Affordable Care Act, including women's annual exams, well-baby care, routine physicals and immunizations. Our plans also come with prescription medication benefits as part of our Preferred Drug Program.
Introducing the Pioneer Network
The Pioneer Network was developed to provide cost-effective coordinated care in Alaska. Choosing medical healthcare and services from our Pioneer Network ensures you receive the best combination of care and value. Pioneer offers three benefit levels (tiers) of healthcare:
Tier One includes:
- Central Peninsula Hospital
- Alaska Regional Hospital
- Bartlett Regional Hospital
- Mat-Su Regional Medical Center
- PeaceHealth Ketchikan Medical Center
- South Peninsula Hospital
- Other contracted providers
Tier Two includes:
- First Choice Network in Alaska
Tier Three includes:
- All other Alaska providers not in Tier One or Tier Two
Healthcare outside of Alaska includes:
Services received outside Alaska are covered at the Tier One benefit level for urgent and emergency care through providers in the First Health Network. Care outside of Alaska is not covered except for:
- Emergency services
- Coverage through the travel network
- Coverage through medical travel support
- Medically necessary non-emergency services that are prior authorized by Moda Health
Enrollment
The new open enrollment period for 2021 medical and dental plans is Feb. 15, 2021 through Aug. 15, 2021. To change your medical or dental plan or to enroll in new coverage outside of the open enrollment period, you'll have to qualify for special enrollment. Learn more about special enrollment.
Download our plans brochure and application
For residents in the Kenai Peninsula, Anchorage or Mat-Su Borough our medical plans use our Pioneer network. Our 2020 brochure also includes our statewide dental plans.
Questions?
Contact our Customer Service team. We're here to support you, every step of the way.
Hello.
We have exciting news to share. ODS is changing its name to Moda Health.
Moda comes from the latin term "modus" and means "a way". We picked it because that's what we are here to do: help our communities find a way to better health.
Together, we can be more, be better.
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