Our 2023 plans
Plan benefit details and documents
See all plan names, the per-person deductible and annual out-of-pocket max, and links to plan documents in the tables for your state below.
For high-level medical and dental plan cost and feature details, open the Schedule of Benefits (SOB) PDF linked to in the tables below. And for comprehensive details on what medical plans cover and what services will cost, open the Summary of Benefits and Coverage (SBC) PDF linked to in the tables below. The CSV & LV plans shown below are only available through the federal and state exchanges, and eligibility for these plans is determined by the exchanges based on demographics and income levels.
Alaska
2023 Alaska individual and family medical and dental brochure
Dental plans
|
Plan name |
Deductible |
Annual Max |
Summary of benefits |
|---|---|---|---|
|
Delta Dental PPO 1000 |
$50 (Applies to Class II and Class III services) |
N/A |
|
|
Delta Dental PPO 1500 |
$50 (Applies to Class II and Class III services) |
N/A |
|
|
Delta Dental Premier |
$0 |
N/A |
|
|
Delta Dental Premier Healthy Smiles |
$0 |
N/A |
Medical plans
|
Plan name |
Deductible |
Out-of-pocket max |
Summary of benefits |
Summary of benefits and coverage |
|---|---|---|---|---|
|
Moda Pioneer Gold 1500 - CSV0 |
$0 |
$0 |
||
|
Moda Pioneer Gold 1500 |
$1,500 |
$6,000 |
||
|
Moda Pioneer Gold 1500 |
$1,500 |
$6,000 |
||
|
Moda Pioneer Silver 4500 - CSV0 |
$0 |
$0 |
||
|
Moda Pioneer Silver 4500 CSV3 |
$250 |
$500 |
||
|
Moda Pioneer Silver 4500 CSV1 |
$3,500 |
$6,850 |
||
|
Moda Pioneer Silver 4500 |
$4,500 |
$7,600 |
||
|
Moda Pioneer Silver 4500 |
$4,500 |
$7,600 |
||
|
Moda Pioneer Silver 4500 CSV2 |
$500 |
$1,500 |
||
|
Moda Pioneer Bronze 6500 - CSV0 |
$0 |
$0 |
||
|
Moda Pioneer Bronze HDHP 5500 - CSV0 |
$0 |
$0 |
||
|
Moda Pioneer Bronze HDHP 5500 |
$5,500 |
$7,000 |
||
|
Moda Pioneer Bronze HDHP 5500 |
$5,500 |
$7,000 |
||
|
Moda Pioneer Bronze 6500 |
$6,500 |
$8,250 |
||
|
Moda Pioneer Bronze 6500 |
$6,500 |
$8,250 |
||
|
Moda Pioneer Alaska Standard Gold - CSV0 |
$0 |
$0 |
||
|
Moda Pioneer Alaska Standard Gold |
$2,000 |
$8,700 |
||
|
Moda Pioneer Alaska Standard Gold |
$2,000 |
$8,700 |
||
|
Moda Pioneer Alaska Standard Silver - CSV0 |
$0 |
$0 |
||
|
Moda Pioneer Alaska Standard Silver - CSV3 |
$0 |
$1,700 |
||
|
Moda Pioneer Alaska Standard Silver - CSV1 |
$5,700 |
$7,200 |
||
|
Moda Pioneer Alaska Standard Silver |
$5,800 |
$8,900 |
||
|
Moda Pioneer Alaska Standard Silver |
$5,800 |
$8,900 |
||
|
Moda Pioneer Alaska Standard Silver - CSV2 |
$800 |
$3,000 |
||
|
Moda Pioneer Alaska Standard Bronze - CSV0 |
$0 |
$0 |
||
|
Moda Pioneer Alaska Standard Bronze |
$9,100 |
$9,100 |
||
|
Moda Pioneer Alaska Standard Bronze |
$9,100 |
$9,100 |
Idaho
2023 Idaho individual and family medical brochure
Medical plans
|
Plan name |
Deductible |
Out-of-pocket max |
Summary of benefits |
Summary of benefits and coverage |
|---|---|---|---|---|
|
Moda Select Gold 1000 Separate Rx + Vision Exam - CSV0 |
$0 |
$0 |
||
|
Moda Select Gold 2200 + Vision Exam - CSV0 |
$0 |
$0 |
||
|
Moda Select Gold 1000 Separate Rx + Vision Exam |
$1,000 |
$8,000 |
||
|
Moda Select Gold 1000 Separate Rx + Vision Exam LV |
$1,000 |
$8,000 |
||
|
Moda Select Gold 2200 + Vision Exam |
$2,200 |
$7,600 |
||
|
Moda Select Gold 2200 + Vision Exam LV |
$2,200 |
$7,600 |
||
|
Moda Select Silver 3000 Separate Rx + Vision Exam - CSV0 |
$0 |
$0 |
||
|
Moda Select Silver 6400 + Vision Exam - CSV0 |
$0 |
$0 |
||
|
Moda Select Silver 3000 Separate Rx + Vision Exam - CSV3 |
$100 |
$750 |
||
|
Moda Silver Select 6400 + Vision Exam - CSV3 |
$100 |
$750 |
||
|
Moda Select Silver 3000 Separate Rx + Vision Exam - CSV1 |
$2,500 |
$6,400 |
||
|
Moda Select Silver 6400 + Vision Exam - CSV1 |
$2,500 |
$6,350 |
||
|
Moda Select Silver 3000 Separate Rx + Vision Exam LV |
$3,000 |
$8,250 |
||
|
Moda Select Silver 3000 Separate Rx + Vision Exam |
$3,000 |
$8,250 |
||
|
Moda Select Silver 6400 + Vision Exam |
$6,400 |
$7,350 |
||
|
Moda Select Silver 6400 + Vision Exam LV |
$6,400 |
$7,350 |
||
|
Moda Select Silver 3000 Separate Rx + Vision Exam - CSV2 |
$750 |
$2,000 |
||
|
Moda Select Silver 6400 + Vision Exam - CSV2 |
$750 |
$2,000 |
||
|
Moda Select Bronze 8900 + Vision Exam - CSV0 |
$0 |
$0 |
||
|
Moda Select Bronze HSA 6900 - CSV0 |
$0 |
$0 |
||
|
Moda Select Bronze HSA 6900 |
$6,900 |
$6,900 |
||
|
Moda Select Bronze HSA 6900 LV |
$6,900 |
$6,900 |
||
|
Moda Select Bronze 8900 + Vision Exam |
$8,900 |
$8,900 |
||
|
Moda Select Bronze 8900 + Vision Exam LV |
$8,900 |
$8,900 |
Oregon
Dental plans
2023 Oregon individual and family dental brochure
|
Plan name |
Deductible |
Annual Max |
Summary of benefits |
|---|---|---|---|
|
Delta Dental EPO |
$0 |
N/A |
|
|
Delta Dental MAC |
$0 |
N/A |
|
|
Delta Dental PPO |
$0 |
N/A |
|
|
Delta Dental PPO Bright Smiles |
$0 |
N/A |
Medical plans
2023 Oregon Affinity individual and family medical and dental brochure
|
Plan name |
Deductible |
Out-of-pocket max |
Summary of benefits |
Summary of benefits and coverage |
|---|---|---|---|---|
|
Moda Health Affinity Gold 1000 - CSV0 |
$0 |
$0 |
||
|
Moda Health Affinity Gold 250 - CSV0 |
$0 |
$0 |
||
|
Moda Health Affinity Gold 1000 |
$1,000 |
$8,700 |
||
|
Moda Health Affinity Gold 1000 LV |
$1,000 |
$8,700 |
||
|
Moda Health Affinity Gold 250 |
$250 |
$8,700 |
||
|
Moda Health Affinity Gold 250 LV |
$250 |
$8,700 |
||
|
Moda Health Affinity Silver 3500 - CSV0 |
$0 |
$0 |
||
|
Moda Health Affinity Silver 4500 - CSV0 |
$0 |
$0 |
||
|
Moda Health Affinity Silver 6400 - CSV0 |
$0 |
$0 |
||
|
Moda Health Affinity Silver 3500 - CSV3 |
$100 |
$750 |
||
|
Moda Health Affinity Silver 4500 - CSV3 |
$100 |
$750 |
||
|
Moda Health Affinity Silver 6400- CSV3 |
$100 |
$750 |
||
|
Moda Health Affinity Silver 3500 - CSV1 |
$2,500 |
$6,400 |
||
|
Moda Health Affinity Silver 4500 - CSV1 |
$2,500 |
$6,400 |
||
|
Moda Health Affinity Silver 6400- CSV1 |
$2,500 |
$6,400 |
||
|
Moda Health Affinity Silver 3400 Direct |
$3,400 |
$8,700 |
||
|
Moda Health Affinity Silver 3500 |
$3,500 |
$8,700 |
||
|
Moda Health Affinity Silver 3500 LV |
$3,500 |
$8,700 |
||
|
Moda Health Affinity Silver 3550 Direct |
$3,550 |
$9,000 |
||
|
Moda Health Affinity Silver 4400 Direct |
$4,400 |
$8,150 |
||
|
Moda Health Affinity Silver 4500 |
$4,500 |
$8,050 |
||
|
Moda Health Affinity Silver 4500 LV |
$4,500 |
$8,050 |
||
|
Moda Health Affinity Silver 6400 LV |
$6,400 |
$7,400 |
||
|
Moda Health Affinity Silver 6400 |
$6,400 |
$7,400 |
||
|
Moda Health Affinity Silver 3500 - CSV2 |
$750 |
$2,100 |
||
|
Moda Health Affinity Silver 4500 - CSV2 |
$750 |
$2,100 |
||
|
Moda Health Affinity Silver 6400- CSV2 |
$750 |
$2,100 |
||
|
Moda Health Affinity Bronze 7000 - CSV0 |
$0 |
$0 |
||
|
Moda Health Affinity Bronze 8700 - CSV0 |
$0 |
$0 |
||
|
Moda Health Affinity Bronze HSA 6900 - CSV0 |
$0 |
$0 |
||
|
Moda Health Affinity Bronze HSA 6900 |
$6,900 |
$6,900 |
||
|
Moda Health Affinity Bronze HSA 6900 LV |
$6,900 |
$6,900 |
||
|
Moda Health Affinity Bronze 7000 LV |
$7,000 |
$8,700 |
||
|
Moda Health Affinity Bronze 7000 |
$7,000 |
$8,700 |
||
|
Moda Health Affinity Bronze 8700 |
$8,700 |
$8,700 |
||
|
Moda Health Affinity Bronze 8700 LV |
$8,700 |
$8,700 |
||
|
Moda Health Oregon Standard Gold (Affinity) - CSV0 |
$0 |
$0 |
||
|
Moda Health Oregon Standard Gold (Affinity) |
$1,800 |
$7,300 |
||
|
Moda Health Oregon Standard Gold (Affinity) LV |
$1,800 |
$7,300 |
||
|
Moda Health Oregon Standard Silver (Affinity) - CSV0 |
$0 |
$0 |
||
|
Moda Health Oregon Standard Silver (Affinity) - CSV2 |
$1,300 |
$3,000 |
||
|
Moda Health Oregon Standard Silver (Affinity) - CSV3 |
$125 |
$1,000 |
||
|
Moda Health Oregon Standard Silver (Affinity) - CSV1 |
$4,800 |
$7,250 |
||
|
Moda Health Oregon Standard Silver (Affinity) |
$4,800 |
$9,100 |
||
|
Moda Health Oregon Standard Silver (Affinity) LV |
$4,800 |
$9,100 |
||
|
Moda Health Oregon Standard Bronze (Affinity) - CSV0 |
$0 |
$0 |
||
|
Moda Health Oregon Standard Bronze (Affinity) LV |
$8,800 |
$8,800 |
||
|
Moda Health Oregon Standard Bronze (Affinity) |
$8,800 |
$8,800 |
2023 Oregon Beacon individual and family medical and dental brochure
|
Plan name |
Deductible |
Out-of-pocket max |
Summary of benefits |
Summary of benefits and coverage |
|---|---|---|---|---|
|
Moda Health Beacon Gold 1000 - CSV0 |
$0 |
$0 |
||
|
Moda Health Beacon Gold 1500 - CSV0 |
$0 |
$0 |
||
|
Moda Health Beacon Gold 250 - CSV0 |
$0 |
$0 |
||
|
Moda Health Beacon Gold 1000 |
$1,000 |
$8,700 |
||
|
Moda Health Beacon Gold 1000 LV |
$1,000 |
$8,700 |
||
|
Moda Health Beacon Gold 1500 |
$1,500 |
$7,000 |
||
|
Moda Health Beacon Gold 1500 LV |
$1,500 |
$7,000 |
||
|
Moda Health Beacon Gold 250 |
$250 |
$8,700 |
||
|
Moda Health Beacon Gold 250 LV |
$250 |
$8,700 |
||
|
Moda Health Beacon Silver 3000 - CSV0 |
$0 |
$0 |
||
|
Moda Health Beacon Silver 3500 - CSV0 |
$0 |
$0 |
||
|
Moda Health Beacon Silver 4500 - CSV0 |
$0 |
$0 |
||
|
Moda Health Beacon Silver 6400 - CSV0 |
$0 |
$0 |
||
|
Moda Health Beacon Silver 3000 - CSV3 |
$100 |
$750 |
||
|
Moda Health Beacon Silver 3500 - CSV3 |
$100 |
$750 |
||
|
Moda Health Beacon Silver 4500 - CSV3 |
$100 |
$750 |
||
|
Moda Health Beacon Silver 6400- CSV3 |
$100 |
$750 |
||
|
Moda Health Beacon Silver 3000 - CSV1 |
$2,500 |
$6,400 |
||
|
Moda Health Beacon Silver 3500 - CSV1 |
$2,500 |
$6,400 |
||
|
Moda Health Beacon Silver 4500 - CSV1 |
$2,500 |
$6,400 |
||
|
Moda Health Beacon Silver 6400- CSV1 |
$2,500 |
$6,400 |
||
|
Moda Health Beacon Silver 2900 Direct |
$2,900 |
$8,700 |
||
|
Moda Health Beacon Silver 3000 |
$3,000 |
$8,700 |
||
|
Moda Health Beacon Silver 3000 LV |
$3,000 |
$8,700 |
||
|
Moda Health Beacon Silver 3400 Direct |
$3,400 |
$8,700 |
||
|
Moda Health Beacon Silver 3500 LV |
$3,500 |
$8,700 |
||
|
Moda Health Beacon Silver 3500 |
$3,500 |
$8,700 |
||
|
Moda Health Beacon Silver 3550 Direct |
$3,550 |
$9,000 |
||
|
Moda Health Beacon Silver 4400 Direct |
$4,400 |
$8,150 |
||
|
Moda Health Beacon Silver 4500 |
$4,500 |
$8,050 |
||
|
Moda Health Beacon Silver 4500 LV |
$4,500 |
$8,050 |
||
|
Moda Health Beacon Silver 6400 |
$6,400 |
$7,400 |
||
|
Moda Health Beacon Silver 6400 LV |
$6,400 |
$7,400 |
||
|
Moda Health Beacon Silver 3000 - CSV2 |
$750 |
$2,100 |
||
|
Moda Health Beacon Silver 3500 - CSV2 |
$750 |
$2,100 |
||
|
Moda Health Beacon Silver 4500 - CSV2 |
$750 |
$2,100 |
||
|
Moda Health Beacon Silver 6400- CSV2 |
$750 |
$2,100 |
||
|
Moda Health Beacon Bronze 7000 - CSV0 |
$0 |
$0 |
||
|
Moda Health Beacon Bronze 8700 - CSV0 |
$0 |
$0 |
||
|
Moda Health Beacon Bronze HSA 6900 - CSV0 |
$0 |
$0 |
||
|
Moda Health Beacon Bronze HSA 6900 |
$6,900 |
$6,900 |
||
|
Moda Health Beacon Bronze HSA 6900 LV |
$6,900 |
$6,900 |
||
|
Moda Health Beacon Bronze 7000 LV |
$7,000 |
$8,700 |
||
|
Moda Health Beacon Bronze 7000 |
$7,000 |
$8,700 |
||
|
Moda Health Beacon Bronze 8700 |
$8,700 |
$8,700 |
||
|
Moda Health Beacon Bronze 8700 LV |
$8,700 |
$8,700 |
||
|
Moda Health Oregon Standard Gold (Beacon) - CSV0 |
$0 |
$0 |
||
|
Moda Health Oregon Standard Gold (Beacon) |
$1,800 |
$7,300 |
||
|
Moda Health Oregon Standard Gold (Beacon) LV |
$1,800 |
$7,300 |
||
|
Moda Health Oregon Standard Silver (Beacon) - CSV0 |
$0 |
$0 |
||
|
Moda Health Oregon Standard Silver (Beacon) - CSV2 |
$1,300 |
$3,000 |
||
|
Moda Health Oregon Standard Silver (Beacon) - CSV3 |
$125 |
$1,000 |
||
|
Moda Health Oregon Standard Silver (Beacon) |
$4,800 |
$9,100 |
||
|
Moda Health Oregon Standard Silver (Beacon) LV |
$4,800 |
$9,100 |
||
|
Moda Health Oregon Standard Silver (Beacon) - CSV1 |
$4,800 |
$7,500 |
||
|
Moda Health Oregon Standard Bronze (Beacon) - CSV0 |
$0 |
$0 |
||
|
Moda Health Oregon Standard Bronze (Beacon) |
$8,800 |
$8,800 |
||
|
Moda Health Oregon Standard Bronze (Beacon) LV |
$8,800 |
$8,800 |
Texas
2023 Texas individual and family medical brochure
Medical plans
|
Plan name |
Deductible |
Out-of-pocket max |
Summary of benefits |
Summary of benefits and coverage |
|---|---|---|---|---|
|
Moda Select Gold 1000 ($0 Virtual Care $2 Rx Value Tier) - CSV0 |
$0 |
$0 |
||
|
Moda Select Gold 1800 ($0 Virtual Care $2 Rx Value Tier) - CSV0 |
$0 |
$0 |
||
|
Moda Select Gold 1000 ($0 Virtual Care $2 Rx Value Tier) |
$1,000 |
$8,000 |
||
|
Moda Select Gold 1000 ($0 Virtual Care $2 Rx Value Tier) LV |
$1,000 |
$8,000 |
||
|
Moda Select Gold 1800 ($0 Virtual Care $2 Rx Value Tier) LV |
$1,800 |
$7,000 |
||
|
Moda Select Gold 1800 ($0 Virtual Care $2 Rx Value Tier) |
$1,800 |
$7,000 |
||
|
Moda Select Silver 3500 ($0 Virtual Care $2 Rx Value Tier) - CSV0 |
$0 |
$0 |
||
|
Moda Select Silver 4800 ($0 Virtual Care $2 Rx Value Tier) - CSV0 |
$0 |
$0 |
||
|
Moda Select Silver 6400 ($0 Virtual Care $2 Rx Value Tier) - CSV0 |
$0 |
$0 |
||
|
Moda Select Silver 3500 ($0 Virtual Care $2 Rx Value Tier) - CSV3 |
$100 |
$750 |
||
|
Moda Select Silver 4800 ($0 Virtual Care $2 Rx Value Tier) - CSV3 |
$100 |
$750 |
||
|
Moda Select Silver 6400 ($0 Virtual Care $2 Rx Value Tier) - CSV3 |
$100 |
$750 |
||
|
Moda Select Silver 3500 ($0 Virtual Care $2 Rx Value Tier) - CSV1 |
$2,500 |
$6,350 |
||
|
Moda Select Silver 4800 ($0 Virtual Care $2 Rx Value Tier) - CSV1 |
$2,500 |
$6,350 |
||
|
Moda Select Silver 6400 ($0 Virtual Care $2 Rx Value Tier) - CSV1 |
$2,500 |
$6,350 |
||
|
Moda Select Silver 3500 ($0 Virtual Care $2 Rx Value Tier) |
$3,500 |
$8,700 |
||
|
Moda Select Silver 3500 ($0 Virtual Care $2 Rx Value Tier) LV |
$3,500 |
$8,700 |
||
|
Moda Select Silver 4800 ($0 Virtual Care $2 Rx Value Tier) |
$4,800 |
$7,850 |
||
|
Moda Select Silver 4800 ($0 Virtual Care $2 Rx Value Tier) LV |
$4,800 |
$7,850 |
||
|
Moda Select Silver 6400 ($0 Virtual Care $2 Rx Value Tier) LV |
$6,400 |
$7,400 |
||
|
Moda Select Silver 6400 ($0 Virtual Care $2 Rx Value Tier) |
$6,400 |
$7,400 |
||
|
Moda Select Silver 3500 ($0 Virtual Care $2 Rx Value Tier) - CSV2 |
$750 |
$2,000 |
||
|
Moda Select Silver 4800 ($0 Virtual Care $2 Rx Value Tier) - CSV2 |
$750 |
$2,000 |
||
|
Moda Select Silver 6400 ($0 Virtual Care $2 Rx Value Tier) - CSV2 |
$750 |
$2,000 |
||
|
Moda Select Bronze 6900 - CSV0 |
$0 |
$0 |
||
|
Moda Select Bronze 8700 ($0 Virtual Care $2 Rx Value Tier) - CSV0 |
$0 |
$0 |
||
|
Moda Select Bronze HSA 6900 |
$6,900 |
$6,900 |
||
|
Moda Select Bronze 6900 LV |
$6,900 |
$6,900 |
||
|
Moda Select Bronze 8700 ($0 Virtual Care $2 Rx Value Tier) LV |
$8,700 |
$8,700 |
||
|
Moda Select Bronze 8700 ($0 Virtual Care $2 Rx Value Tier) |
$8,700 |
$8,700 |
||
|
Moda Select Texas Standard Gold - CSV0 |
$0 |
$0 |
||
|
Moda Select Texas Standard Gold |
$2,000 |
$8,700 |
||
|
Moda Select Texas Standard Gold LV |
$2,000 |
$8,700 |
||
|
Moda Select Texas Standard Silver - CSV0 |
$0 |
$0 |
||
|
Moda Select Texas Standard Silver - CSV3 |
$0 |
$1,700 |
||
|
Moda Select Texas Standard Silver - CSV1 |
$5,700 |
$7,200 |
||
|
Moda Select Texas Standard Silver LV |
$5,800 |
$8,900 |
||
|
Moda Select Texas Standard Silver |
$5,800 |
$8,900 |
||
|
Moda Select Texas Standard Silver - CSV2 |
$800 |
$3,000 |
||
|
Moda Select Texas Standard Bronze - CSV0 |
$0 |
$0 |
||
|
Moda Select Texas Standard Bronze LV |
$9,100 |
$9,100 |
||
|
Moda Select Texas Standard Bronze |
$9,100 |
$9,100 |