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.

Jump to: Alaska, Idaho, Oregon, Texas

Alaska

2023 Alaska individual and family medical and dental brochure

Dental plans

Delta Dental of Alaska

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

Pioneer Network

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

Shop Alaska plans

Idaho

2023 Idaho individual and family medical brochure

Medical plans

Moda Select Network

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

Shop Idaho plans

Oregon

Dental plans

2023 Oregon individual and family dental brochure

Delta Dental of Oregon

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

Affinity Network

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

Beacon Network

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

Shop Oregon plans

Texas

2023 Texas individual and family medical brochure

Medical plans

Moda Select Network

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 8700 ($0 Virtual Care $2 Rx Value Tier) - 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 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

Shop Texas plans