Individual and family medical plans
Better plans for the real you
You have a lot to think about when choosing the right medical benefits for you and your family. Our exclusive provider organization (EPO) plans connect you with your primary care provider (PCP), who works closely with the rest of your care team (other providers, specialists, etc.) to help you achieve better health and wellness.
Moda Select Network
Our Individual medical plans give you access to providers in the Moda Select Network. This network includes a group of licensed medical professionals, clinics, pharmacies, labs and hospitals. These providers offer quality care and services to our Individual members who live within the Hays, Travis, and Williamson service area.
EPO Plans
Our network of healthcare providers offers you the right combination of value and service. No referrals are needed for in-network specialist care. Please note that there is no out-of-network coverage, except for services listed in the medical plan policies.
In network providers and health systems
Serving Hays, Travis and Williamson counties in the greater Austin area, the network is made of a carefully selected community of PCPs, specialists and partner health systems, including:
- Austin Diagnostic Clinic
- Austin Regional Clinic
- Capital Area Primary Care Providers
- Capital Area Providers
- Capital Area Surgeons
- St. David's HealthCare
- St David’s Ortho Neuro and Rehab
- St David’s Specialized Women’s Services
Pharmacy benefits
In-network pharmacies
The pharmacy network includes access to over 95% of pharmacies in Texas, plus more than 65,000 pharmacies nationwide. This means you can fill prescriptions almost anywhere, including these local and national drug store chains.
Locate a pharmacy in the Navitus network >
Mail-order services If you have a chronic health condition, our mail-order services via Costco and PPS may be for you.
Covered prescription drugs
And you can review our Texas specific formulary (list of covered prescription drugs) to see if any current prescriptions are covered in our plans.
Ready to see individual plans?
You can review plan details, including copays and deductibles, in benefit summaries.
Shop individual and family plansImpacted 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.