You’ll be assigned to a home network based on where you live (Oregon, Cowlitz and Clark Counties in Washington, Seattle, or remote). The providers in Tier I will be the same across all three plans, but the Tier II providers will vary based on where you live.
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.
Please note: We are still building the customized PeaceHealth network directory search capabilities. We will update the website once completed. In the meantime, you can use the documents linked below to search for Tier I physicians and clinicians. Thank you for your patience and understanding.
This network includes:
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 833-599-5891.
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. That’s because the plans will cover a lower percentage of the costs for care received from Tier II providers.
ZoomCare and PeaceHealth have 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:
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.
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Health plans in Oregon and Alaska provided by Moda Health Plan, Inc.
This site is meant to help you learn about plans and healthcare for you and your family. This site is subject to change in order to comply with state and federal law, including the Affordable Care Act (ACA) and related regulations, and connectivity with the federal Marketplace. If questions regarding benefits arise, the summary of benefits and coverage document is the master resource.