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. 

View network quick-guide PDF

Tier 1

Tier I

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: 

  • ZoomCare
  • PeaceHealth facilities
  • Peacehealth and employed professional providers
  • The Clinically Integrated Network community providers
  • PeaceHealth Joint Ventures*
  • Slocum professional providers (the surgery center is Tier II)
  • Willamette Valley Cancer Institute: Oncology Associates of Oregon
  • Seattle Children’s Hospital (for Zoomers residing in NW Washington)

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 2

Tier II

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:

  • Moda Health Connexus network for residents of Oregon and Washington (Cowlitz and Clark counties)
    • Moda Health Connexus network Directory Link
    • Although the following provider groups will display as in-network in the Moda Health Connexus network provider directory,they will be in Tier III (out-of-network) in 2025 and are covered at a different benefit level for the PPO and ABHP plans; there is NO coverage for them on the EPO (unless true emergency):
      • Legacy Salmon Creek Medical Center (providers remain in Tier II)
      • McKenzie Surgery Center
      • McKenzie-Willamette Medical Center
      • Option Care at Legacy Health (home infusion)

         

  • Aetna® PPO Network through Aetna Signature Administrators® for residents outside Oregon and SW Washington (Cowlitz and Clark counties). It’s also the travel network for caregivers residing in Oregon and SW Washington (Cowlitz and Clark counties) when traveling outside of their network service area. Please note that travel benefits are available for emergency care ONLY.
Tier 3

Tier III

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.

  • PPO and ABHP plans may cover a small amount of provider fees

  • EPO plan provides no coverage, unless it’s a medical emergency

 

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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.

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