Moda Health MedAdvantage Plans Calling 1.800.884.2343 will direct you to a licensed insurance agent

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Moda Advantage PPO Plan Information
Moda Health  Advantage PPO Plan Information
Helpful Information
Moda Customer Support

Existing Customers

503-265-4762
Toll-free - 877-299-9062
TTY - 711
7 a.m. to 8 p.m., seven days a week.

2015 Moda Medicare Advantage Plans

Moda Health Advantage PPO (PPO MA)
Moda Health Advantage PPO Rx
(PPO MAPD)
Moda Health Advantage HMO (HMO MAPD)

Moda Health Plan List
Plan Name Plan Type Plan Details Application Premium
Advantage PPO PPO MA Benefit Summary Download app $10
Available in: all counties in Oregon
Advantage PPO Rx PPO MAPD Benefit Summary Download app $70
Available in: all counties in Oregon
Advantage HMO HMO MAPD Benefit Summary Download app $33.80
Available in: Baker, Gilliam, Grant, Harney, Lake, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, Wheeler counties

Medicare Disclaimers

  • If you need help, please call 1-800-884-2343 Mon - Fri, 9am - 4pm PT for Customer Service Representatives and licensed insurance agents who can assist with finding information on available Medicare Advantage.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year.
  • You must be enrolled in both Medicare Part A and Medicare Part B and live in the plan's service area to be eligible for these plans.
  • You must continue to pay your Medicare Part B premium in addition to any plan premium shown below.
  • Estimated annual savings is determined by subtracting a plan's annual cost estimate of the medications entered from the medications' average retail prices. The annual cost estimate for a plan includes covered annual monthly premiums and any annual cost sharing expenses that you must pay out-of-pocket for the medications entered. This number can only be calculated if the consumer enters medication information.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.

Important details and dates

  • You are first eligible during the 7–month Initial Coverage Enrollment Period (ICEP), the 3 months before your 65th birthday, the month of, and 3 months after. CAUTION: You only have one choice so take your time, ask for help and choose wisely.
  • You are also eligible during the Annual Election Period (AEP) which is from Oct.15 to Dec.7. You can change as many times as you want. The last change received by CMS prevails.
  • You have an opportunity to disenroll from your plan and return to Original Medicare and purchase a Part D Prescription Drug Plan during the new Annual Disenrollment Period from Jan 1 to Feb 14.
  • You may be eligible for a Special Enrollment Period (SEP) if you reside in a nursing home, join a Special Needs Plan (SNP), move outside the plan's service area, the plan leaves your area, or other special situations.
  • This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consultwww.medicare.gov.
  • For plans with Part D Coverage: You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your Medicaid Office.
  • A Medicare Advantage Plan Health plan sold by an insurance company with a Medicare contract.

Coverage Area
The service area for these plans includes Baker, Benton, Clackamas, Clatsop, Columbia, Coos, Crook, Curry, Deschutes, Douglas, Gilliam, Grant, Harney, HoodRiver, Jackson, Jefferson, Josephine, Klamath, Lake, Lane, Lincoln, Linn, Malheur, Marion, Morrow, Multnomah, Polk, Sherman, Tillamook, Umatilla, Union, Wallowa, Wasco, Washington, Wheeler and Yamhill Counties in Oregon. You must live in one of these areas to join a plan.

Moda Health, Inc. offers three medical plan options: Moda Health Advantage PPORx, Moda Health Advantage PPO & Moda Health Advantage HMO. Under all of these plans, your medical coverage is through Moda Health, Inc.

Moda Health Advantage PPO plans provide medical services through Medicare–certified healthcare facilities and other healthcare professionals who are in compliance with Medicare credentialing standards. Moda Health Advantage PPO plans are not Medicare supplement policies, sometimes known as “Medigap” insurance policies. Once you have enrolled in an Moda Health Advantage PPO plan, you are getting your Medicare medical benefits through Moda Health, Inc. The Medicare program pays us to manage health services for people with Medicare who are members of an Moda Health Advantage PPO plan.

As a member of an Moda Health Advantage PPO plan, you may get your health services from doctors, hospitals and other healthcare providers in the Moda Health Advantage network or from any Medicare provider.

  • These Moda Health Advantage plans offer exceptional benefits and flexibility:
  • Access to more than 6,000 statewide Moda Health Advantage contracted providers or any Medicare provider
  • Continue to seek care with your existing Medicare providers
  • Access to Medicare providers without a referral or prior authorization
  • No medical deductible
  • Fixed co–payments or co-insurance for most services
  • Annual out–of–pocket maximum protection
  • Travel throughout the United States for up to 12 months – and keep your coverage
  • Moda Health Advantage PPO plans are available to residents throughout the state of Oregon.
  • Moda Health Advantage HMO plan is available to residents in Baker, Gilliam, Grant, Harney, Lake, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, Wheeler counties.

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