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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
|Available in: all counties in Oregon
|Advantage PPO Rx
|Available in: all counties in Oregon
|Available in: Baker, Gilliam, Grant, Harney, Lake, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, Wheeler counties
- 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.
Important details and dates
- 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 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 must continue to pay your Medicare Part B premium.
- 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.
- A Health plan with a Medicare contract.
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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