Health Plans

Moda Health formerly ODS Health Plans

Moda Health Plans in Oregon

We love our new health plans - and we hope you will, too. After all, they were created with you in mind. They are meant to help you get well sooner and live well longer.

Which plans are only available for purchase through the health insurance marketplace?

Providence Preferred Network Rose City plans are only available through the Federal marketplace. Those plans include Be Focused - Rose City, Be Aligned - Rose City and Be Connected - Rose City.

myModa

Need information about your plan? Your personalized member website, myModa, helps you understand and get the most from your benefits.

  • View your benefits, eligibility and history.
  • See prescription history, pharmacy benefits and estimate prices on your medications.
  • See account details, such as contact information and enrolled dependents.
  • See and download ID cards.
  • Check the status of a claim, see your claim history and access claim forms.
  • Review electronic explanations of benefits (EOBs).
  • Pay your premium online with eBill - see invoices, set up payment (credit card, debit, checking or savings) and set a recurring payment using AutoPay.

eDoc

Knowledge is power. By understanding your health conditions, you can make better decisions for yourself. eDoc lets you email a specialized health professional at any time to get the answers you need.

eDoc gives you access to:

  • Board-certified physicians
  • Licensed psychologists
  • Pharmacists
  • Dentists
  • Dietitians
  • Fitness experts
  • eDocVoice - leave a message for a provider, and you’ll get a phone response within 24 hours

10 Essential Benefits

Healthcare reform says all health plans must include ten essential benefits. The basic benefits include:

  1. Outpatient Care - the kind you get without being admitted to a hospital
  2. Emergency Services - for issues that could lead to death or disable you if you do not treat them.
  3. Inpatient Care - covers room and board, tests, drugs, and care from doctors and nurses while admitted, which may include organ and tissue transplants, and hospice and respite care.
  4. Maternity and Newborn Care - care before and after your baby is born
  5. Mental Health and Substance Use Disorder Services - this includes behavioral health treatment, counseling, and psychotherapy.
  6. Prescription Drugs - covers retail, mail order, and specialty drugs.
  7. Rehabilitative and Habilitative Services - services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
  8. Laboratory Services - covers lab tests, X-ray services, and pathology, and imaging and diagnostics such as MRI, CT scan, and PET scan.
  9. Preventive and Wellness Services - including mammograms, colonoscopies, vaccines. Covered in full if you use in-network providers for care such as routine physicals, screening, and immunizations. Disease management coordinates care for diabetes, asthma, and other conditions.
  10. Pediatric Services - including dental care (preventive, basic, major) and vision care (eye exam, lenses, and eyewear).