Moda Be Aligned (Oregon)

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Company Moda Health Plan
Plan Year 2014
State Oregon
Metal Tier Silver
Plan Type PPO
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Cost Sharing Benefits (In Network)

These details are for the standard Silver plan. For reduced Cost Sharing versions scroll down below

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductible (Individual) $2,500
Deductible (Family) $5,000
Coinsurance 35%
Out of Pocket Maximum (Individual) $6,000
Out of Pocket Maximum (Family) $12,000

Doctors Visits

Primary Care Visit First five visits 30 copay each, then 0.35
Specialist Visit 35% coinsurance
In Patient Hospital Services 35% coinsurance
Emergency Room Services 35% coinsurance

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 35% coinsurance
Laboratory Outpatient and Professional Services 35% coinsurance
X-ray and Diagnostic Imaging 35% coinsurance


Mental / Behavioral Health 35% coinsurance
Rehabilitative Speech Therapy 35% coinsurance
Rehabilitative Occupational & Physical Therapy 35% coinsurance
Outpatient Facility 35% coinsurance
Outpatient Surgery 35% coinsurance

Prescription Drugs

Generic Rx $10 copay
Preferred Brand Rx 50% coinsurance
Non Preferred Brand Rx 50% coinsurance
Specialty Drugs 0.5

Other Plans

Other plans that are available in the state.

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