Moda Be Aligned OR

Plan Information
Company Moda Health Plan
State OR
Metal Tier Silver
Plan Type PPO

Cost Sharing Benefits

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.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $2,500 $5,000
Deductible (Family) $5,000 $10,000
Coinsurance 35% 50%
Out of Pocket Maximum (Individual) $6,000 $12,000
Out of Pocket Maximum (Family) $12,000 $24,000
Services In Network Out of Network
Primary Care Visit First five visits 30 copay each, then 0.35 50% coinsurance
Specialist Visit 35% coinsurance 50% coinsurance
In Patient Hospital Services 35% coinsurance 50% coinsurance
Emergency Room Services 35% coinsurance 35% coinsurance
Mental / Behavioral Health 35% coinsurance 50% coinsurance
Imaging (CT/PET Scans, MRIs) 35% coinsurance 50% coinsurance
Rehabilitative Speech Therapy 35% coinsurance 50% coinsurance
Rehabilitative Occupational & Physical Therapy 35% coinsurance 50% coinsurance
Preventative Care $0 50% coinsurance
Laboratory Outpatient and Professional Services 35% coinsurance 50% coinsurance
X-ray and Diagnostic Imaging 35% coinsurance 50% coinsurance
Prescription Drugs In Network Out of Network
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.

Plan Name
Be Bold
Be Connected
Be Connected Rose City
Be Savvy
Standard Bronze
Be Prepared
Be Smart
Be Aligned
Be Aligned Rose City
Standard Silver
Be Protected
Be Focused
Be Focused Rose City
Standard Gold
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This tool is for research purposes only. The numbers shown are estimates based on the information you have provided and our best efforts to provide accurate data. We try to keep the information up to date however we cannot make warranties about the accuracy of our information. We advise that users confirm any research with the respective health insurance companies and health exchanges.