Moda Select Idaho Bronze 9200 + Vision Exam

Moda Health Plan, Inc. · 2026 plan year

Expanded BronzeHSA eligible
Ind. deductible
$9,200
Family deductible
$9,200
Ind. OOP max
$9,500
Family OOP max
$9,500

Compare with other Expanded Bronze plans in ID

Side by side: deductibles, out-of-pocket limits and copays.

More Moda Health Plan, Inc. plans in ID

Monthly premiums by age

Rating Area 3 — the lowest-priced of the 6 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$200$200
21$261$300
30$297$341
40$334$384
50$467$537
60$709$816
64 and over$784$901

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$50.00

Specialist

BenefitIn-network
Specialist Visit$100.00

Hospital

BenefitIn-network
Emergency Room Services25.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)25.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services25.00% Coinsurance after deductible
Urgent Care Centers or Facilities$100.00

Pharmacy

BenefitIn-network
Generic Drugs$25.00
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Preferred Brand Drugs40.00%
Specialty Drugs40.00%

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services25.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$50.00

Other

BenefitIn-network
Accidental Dental25.00% Coinsurance after deductible
Allergy Testing25.00% Coinsurance after deductible
Chemotherapy25.00% Coinsurance after deductible
Chiropractic Care$100.00
Delivery and All Inpatient Services for Maternity Care25.00% Coinsurance after deductible
Diabetes Education25.00% Coinsurance after deductible
Dialysis25.00% Coinsurance after deductible
Durable Medical Equipment25.00% Coinsurance after deductible
Emergency Transportation/Ambulance25.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Gender Affirming Care25.00% Coinsurance after deductible
Habilitation Services25.00% Coinsurance after deductible
Hearing Aids25.00% Coinsurance after deductible
Home Health Care Services25.00% Coinsurance after deductible
Hospice Services25.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)25.00% Coinsurance after deductible
Infusion Therapy25.00% Coinsurance after deductible
Inpatient Physician and Surgical Services25.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services25.00% Coinsurance after deductible
Nutritional Counseling25.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)$50.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)25.00% Coinsurance after deductible
Outpatient Rehabilitation Services25.00% Coinsurance after deductible
Prenatal and Postnatal Care25.00% Coinsurance after deductible
Prosthetic Devices25.00% Coinsurance after deductible
Radiation25.00% Coinsurance after deductible
Reconstructive Surgery25.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy25.00% Coinsurance after deductible
Rehabilitative Speech Therapy25.00% Coinsurance after deductible
Routine Eye Exam (Adult)$10.00
Routine Eye Exam for ChildrenNo charge
Routine Foot Care25.00% Coinsurance after deductible
Skilled Nursing Facility25.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services25.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$50.00
Transplant25.00% Coinsurance after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging25.00% Coinsurance after deductible

Service area

This plan covers 33 geographic areas.

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