Moda Pathways Oregon Silver 5000
Moda Health Plan, Inc. · 2027 plan year
Silver
- Ind. deductible
- $5,000
- Family deductible
- $10,000
- Ind. OOP max
- $10,000
- Family OOP max
- $20,000
Compare with other Silver plans in OR
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Moda Health Plan, Inc. plans in OR
Monthly premiums by age
Rating Area 1
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $337 | $337 |
| 21 | $531 | $610 |
| 30 | $603 | $693 |
| 40 | $679 | $780 |
| 50 | $949 | $1,091 |
| 60 | $1,442 | $1,658 |
| 64 and over | $1,593 | $1,830 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $15.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $70.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 20.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 20.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 20.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $70.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $20.00 |
| Non-Preferred Brand Drugs | 50.00% Coinsurance after deductible |
| Preferred Brand Drugs | 40.00% |
| Specialty Drugs | 45.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 20.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $15.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | No charge |
| Accidental Dental | 20.00% Coinsurance after deductible |
| Acupuncture | $15.00 |
| Allergy Testing | 20.00% Coinsurance after deductible |
| Chemotherapy | 20.00% Coinsurance after deductible |
| Chiropractic Care | $15.00 |
| Cosmetic Surgery | 20.00% Coinsurance after deductible |
| Delivery and All Inpatient Services for Maternity Care | 20.00% Coinsurance after deductible |
| Diabetes Education | 20.00% Coinsurance after deductible |
| Dialysis | 20.00% Coinsurance after deductible |
| Durable Medical Equipment | 20.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 20.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Habilitation Services | $70.00 |
| Hearing Aids | 20.00% |
| Home Health Care Services | 20.00% Coinsurance after deductible |
| Hospice Services | 20.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | 20.00% Coinsurance after deductible |
| Infusion Therapy | 20.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | 20.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | 20.00% Coinsurance after deductible |
| Nutritional Counseling | 20.00% Coinsurance after deductible |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $15.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 20.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | $70.00 |
| Prenatal and Postnatal Care | 20.00% Coinsurance after deductible |
| Prosthetic Devices | 20.00% Coinsurance after deductible |
| Radiation | 20.00% Coinsurance after deductible |
| Reconstructive Surgery | 20.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $70.00 |
| Rehabilitative Speech Therapy | $70.00 |
| Routine Eye Exam (Adult) | $15.00 |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | 20.00% Coinsurance after deductible |
| Skilled Nursing Facility | 20.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 20.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $15.00 |
| Telehealth - Primary Care | $10.00 |
| Telehealth - Specialist | $10.00 |
| Transplant | 20.00% Coinsurance after deductible |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | 20.00% Coinsurance after deductible |
Service area
This plan covers 3 geographic areas.
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