Moda Health Oregon Standard Bronze Plan (Affinity) Plan Details for 2020- HealthPocket

Moda Health Oregon Standard Bronze Plan (Affinity)

$291.00/mo

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Zip Code97229
Applicant2/25/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameModa Health Oregon Standard Bronze Plan (Affinity)
Plan IDqhp-39424OR1610006
Plan Year2020
Insurance ProviderModa Health
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$7,900
Out-of-Pocket Maximum$7,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$45 Copay
Specialist Visit$90 Copay
Laboratory Outpatient and Professional Services0.00% Coinsurance after deductible
X-rays and Diagnostic Imaging0.00% Coinsurance after deductible
Deductible - Family$15800
Out-of-Pocket Maximum - Family$15800

Prescription drug coverage

Generic Drugs$15 Copay
Preferred Brand DrugsNo Charge after Deductible
Non-Preferred Brand DrugsNo Charge after Deductible
Specialty DrugsNo Charge after Deductible

Access to doctors and hospitals

Provider directory URLhttps://www.modahealth.com/shop/provider-search/medical/or/Affinity

Hospital services

Emergency Room ServicesNo Charge after Deductible
Inpatient Hospital Services (e.g., Hospital Stay)No Charge after Deductible
Inpatient Physician and Surgical ServicesNo Charge after Deductible

Maternity

Prenatal and Postnatal Care0.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient ServicesNot Applicable
Mental/Behavioral Health Inpatient Services0.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for ChildrenNot Applicable

Exclusions and Limitations

More Included BenefitsRehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
Abortion for Which Public Funding is Prohibited
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Cosmetic Surgery
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Routine Foot Care
Rehabilitative Speech Therapy
Diabetes Education
Prosthetic Devices
Infusion Therapy
Nutritional Counseling
Reconstructive Surgery
More Excluded BenefitsInfertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Chiropractic Care
Acupuncture
Weight Loss Programs
Dental Check-Up for Children
Treatment for Temporomandibular Joint Disorders
PremiumPlan NameDeductible
from $234
Bronze Care On Demand 8000 EPO OHSU Plus
$8,000.00Select
from $255
Bronze Care On Demand 8000 EPO RealValue
$8,000.00Select
from $256
Moda Health Oregon Standard Bronze Plan (Beacon)
$7,900.00Select
from $266
PacificSource Oregon Standard Bronze Plan NAV
$7,900.00Select
from $274
KP Oregon Standard Bronze Plan
$7,900.00Select
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  • Phone Number
    (503) 629-0237
  • Office Locations
    14223 Nw Spruceridge Ln
    Portland, OR 97229
14223 Nw Spruceridge Ln Portland OR, 97229

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).