Click here to be connected to Moda Health directly, where you can learn more about the medical, prescription and dental plan options, as well as how to contact their team for support and additional resources.
Prescriptions
| To determine under which classification your medications fall, visit: | ||
|---|---|---|
| Preferred Drug List | https://www.modahealth.com/pdfs/Prescription-drug-list-large-group.pdf | |
Filling your prescriptions
Present your Moda Health card at in-network pharmacies. To receive the highest level of benefits be sure to utilize Salem Health Pharmacies.
When you fill your prescription through Salem Health Pharmacies, you may request up to a 90-day supply, saving you money over a 30-day supply that would be filled at an in-network pharmacy.
Mail order prescriptions
You also have the choice to have a prescription delivered directly to your home through Postal Prescription Services (PPS) or Costco mail order pharmacy. The amount (30 to 90 days) varies by type of prescription.
Comparing prescription costs
To determine and compare prescription costs between different pharmacies, visit the Prescription Price Check tool on the Pharmacy tab after you have logged into modahealth.com/memberdashboard.
Prescription Benefits
Prime Plan - HDP
| High Deductible Plan Deductible must be met before coverage for prescription benefits can begin. Preventive and ‘value’ medications are not subject to the deductible under our HDP. |
|||||
|---|---|---|---|---|---|
| Tier I | Tier II | Tier III | |||
| Salem Health, PPS or Costco mail order, and Ardon specialty pharmacies |
ArrayRx Core Netwrok | Out-of-network | |||
| 'Value’ tier † | $2 co-pay, Up to a 30-day supply $6 co-pay, Up to a 90-day supply |
$2 co-pay, Up to a 30-day supply | $2 co-pay, Up to a 30-day supply | ||
| Generic | 25% $5 minimum, $25 maximum Up to a 90-day supply |
35% $15 minimum, $25 maximum Up to a 30-day supply |
50% $15 minimum Up to a 30-day supply | ||
| Preferred brand | 30% $5 minimum, $75 maximum Up to a 90-day supply |
40% $15 minimum and no maximum Up to a 30-day supply |
50% $15 minimum Up to a 30-day supply | ||
| Non-preferred | 50% $5 minimum and no maximum Up to a 90-day supply |
50% $15 minimum and no maximum Up to a 30-day supply |
50% $15 minimum and no maximum | ||
| Preferred Specialty ‡ | 30% $150 maximum Up to a 30-day supply |
Not covered | Not covered | ||
| Select Specialty | 25% $5 minimum $25 maximum Up to a 30-day supply |
Not covered | Not covered | ||
Prescription Benefits
Choice Plan - MHP
| Medical Home Plan | |||||
|---|---|---|---|---|---|
| Tier I | Tier II | Tier III | |||
| Salem Health, PPS, Costco mail order pharmacy, and Ardon specialty pharmacies |
ArrayRx Core Network | Out-of-network | |||
| 'Value’ tier † | $2 co-pay, Up to a 30-day supply $6 co-pay, Up to a 90-day supply |
$2 co-pay, Up to a 30-day supply | $2 co-pay, Up to a 30-day supply | ||
| Generic | 25% $5 minimum, $25 maximum Up to a 90-day supply |
35% $15 minimum, $25 maximum Up to a 30-day supply |
50% $15 minimum Up to a 30-day supply | ||
| Preferred brand | 30% $5 minimum, $75 maximum Up to a 90-day supply |
40% |
50% $15 minimum Up to a 30-day supply | ||
| Non-preferred | 50% $5 minimum and no maximum Up to a 90-day supply |
50% $15 minimum and no maximum Up to a 30-day supply |
50% $15 minimum and no maximum | ||
| Preferred Specialty ‡ | 30% $150 maximum Up to a 30-day supply |
Not covered | Not covered | ||
| Select Specialty | 25% $5 minimum, $25 maximum Up to a 30-day supply |
Not covered | Not covered | ||
Video: Prescription Drug Benefits
