From 2015 to 2016 there are only a few changes to Moda plans. They updated their Silver and Bronze plans. While they have truly solid plan designs, the pricing is the most expensive in 2016 compared with other carriers (Group Health Cooperative has a true PPO with the SAME First Choice Health Network that Moda takes, yet it is 20% to 25% cheaper…so switching makes sense in most situations). Below is a highlight of the main features of plans, click on the links to see the full detailed plans.
Changes to Moda Plans
The best plan on the market is the Moda Gold $650 plan is not changing at all and Silver $1,550 (was $1,250 in 2015) has small changes (increasing doctor visits). The new Silver $3,500 and Bronze $5,400 are not competitive (Premera has better plan layouts). Moda has the largest price increase at 16.1%.
Moda uses the First Choice Health Network in the northwest and outside the northwest area.
Quick Overview of Plans
MODA Gold $650: This plan is not changing at all (woo hoo). Doctor visits are a flat $15/visit. The Prescription Drug coverage is 50% up front before the deductible (if you take more expensive Prescriptions choose the GHC Gold or Premera Gold/Silver). Chiropractic visits (10 max) and Acupuncture visits (12 max) are $15/visit before the deductible. Physical Therapy/Massage (25 visits) are covered BEFORE the deductible (best plan if this coverage is important to you). The max out of pocket in the network is $4,000. Overall it’s the lowest deductible plan on the market for 2016 and strong coverage network.
MODA Silve $1,550: This plan has a few minor changes. Doctor visits are a flat $30 per primary and $40 per specialist. The Prescription Drug coverage is 50% up front before the deductible (if you take more expensive Prescriptions choose the GHC Gold or Premera Gold/Silver). Chiropractic visits (10 max) and Acupuncture visits (12 max) are $30/visit before the deductible. Physical Therapy/Massage (25 visits) are covered BEFORE the deductible (best plan if this coverage is important to you). The max out of pocket in the network is $6,850. Overall it’s a good on the market for 2016 and strong coverage network.
MODA Silve $3,500: This is new plan for 2016 (technically it’s replacing a bad plan, but not much better). I don’t see much value in this plan for the price, so choose the Premera Silver $3,000 instead. Doctor visits are 30% of the visit cost. The Prescription Drug coverage is 50% up front before the deductible (if you take more expensive Prescriptions choose the GHC Gold or Premera Gold/Silver). Chiropractic visits (10 max) and Acupuncture visits (12 max) where you pay 30% of the visit cost before the deductible. Physical Therapy/Massage (25 visits) are covered BEFORE the deductible (best plan if this coverage is important to you). The max out of pocket in the network is $6,850. Overall it’s a mediocre plan with a strong coverage network.
MODA Bronze $5,400: This is new plan for 2016 (technically it’s replacing a bad plan, but not much better). I don’t see much value in this plan for the price, so choose the Premera Bronze $6,350 instead. Doctor visits are $80/visit for primary and $100/visit for specialist . The Prescription Drug coverage is 50% AFTER the deductible. Chiropractic visits (10 max) and Acupuncture visits (12 max) where you pay 80/visit cost before the deductible (which is usually more expensive than the actual cash price). Physical Therapy/Massage (25 visits) are covered after the deductible. The max out of pocket in the network is $6,850. Overall it’s a mediocre plan with a strong coverage network, (the Premera $6,850 is a better plan and lower cost).
MODA Bronze $3,250 HSA: Health Savings Accounts are a very unique type of coverage that ONLY cover medical expenses AFTER the $3,250 deductible (annual preventative exam is still no cost). The max out of pocket is $6,550. This is not a competitive plan for 2016 (buy the Premera Silver or Bronze).
Health Savings Accounts are good for those that intend on having a significant amount of medical expenses for the year since you get a tax deduction for putting money in to a HSA checking account. You can deposit up to a max of $3,350 single or $6,750 family amount. This is tax deductible and the money can be used tax free for qualifying medical expenses (for anyone in the immediate family, even if they are not on the HSA plan). This is truly one of the only ways you can use money without the government taxing it.
Below are my areas of expertise:
- Health Insurance (Every company in Washington State)
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- Tax Sheltered Accounts (Following IRS guidelines)
Gary Franke, MBA
Independent Broker
Achieve Alpha Insurance, LLC
12507 Bel-Red Rd, Ste 103
Bellevue, WA 98005
(425) 802-2783
gary@achieve-alpha.com
www.achieve-alpha.com