Moda is a point of service health insurance plan that combines elements of an HMO and PPO based on a managed care model.
Enrollees in a POS plan are required to choose a primary care physician from within the health care network; this PCP becomes their "point of service". The PCP may make referrals outside the network, but with lesser compensation offered by the patient's health insurance company. For medical visits within the health care network, paperwork is usually completed for the patient. If the patient chooses to go outside the network, it is the patient's responsibility to fill out forms, send bills in for payment, and keep an accurate account of health care receipts.
Visit these Moda websites for more information:
Member Handbook (includes prescription drugs)