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Use this comparison tool to compare the features of the 2025–26 medical, dental and vision plans available to you. You can choose which features you want to compare, or you can compare them all.
Step 1
- Choose the plan features you want to compare by checking or unchecking the box next to each feature.
- To view more details for each feature, click the "plus" sign.
Once you've chosen which features to show, click "Next Step" to view and compare the plans.
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Network
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Deductible per person
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Maximum deductible per family
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Out-of-pocket (OOP) maximum per person
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Out-of-pocket (OOP) maximum per family
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Routine adult, well-child and women’s exams; annual obesity screening & immunizations
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Primary care office visits
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Primary care office visits with a provider other than your chosen PCP 360 (Moda Plans only)
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Incentive care office visits (Moda Plans only)
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Virtual Care (Kaiser Plans) / CirrusMD telehealth (Moda Plans)
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Specialist office visits
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Urgent care
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Mental health office visits
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Mental health inpatient and residential services
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Chemical dependency services (outpatient or residential)
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Chemical dependency services (inpatient)
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Outpatient surgery/facility care
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Outpatient rehabilitation (physical, occupational & speech therapy)
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Labs, X-ray, and imaging
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CT, MRI, PET scans
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Acupuncture and Chiropractic7
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Naturopathic office visits
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Routine maternity care
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Physician or midwife services & hospital stay, delivery & routine newborn nursery care
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Inpatient care/surgery
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Skilled nursing facility care
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Moda Plans Only: $100 Additional Cost Tier (ACT)3: specified imaging (MRI, CT, PET), spinal injections, tonsillectomies for members under age 18 with chronic tonsillitis or sleep apnea, viscosupplementation, upper endoscopies, sleep studies, lumbar discographies
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Moda Plans Only: $500 Additional Cost Tier (ACT)3: Spine surgery, knee & hip replacement, knee & shoulder arthroscopy, uncomplicated hernia repair
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Emergency room
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Ambulance
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Hearing aids: $4,000 maximum benefit every 48 months for adults, see handbook for state-mandated benefit for children
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Durable medical equipment (DME)
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Out-of-pocket (OOP) maximum
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Value
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Generic (Kaiser Plans) / Select generic (Moda Plans)
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Preferred brand
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Non-preferred brand4
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Value
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Generic (Kaiser Plans) / Select generic (Moda Plans)
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Preferred brand
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Non-preferred brand4
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Generic (Moda Plans only)
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Select generic (Kaiser Plans) / Preferred brand (Moda Plans)
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Non-preferred brand4
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Network
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Copay
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Benefit maximum
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Deductible
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Oral exams, X-rays, cleaning (prophylaxis), fluoride treatments, and space maintainers
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Routine fillings, inlays and stainless steel crowns
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Simple tooth extractions
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Surgical tooth extractions, including diagnosis and evaluation
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Diagnosis, evaluation, and treatment of gum disease including scaling and root planing
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Root canal and related therapy including diagnosis and evaluation
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Gold or porcelain crowns and onlays
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Implants
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Occlusal guards (night guards)
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Athletic mouth guards
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Nitrous Oxide
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Full and partial dentures, relines, rebases
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Bridge retainers and pontics
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Orthodontic treatment
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