Additional Cost Tier
Medical science has developed many new ways to treat disease and injury. But with these advances, there can be overuse of some of these specialty procedures.
It is important to understand and consider all factors - including additional costs - as you discuss treatment options with your provider.
You will want to have a say in this decision based on your unique situation and values. The information provided in this website will help you become aware of what your choices are so that you can talk to your healthcare provider about these procedures, and understand realistic expectations about their outcomes.
Evidence suggests that, depending on your condition or injury, alternative treatments such as anti-inflammatory medication, weight loss, and modified physical activity, can work just as well as surgery.
Procedures
The Additional Cost Tier is designed to encourage exploration of less invasive treatment alternatives.
Additional Cost Tier refers to select procedures including the following:
- Arthroscopy
- Bariatric surgery
- *Hip replacement
- *Knee replacement
- Upper endoscopy
- Spine surgery for pain
*Subject to Reference Price Program for statewide (Connexus Network) plans. Click here to learn more.
Questions?
We're here to help. Just email OEBBquestions@modahealth.com or call the Moda 360 Health Navigator team:
Medical/Vision
866-923-0409
Pharmacy
866-923-0411
Dental:
866-923-0410
TTY users, please call 711.
You can also chat with a Moda 360 Health Navigator by logging in to your Member Dashboard.
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