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PEBB Networks FAQs

What medical provider networks will be used for PEBB members?

Active PEBB employees and their dependents in Oregon, Idaho, Southern Washington and Northern California will use the statewide Synergy Network. Out-of-area dependents (such as college students) who reside outside the state of Oregon will use the following networks as their primary network:

Alaska - First Health

Idaho - First Health and Synergy networks

All other states - Aetna PPO® through the Aetna Signature Administrators®

With our medical plans, you have access to our travel network which allows you to receive urgent and/or emergent care outside of your primary service area while traveling. You need to seek care from an Aetna PPO® through Aetna Signature Administrators® provider to receive in-network benefits. The Moda Health travel network is not an alternative primary network. You must seek in-network services whenever possible, and preauthorization is required for in-patient services. You can locate Aetna PPO® through Aetna Signature Administrators® providers through FindCare, our online provider directory.

What dental provider networks will I use as a PEBB member?

Active employees, retirees and your dependents enrolled in PEBB Dental Premier® plans will use the Delta Dental Premier® Network. Active employees, retirees and your dependents enrolled in PEBB's Delta Dental PPOSM plan will use the Delta Dental PPOSM Network. Both the Delta Dental Premier® and Delta Dental PPOSM networks include access to the Delta Dental Provider Network nationwide. If enrolled in the Delta Dental PPOSM plan and you see a Delta Dental Premier® provider who does not participate in the PPO Provider Network you will receive the out-of-network benefit level.

How can I find out if my medical provider is in- or out-of-network?

You have access to the Synergy Network. Out-of-area dependents may have a different network depending on where they reside (see question 1. above). You can find providers in your network by using our online Find Care tool and entering your PEBB ID number. If you are not yet active on a Moda Health medical plan, you can search by network by selecting the appropriate network from the "Networks" drop-down box.

If a specific clinic is not listed on the Moda Health website, how can I find out if my provider is part of my medical network with Moda Health?

The best way to search is by the provider's last name or ZIP code because providers with multiple practice specialties may not be listed under all their specialties. You can search for the provider by name, specialty, ZIP code or city where the provider is located.

You should be sure to select the appropriate network (Synergy.) Moda 360 Health Navigators are also available to help you locate in-network providers and can help verify if a provider is in-network for a plan.

If a provider is added to the network after I receive services, will Moda Health reprocess the claim to pay the in-network level?

No. The provider will be paid the in-network rate only after being added to the network.

What pharmacy network will I use as a PEBB member?

You use a network called the ArrayRx Core network. This network excludes CVS pharmacies.

You can find in-network pharmacies by choosing "ArrayRx Core network" from the Networks drop-down box in Find Care. You can also call your Moda 360 Health Navigator team at 844-776-1594.

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