Medical Frequently Asked Questions

All Member FAQs

How do I know what plan I have?

Look on the top of your Moda Health ID Card to see if you are on the Plus or Standard Plan. This information can also be found on the coverage letter than comes with your DHS Medical Care ID card.

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Can I choose a PCP or specialist online?

Yes, you can select a PCP online. To find a physician in your area, go to our provider directory. When you have selected a PCP , contact Customer Service, register online or print, complete and fax a PCP Change form to our customer service department. A new ID card will be sent to you within 5-10 working days. You can change PCPs up to two times every six months.

You can find specialists online as well through the provider directory. If you need to see a specialist or provider other than you PCP , you must see your PCP first. Your PCP will decide whether you should see another provider and complete a referral with Moda Health is necessary.

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What if I cannot keep my doctor appointment?

Contact your provider as soon as you can and let them know you cannot keep your appointment. The office will reschedule your appointment and make the time available for someone else. If you miss too many appointments, your PCP may dismiss you as a patient.

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Do I have to call Customer Service to update my account or can I do it through the web site?

You can request an ID Card and change your PCP by contacting Customer Service or filling out the online form. If you change your phone number or move, you must contact your OHP caseworker right away.

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I have other insurance coverage, will Moda Health coordinate benefits?

Yes. It is important that you notify us of your other group coverage. Please contact Customer Service for more information.

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A family member has a question, but doesn't speak English very well. Can you help?

Yes. Simply have your family member contact Customer Service. One of our representatives will coordinate the services of an interpreter over the telephone.

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What do I do if I become pregnant?

If you become pregnant contact your DHS caseworker right away. Your DHS caseworker will make sure you do not lose medical coverage. If you are pregnant, or think you might be, it is important that you see a healthcare provider right away. Regular check-ups are important to have a healthy baby.

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How do I sign up my new baby on the plan?

Call your DHS caseworker as soon as your baby is born. Your caseworker will enroll your baby in the Oregon Health Plan.

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What if I need urgent or emergency room care?

If you have an emergency call 911 or go to the emergency room. Please call your PCP or our customer service department within 72 hours of receiving emergency care. If you have an urgent medical problem, call your PCP 's office. You can call them anytime day or night. Your PCP 's office will give you advice or refer you for care.

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What do I do if I move?

Contact your DHS caseworker if you move or change your phone number so you will continue to receive information from DHS. Your DHS caseworkerís phone number is listed on the coverage letter that comes with your DHS Medical Care ID card. You should also give your providers your new address or phone number.

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How do I order an ID card?

To order a new ID card contact Customer Service or fill out our online form.

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What if the answers to my questions are not here?

If you can't find answers to your questions here, we offer other options on our web site where you might find the information you're looking for. Look at your Member Handbook, which outlines your plan's details. Or read some of the other Frequently Asked Questions. You can always contact Customer Service for answers to your questions.

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Hello.

We have exciting news to share. ODS is changing its name to Moda Health.

Moda comes from the latin term "modus" and means "a way". We picked it because that's what we are here to do: help our communities find a way to better health.

Together, we can be more, be better.

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