Moda Health. Healthcare from your head to your toes. Delta Dental | Moda Health

Individual and family plan FAQs

Who is eligible to apply for Moda Health individual medical and dental plans?

You are eligible to enroll in a plan during the standard open enrollment period or throughout the year if you experience a qualifying event, such as losing health coverage or moving to a new service area. Eligible members include you, your legal spouse or registered partner and any children younger than age 26. Individuals who are eligible for Medicare are not eligible for a Moda Health individual medical plan, regardless of age.

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Do you offer a dental plan?

We offer two individual dental options. You can enroll in a dental plan at any time throughout the year. If you terminate this coverage, you will be required to wait two years before you may re-apply, except for a special enrollment qualifying event.

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What payment methods do you offer?

Payment can be made via monthly electronic deduction from your checking account, free of charge, or you can access our eBill online payment option. You may also request to receive a paper billing statement.

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There was an error on my bill or my bill processed incorrectly, will this be fixed?

Yes. If there was an error on your bill, or if your bill processed incorrectly, we will issue you a refund or credit within 14 days.

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Can my employer sponsor my individual coverage?

Moda Health individual plans cannot be employer sponsored plans. You will be responsible for directly paying Moda Health your monthly premium using a personal check. Moda Health does not accept employer checks for individual plans.

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When do your rates change?

Moda Health will renew the rates for these plans on a yearly basis, beginning on Jan. 1, 2014. Rates also change when the primary applicant moves into the next age category; new rates are effective the following month.

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Is there a waiting period for pre-existing conditions?

There are no longer waiting periods for pre-existing conditions. Applicants cannot be denied coverage based on their health status.

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Can I switch to a different plan at any time?

No, you will need to wait until the next open enrollment period unless you experience a qualifying event.

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Cover Oregon recently announced information about retroactive tax credits, am I eligible?

You might be. Cover Oregon announced Tuesday, June 10 that members may be eligible for retroactive tax credits if they meet certain criteria. You qualify if:

  • You enrolled in a qualified health plan outside of Cover Oregon, meaning, you enrolled directly with the carrier for a 2014 plan.
  • You attempted to enroll through Cover Oregon before April 1, 2014 but had technical issues when trying to enroll.
Next steps

If you meet the criteria listed above, you must contact Cover Oregon by June 27, 2014 to report your case. Cover Oregon can be reached at 855-268-3767.

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Who is eligible to apply for Moda Health individual medical and dental plans?

You are eligible to enroll in a plan during the standard open enrollment period or throughout the year if you experience a qualifying event, such as losing health coverage or moving to a new service area. Eligible members include you, your legal spouse or registered partner and any children younger than age 26. Individuals who are eligible for Medicare are not eligible for a Moda Health individual medical plan, regardless of age.

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Do you offer a dental plan?

We do not offer dental plans in the state of Washington.

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What payment methods do you accept?

Payment can be made via mail or monthly electronic deduction from your checking account. We also offer electronic billing (eBill) services that allow you to pay your monthly premium online via your myModa account.

Eligible members include you, your legal spouse or registered domestic partner and any children up to age 26. Individuals who are eligible for Medicare are not eligible for a Moda Health individual medical plan, regardless of age.

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There was an error on my bill or my bill processed incorrectly, will this be fixed?

Yes. If there was an error on your bill, or if your bill processed incorrectly, we will issue you a refund or credit within 14 days.

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Can my employer sponsor my individual coverage?

Moda Health individual plans cannot be employer-sponsored plans. In general, you will be responsible for paying your monthly premium directly to Moda Health using a personal check. However, Moda Health will accept business checks that are not part of pre-tax deductions.

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When do your rates change?

Moda Health will renew the rates for these plans on a yearly basis, beginning on Jan. 1, 2014. Rates also change when the primary applicant moves into the next age category; new rates are effective the following month.

Return to top

Is there a waiting period for pre-existing conditions?

There are no longer waiting periods for pre-existing conditions. Applicants cannot be denied coverage based on their health status.

Return to top

Can I switch to a different plan at any time?

No, you will need to wait until the next open enrollment period unless you experience a qualifying event.

Return to top

Who is eligible to apply for Moda Health individual medical and dental plans?

You are eligible to enroll in a plan during the standard open enrollment period or throughout the year if you experience a qualifying event, such as losing health coverage or moving to a new service area. Eligible members include you, your legal spouse or registered partner and any children younger than age 26. Individuals who are eligible for Medicare are not eligible for a Moda Health individual medical plan, regardless of age.

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Do you offer a dental plan?

We offer one individual dental option, the Delta Dental Premier plan. You can enroll in a dental plan at any time throughout the year. If you terminate this coverage, you will be required to wait two years before you may re-apply, except for a special enrollment qualifying event.

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What payment methods do you offer?

Payment can be made via monthly electronic deduction from your checking account, free of charge, or you can access our eBill online payment option. You may also request to receive a paper billing statement.

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There was an error on my bill or my bill processed incorrectly, will this be fixed?

Yes. If there was an error on your bill, or if your bill processed incorrectly, we will issue you a refund or credit within 14 days.

Return to top

Can my employer sponsor my individual coverage?

Moda Health individual plans cannot be employer sponsored plans. You will be responsible for directly paying Moda Health your monthly premium using a personal check. Moda Health does not accept employer checks for individual plans.

Return to top

When do your rates change?

Moda Health will renew the rates for these plans on a yearly basis, beginning on Jan. 1, 2014. Rates also change when the primary applicant moves into the next age category; new rates are effective the following month.

Return to top

Is there a waiting period for pre-existing conditions?

There are no longer waiting periods for pre-existing conditions. Applicants cannot be denied coverage based on their health status.

Return to top

Can I switch to a different plan at any time?

No, you will need to wait until the next open enrollment period unless you experience a qualifying event.

Return to top

Who is eligible to apply for Moda Health individual medical plans?

You are eligible to enroll in a plan during the standard open enrollment period or throughout the year if you experience a qualifying event, such as losing health coverage or moving to a new service area. Eligible members include you, your legal spouse or registered partner and any children younger than age 26. Individuals who are eligible for Medicare are not eligible for a Moda Health individual medical plan, regardless of age.

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Do you offer a dental plan?

No. We do not offer stand-alone dental products in California. However, some of our medical plans include embedded pediatric dental coverage.

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What payment methods do you offer?

Payment can be made via monthly electronic deduction from your checking account, free of charge, or you can access our eBill online payment option. You may also request to receive a paper billing statement.

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There was an error on my bill or my bill processed incorrectly, will this be fixed?

Yes. If there was an error on your bill, or if your bill processed incorrectly, we will issue you a refund or credit within 14 days.

Return to top

Can my employer sponsor my individual coverage?

Moda Health individual plans cannot be employer sponsored plans. You will be responsible for directly paying Moda Health your monthly premium using a personal check. Moda Health does not accept employer checks for individual plans.

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When do your rates change?

Rates will change when the family composition changes. The new rate will be effective the first day of the following month. Rates also will change when a member moves into the next age bracket, but not until the following renewal date. Moda Health will renew the rates for individual plans on a yearly basis, beginning in January. If the rates change with renewal, the new rates will be provided with 30 day's prior notice.

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Is there a waiting period for pre-existing conditions?

There are no longer waiting periods for pre-existing conditions. Applicants cannot be denied coverage based on their health status.

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Can I switch to a different plan at any time?

No, you will need to wait until the next open enrollment period unless you experience a qualifying event.

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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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