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

Frequently asked questions

  • Am I eligible?
  • When does coverage begin?
  • Is there a waiting period?
  • Can I see the doctors I want if I enroll in a Moda Health Medicare Supplement plan?
  • Are there prescription benefits available in my Moda Health Medicare Supplement plan?
  • Are there dental benefits available in my Moda Health Medicare Supplement plan?
  • What is the address for filing a claim?
  • Am I eligible?

    You can apply for coverage if you live in OregonAlaska, are 65 or older as of the date your policy is effective and are enrolled in Medicare Part B. This includes individuals who are under age 65 and are enrolled in Medicare because of disability. For more information regarding eligibility periods and conditions for enrollment, please download the Moda Health Medicare Supplement brochure and application for a complete description or contact us for qualifications review.

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    When does coverage begin?

    If you apply during an open enrollment period (within six months of becoming eligible for Part B), your coverage will start the first of the month following the date we receive your application. If you do not apply during an open enrollment period, we will notify you of the date coverage will begin after your application is approved.

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    Is there a waiting period?

    If you transfer directly to a Moda Health Medicare Supplement plan from a Medicare Advantage, a Medicare Supplement (Medigap) policy or other coverage, we will credit month for month the amount of time you were enrolled under one of those plans. If you were enrolled for six or more months, you will not have a six-month pre-existing waiting period.

    For our individual and family and dental plans, there are waiting periods on Class 2 and Class 3 services. These waiting periods may be waived with one year of coverage from a comparable plan with no more than a 90-day break in coverage12 continuous months of prior dental coverage with no more than a 90-day break in coverage from the end of the old policy to the expected effective date of the new policy. Please see the dental benefit descriptionsdental benefit descriptions for more details on benefits with waiting periods.

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    Can I see the doctors I want if I enroll in a Moda Health Medicare Supplement plan?

    As a member of a Moda Health Medicare Supplement plan, you are free to choose any licensed doctor or provider for your healthcare needs.

    Should you seek care from a doctor or provider who has not accepted Medicare assignment, you will be responsible for paying the difference between what Medicare pays and the maximum amount the doctor or provider can charge Medicare patients for covered services. However, using Medicare-assigned doctors and providers can reduce those out-of-pocket expenses.

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    Are there prescription benefits available in my Moda Health Medicare Supplement plan?

    Medicare Supplement plans do not offer benefits for prescription drugs. People who want to add prescription drug coverage to their plan will need to purchase a stand-alone Prescription Drug Plan (PDP). Moda Health does not offer a stand-alone PDP. For information on the stand-alone PDPs available in your area, please visit www.medicare.gov or call 800-Medicare (800-633-4227).

    For more information on Moda Health Medicare Advantage plans that include prescription drug coverage, click here

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    Are there dental benefits available in my Moda Health Medicare Supplement plan?

    Moda Health provides Medicare Supplement plan members the opportunity to enroll in one of our individual dental plans. Click here for more information about the dental plans we offer.

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    What is the address for filing a claim?

    Send claims to:
    Moda Health Plan, Inc.
    Attn: Medicare Supplement
    P.O. Box 40384
    Portland, OR 97240-0384

    Please include the following information:

    • Patient's name and ID number
    • Date of treatment
    • Diagnosis
    • An itemized description of services and charges

    If the treatment is for an accidental injury, include a statement with the date, time, place and circumstances of the accident when you send us the physician or professional provider's bill.

    For Plans F, high deductible F and N, if you received emergent or urgent care out of the country, submit the same information indicated above to the address listed along with the following additional information in order to receive reimbursement for the expense:

    • Copy of the medical record (translated is preferred, if available)
    • Proof of payment in the form of a credit card/bank statement or cancelled check if there is no assignment of benefits.

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Frequently asked 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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