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