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Moda Health HMO medical provider network

The Moda Health Medicare Advantage provider network is a network of doctors, specialists and hospitals – however certain services require a referral from your Primary Care Provider (PCP). You must also choose a PCP upon enrollment into this plan to provide and oversee your medical care. The provider network can change at any time. You will receive notice when necessary.

To find a Moda Health Medicare Advantage PCP or other network provider, you can search our online directory, Find Care. When searching Find Care for network providers, be sure to select the Medicare Advantage network.

If you would like to request a printed version of our provider directories, you can do so by sending an email to MedicalMedicare@modahealth.com and we will send you a hard copy. Or, if you prefer to download a printable version yourself, click on the provider directory links below. Due to the size of our network, the printable directories are separated into four books based on Oregon geographical regions:

You may also contact member services at 1-877-299-9062 (TTY users call 711) seven days a week from 7 a.m. to 8 p.m. Pacific Time, with any questions regarding our Medicare Advantage network or help finding a network provider.

Prior authorization and referrals

Prior authorization is approval in advance to get services. A referral is when your PCP refers you to a specific provider for certain types of specialty care. Some medical services are covered only if your provider gets prior authorization from our plan or refers you to a specialist. Covered services that need prior authorization or that require a PCP referral are listed in the Benefits Chart of your Evidence of Coverage.

Your provider can call Moda Health Healthcare Services at 1-800-592-8283 or fax a prior authorization request form to 1-855-637-2666. Moda Health Healthcare Services hours of operation are from 7 a.m. to 4:30 p.m. Pacific time, Monday through Friday. (TTY users call 711.)

Last updated October 1, 2017
Y0115_WEB_2018A Approved

We're sorry, we don't currently offer Medicare plans in . View our plans in or use the dropdown at the top of the page to view Medicare plans in Oregon.

Moda Health HMO (HMO-POS) medical provider network

The Moda Health Medicare Advantage provider network is a network of doctors, specialists and hospitals – however certain services require a referral from your Primary Care Provider (PCP). You must also choose a PCP upon enrollment into this plan to provide and oversee your medical care. The provider network can change at any time. You will receive notice when necessary.

To find a Moda Health Medicare Advantage PCP or other network provider, you can search our online directory, Find Care. When searching Find Care for network providers, be sure to select the Medicare Advantage network.

If you would like to request a printed version of our provider directories, you can do so by sending an email to MedicalMedicare@modahealth.com and we will send you a hard copy. Or, if you prefer to download a printable version yourself, click on the provider directory links below. Due to the size of our network, the printable directories are separated into four books based on Oregon geographical regions:

You may also contact member services at 1-877-299-9062 (TTY users call 711) seven days a week from 7 a.m. to 8 p.m. Pacific Time, with any questions regarding our Medicare Advantage network or help finding a network provider.

Prior authorization and referrals

Prior authorization is approval in advance to get services. A referral is when your PCP refers you to a specific provider for certain types of specialty care. Some medical services are covered only if your provider gets prior authorization from our plan or refers you to a specialist. Covered services that need prior authorization or that require a PCP referral are listed in the Benefits Chart of your Evidence of Coverage.

Your provider can call Moda Health Healthcare Services at 1-800-592-8283 or fax a prior authorization request form to 1-855-637-2666. Moda Health Healthcare Services hours of operation are from 7 a.m. to 4:30 p.m. Pacific time, Monday through Friday. (TTY users call 711.)

Last updated October 1, 2016
Y0115_WEB_2017A Approved

We're sorry, we don't currently offer Medicare plans in . View our plans in or use the dropdown at the top of the page to view Medicare plans in Oregon.

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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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