Dependents are a lawful spouse or registered domestic partner and eligible children up to age 26.
If your enrolled child(ren) resides outside the service area, we will extend benefits as if care were rendered by a participating provider. Out-of-area children may receive the in-network benefit level by using the Travel Network. If a Travel Network provider is not available, the services will be paid at the in-network benefit level if provided within a 30-mile radius of the child's residence or at the closest appropriate facility. Fees charged by out-of-area providers will be reimbursed at the maximum plan allowance for those services.
12-month exclusion period applies to:
Note: Your plan's exclusion period will be shortened one day for each day you had "creditable coverage" under another health plan, provided you do not have a 63-day lapse (or longer) in coverage immediately prior to your effective date in our plan.
For costs and further details of the coverage, including exclusions, any reductions or limitations and the terms under which the policy may be continued in force, see your producer or write to Moda Health.
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For value-based provider programs, including Synergy, Summit, Beacon, Affinity, CPC+, and EOCCO
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If you are creating an account for an adult member of your family, that member must have given you permission to set up an account in his/her behalf. If permission has not been provided, you may be violating the privacy of that individual's information.
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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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