Medicare Supplement Plans

We offer Medicare Supplement Plans A, G, High-deductible G and N. Below is a breakdown of the basic benefits covered by all plans and additional benefits that are plan-specific. For more detailed information about these plans and rates, see our Medicare Supplement brochure. 

If you have questions about our plans or would like to request a free Moda Health Medicare Supplement enrollment packet, please call us toll-free at 855-718-1767 or send us an email.

Once you are ready to enroll, you have two options to apply:

1. Fill out the online version of our application. Upon your digital signature, the application will be sent to us directly. You may want to save a copy for your records.
   
   
2. Download and complete our paper application, and send to us at

• Mail
  Moda Health Plan, Inc.
  Attn: Medicare Membership Accounting
  P.O. Box 40384
  Portland, OR 97240-0384
• Fax: 503-224-1975
• Email: bemc@modahealth.com

Plan Options

Plan A

Basic benefits

• Your Medicare Part A coinsurance for hospital care, PLUS coverage for 365 additional days after Medicare benefits end
• The first three pints of blood each year
• Coverage for the Part B coinsurance amount (generally 20 percent of Medicare – approved expenses) after the annual deductible is met

Plan G or Plan High-deductible G

Basic benefits

• Same as Plan A
• Additional benefits
• Foreign travel emergency care – after a $250 calendar year deductible, pays 80 percent of eligible expenses for a lifetime maximum of $50,000
• Part A deductible
• Skilled nursing facility – coinsurance for Medicare-approved stays of 100 days or less
• Part B excess physician charges – pays 100 percent of the difference between what Medicare pays and the maximum amount the doctor or provider can charge Medicare patients for covered services
• $2,870 deductible option available with High Deductible Plan G

Plan N

Basic benefits

• Same as Plan A
• Additional benefits
• Foreign travel emergency care – after a $250 calendar year deductible, pays 80 percent of eligible expenses for a lifetime maximum of $50,000
• Part A deductible
• Skilled nursing facility – coinsurance for Medicare-approved stays of 100 days or less
• The lesser of $20 or the Part B coinsurance for office visits and the lesser of $50 or the Part B coinsurance for emergency room visits after the Part B deductible is met 
  
  

Value-added services and discounts

These additional services are a complement to the Medicare Supplement plan but are not insurance. They may not be available in all areas and may be discontinued at any time.

• Access to discounts on hearing aid exam and hearing aids though TruHearing Program
• 24/7 Nurse line
• Quick advice from clinical professionals on non-critical medical issues
• Travel Assist
• Need help more than 100 miles from home? Call Assist America® for emergency medical assistance including:
  • Medical consultations
  • Foreign hospital admission help
  • Prescription assistance
    
    
• Health and wellness services from ChooseHealthy™
  • Discounts of up to 50% on popular health and fitness brands, including Garmin®, Vitamix®, and PRO Compression®.
  • Savings of up to 25% on services including acupuncture, chiropractic, physical therapy, therapeutic massage, occupational therapy, nutrition and podiatry. You will need to see providers who are in the ChooseHealthy network.
  • Access to no-cost online health classes.

Extra features

It is important to us to provide you with the best health plans possible, matched by the best customer service possible. That's why we've added extra features for added convenience:

• Electronic claims filing. At no extra cost, Medicare Part B claims will be forwarded directly to Moda Health after Medicare pays its share. You will know that a bill was submitted directly to Moda Health because it will have the following statement printed on the bottom: THIS CLAIM HAS BEEN FORWARDED TO YOUR SECONDARY MEDICARE PAYOR. Moda Health will send you an Explanation of Benefits (EOB) indicating the amount paid or payment to you if you are being reimbursed.
• No claim forms. If you have a claim, just mail a copy of the Explanation of Medicare Benefits (EOMB) form you receive from Medicare to us. We'll do the rest.
• Benefit and information updates. Your Moda Health Medicare Supplement policy will automatically coordinate with changes in Medicare each year. We'll keep you informed about any changes that take place.
• Guaranteed renewable. We will never cancel your policy because of your age or claims experience.
• 30-day free look. If you're not completely satisfied with your Moda Health Medicare Supplement policy, return it to us within 30 days and receive a full refund of any premiums paid.

Frequently asked questions

Am I eligible?

You can apply for coverage if you live in Idaho, are 65 or older as of the date your policy is effective and are enrolled in Medicare Part A and B. 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.

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.

Is there a waiting or an exclusion 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.

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.

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 1-800-MEDICARE (1-800-633-4227).

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 , G, High-deductible G 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.

Questions?

If you can't find an answer, please feel free to contact our Customer Service