Member rights

Understand your rights as a Moda Health Medicare member.

Prior authorization

You have the right to timely access to covered services and drugs. Some require prior authorization (pre-approval) from us to cover a provider visit or prescription drug. Prior authorization is also referred to as organization determination or coverage determination.

Get prior authorization details

Requesting an appeal and filing a complaint

Find out what you need to do to request an appeal or file a complaint. Learn how to appoint a representative.

Learn about appeals and grievances

 

SMS terms and conditions

These terms and conditions apply to anyone who agrees to receive informational text messages from or on behalf of Moda Health.

SMS terms and conditions