Questions & answers · Vision insurance
What events does Moda Health Plan, Inc.'s filed vision insurance policy say it pays for?
AI-drafted from filed documents · reviewed: pendingwhether a specific event is coveredModa Health Plan, Inc.
Moda Health Plan, Inc.'s filed vision insurance policy in Idaho (ID) states that benefits may be paid for services or supplies you actually receive [1]. Payment may be made to you, to the provider, or to both [1]. The date of service is the date you receive the service or supply, and payment will only be made if the service or supply is actually received [1]. Providers typically bill Moda Health directly when you show your ID card, and Moda Health will pay the provider and send a copy of the payment record to you; the provider will then bill you for any charges that were not covered [1]. This does not appear in these excerpts — check the full policy.
Information only — not legal advice. The insurer decides.
These answers quote forms insurers filed with state regulators. Your own policy, its endorsements and your state’s rules control. A filed form may not be the version sold to you.
Where this comes from (1)
[1] Moda Health Plan, Inc. · ID · SERFF ODSV-133624163 · form ModaIDVisbk 1-1-2023 - a · p. 25 · 74.5 · SUBMISSION & PAYMENT OF CLAIMS
This may affect how your cost sharing is applied to claims. d. We may pay benefits to you, to the provider or to both of you The date of service is the date you receive the service or supply. You must actually receive the service or supply before we will pay the claim. Usually, you can show your Moda Health ID card to the provider, and they will bill us for you. We will pay the provider and send a copy of our payment record to you. The provider will then bill you for any charges that were not covered. … (excerpt — the filed text continues)
Drafted by a local AI model from the excerpts above, then checked by rules (citations, no rankings, no “not covered” claims from a partial excerpt). Question id Qc043b4de. Spotted an error? Tell us.