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OPM.gov / Insurance / Guide Me
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Guide Me

Federal Employees

Overview

Choose a program to begin:

Health

As a Federal employee, you may be able to enroll in health, dental, vision and life insurance, flexible spending accounts, and apply for long term care insurance. You can find information about each program by clicking on one of the links below. Each section includes common questions to help guide you to the information you need. Learn More

Dental

Eligible employees and annuitants can choose among 7 nationwide and 5 regional dental plans. Nationwide plans also offer international coverage. Learn More

Vision

Eligible employees and annuitants can choose among 5 nationwide vision plans. Nationwide plans also offer international coverage. Learn More

Life

We offer the largest group life insurance program in the world, covering employees, retirees and family members. Learn More

Flexible Spending Accounts

Eligible employees can choose to enroll in up to three different flexible spending accounts during Open Season. Learn More

Long Term Care

Most Federal and U.S. Postal Service employees and annuitants, active and retired members of the uniformed services, and their qualified relatives are eligible to apply for insurance coverage under the FLTCIP. Learn More

Health

I don’t agree with the way the plan paid my claim. What can I do?

If you disagree with the plan’s decision on your claim, the Federal Employees Health Benefits (FEHB) Program provides for an appeal process.

  1. Check your plans FEHB brochure to see if the service is covered, limited, or excluded.
  2. Review and follow the directions in the disputed claims section of the brochure. This section will tell you how to ask the plan to reconsider your claim. You must explain why (in terms of the applicable brochure coverage provisions) you feel the services should be covered.

If the plan again denies the claim, read the plans decision letter carefully. Then, check your plans brochure again. If you still disagree with the plans decision, the disputed claims section of the brochure will tell you how to write to the U.S. Office of Personnel Management to ask us to review the claim.

Related Questions

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