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Federal and U.S. Postal Service employees eligible for FEHB coverage (whether or not enrolled) and annuitants/survivor annuitants/compensationers (regardless of FEHB eligibility) are eligible to enroll.
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Unfortunately, parents are not eligible family members.
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No. Under the Federal Employees Dental and Vision Insurance Program (FEDVIP), there is no extension of coverage, temporary continuation of coverage (TCC), spouse equity coverage, or right to convert to an individual policy (conversion policy).
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For FEDVIP, eligible family members are your:
- spouse (Public Law 104-199, Defense of Marriage Act, states, " the word 'marriage' means only a legal union between one man and one woman as husband and wife, and the word 'spouse' refers only to a person of the opposite sex who is a husband or a wife."),
- unmarried dependent child(ren) under age 22 (including an adopted child, stepchild, foster child, and recognized natural child), and
- child(ren) age 22 or over who are incapable of self-support because of a mental or physical disability that existed before age 22.
Please note that family member eligibility under the Federal Employees Dental and Vision Insurance Program (FEDVIP) is NOT the same as for the Federal Employees Health Benefits (FEHB) Program. Changes in dependent eligibility under the Affordable Care Act (also known as health care reform) do NOT affect eligibility for children under FEDVIP.
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Yes, if you are an employee who is eligible for FEHB. You don't have to be enrolled. Annuitants, survivor annuitants and compensationers do not have to be eligible for FEHB to enroll in FEDVIP.
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The following people are not eligible to enroll in FEDVIP, regardless of FEHB eligibility or receipt of an annuity or portion of an annuity.
- deferred annuitants,
- former spouses of employees or annuitants,
- FEHB temporary continuation of coverage (TCC) enrollees,
- temporary employees who are:
- serving under an appointment limited to one year or less and have not completed at least one year of current continuous employment, excluding any break in service of 5 days or less; or
- expected to work less than 6 months in each year.
- intermittent employees (who do not have a prearranged regular tour of duty)
- seasonal or occasional employment for one calendar year that amounted to less than 6 months of work does not meet the one year of current continuous employment requirement.
- anyone receiving an insurable interest who is not an eligible family member
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No, they are not eligible.
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No. For your child age 26 or over to be covered under your FEHB Self and Family enrollment, he/she must be incapable of self-support because of a mental or physical disability that existed before the child reached age 26.
For your child age 22 or over to be covered under your FEDVIP Self and Family enrollment, he/she must be incapable of self-support because of a mental or physical disability that existed before the child reached age 22.
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If you are an annuitant when you die and your survivor(s) are receiving an annuity, then they may enroll or continue the existing enrollment.
If you are an employee when you die and your survivor(s) are eligible to receive a survivor annuity or a Basic Employee Death Benefit, in most cases they are eligible to continue your FEDVIP enrollment.
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Yes. Some of the dental and vision plans under FEDVIP may coordinate benefits with the benefits of your non-FEDVIP plan. Review Section 3 "How You Obtain Care" of your
dental plan brochure or
vision plan brochure for specific information on coordination of benefits.
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For an employee to be eligible for FEDVIP, you must be eligible for the Federal Employees Health Benefits Program (FEHB). You do not have to be enrolled in FEHB; you only need to be eligible for FEHB. You can read more about FEDVIP eligibility at
www.opm.gov/healthcare-insurance/dental-vision/eligibility/.If you have questions about your eligibility, please contact BENEFEDS at 1-877-888-3337 or go to
www.benefeds.com.
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Yes, all unmarried dependent children under age 22 are eligible to be covered under FEDVIP, including adopted children, stepchildren, and recognized foster children. There is no requirement that the child be a student.
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No. Orthodontia is only covered for eligible dependent children under 19 years old.
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Yes, if you name your husband as the “plus one” at time of enrollment. Any eligible family member can be named as your “plus one”. Once you select your “plus one”, that person cannot be changed outside of Open Season.
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If the plan pays out-of-network benefits, a portion of your dentist’s eligible services will still be covered. The amount covered will depend on the service and may vary among plans. Generally, you will pay less out-of-pocket when you use an in-network dentist.
Most plans pay out-of-network benefits. You can review your plan’s brochure at
www.opm.gov/healthcare-insurance/dental-vision/plan-information/#url=Dental-Overview.
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For dependent children, coverage ends at midnight on the eve of their 22nd birthday. Benefits are not available on the day of their 22nd birthday.
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Generally no, parents are not eligible for coverage under FEDVIP.
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No, the retirement must be from a Federal position.
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Under FEDVIP, unmarried dependent children are eligibleuntil age 22. There is an exception for orthodontic services, which are only covered until age 19.
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Not all plans and/or options cover out-of-network providers. For plans that do cover them, in most cases, the plan will pay a lesser benefit then if you had visited an in-network provider.
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