Benefits

• Can I enroll in a FEDVIP dental or vision plan and keep the dental or vision coverage I have under my spouse's non-Federal plan? View more
  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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• What specific benefits are offered by FEDVIP? View more
  Each FEDVIP dental plan offers comprehensive dental coverage, but each plan's specific benefits, exclusions, provider networks, and premiums are different.  Similarly, each FEDVIP vision plan offers comprehensive vision coverage, but each plan's specific benefits, exclusions, provider networks, and premiums are different.  
  
  To compare plans, review the dental and vision brochures on OPM's website.
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• Does FEHB pay any dental and/or vision services when you are covered under FEDVIP? View more
  It depends.  FEHB plans vary greatly in the amount and type of dental and/or vision services they cover.  The FEHB plan is the first payor of benefits.  FEDVIP is the secondary payor to any FEHB benefits.  Review your FEHB plan’s brochure to find out what dental and vision coverage it offers.
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• Under which category do dental implants fall? View more
  Dental implants fall under the “Class C Major” section, subsection Prosthodontics.
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• When I go to a dentist or optometrist, should I give them both my health plan card and my FEDVIP plan card? View more
  Yes.  Your FEHB plan is considered your primary insurance, even if they have little or no benefits.  Not all FEDVIP plans issue ID cards, but you should let your provider know what coverage you have. 
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• I have a FEDVIP vision plan now. Does it cover laser eye surgery? View more
  Most vision plans cover laser eye surgery with a discount.  Review the plan brochures to learn if a discount is available.  You can download each plan’s brochure at www.opm.gov/healthcare-insurance/dental-vision/plan-information/.
  
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• Does FEDVIP cover new enrollees in the plan for bridges and implants? View more
  Yes, FEDVIP cover new enrollees in the plan for bridges and implants.  There is no waiting period for these services. However, because plans vary in their requirements for coverage we suggest that you have your dentist submit a predetermination of benefits prior to beginning the work. This way, both you and your dentist have an estimate of what the plan may pay and what your out-of-pocket expense may be before the charge is incurred.
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• If you have dental coverage under FEHB, is FEHB primary payor and FEDVIP secondary payor? View more
  Yes, FEHB is the primary payor if you have both FEDVIP and FEHB.
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• I am currently enrolled in a FEDVIP dental plan (mainly for the orthodontic coverage). My dependent has come to the end of this phase of treatment and we have used the maximum allowance under the current plan. I am thinking about switching coverage and understand that I would have a waiting period to use the orthodontics coverage under the new plan. I am being told through my orthodontist provider that since I have used my maximum allowance under one plan, that even if I switch plans and wait the waiting period, the insurance provider would not have to pay out since I used a maximum under a different plan. Is this true? Should I change plans? View more
  If you switch plans you will have to satisfy the new plan’s waiting period for orthodontic care.  Also, the new plan may not continue the work that was in progress prior to enrolling.  Contact the new plan and inquire before deciding whether or not to switch.  You may also review the “Things We Do Not Cover” sectionof the new plan’s brochure, available atwww.opm.gov/healthcare-insurance/dental-vision/plan-information/.
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• I currently have FEHB coverage, and both dental and vision coverage under FEDVIP. My 22 year old daughter is my dependent for life (she is totally disabled). Currently my FEHB and FEDVIP plans are aware of her disability status; thus, she and I are currently covered by all 3. If I change my plans, do I have to prove her disability again? Also, will she incur a break in coverage? View more
  There will be no break in coverage if you change your plan during Open Season. However, if you change to another plan, you may be asked to resubmit the documentation that your daughter is certified as incapable of self-support.
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