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U.S. Office of Personnel Management

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Insurance FAQs Dental & Vision

Benefits

What do I need to do if a FEDVIP (Federal Employees Dental and Vision Insurance Program) plan does not pay a claim they should have paid? View more

Each FEDVIP plan brochure includes instructions on how to appeal a claim. Please review the “Claims Filing and Disputed Claims Processes” sections of your plan brochure, available atwww.opm.gov/healthcare-insurance/dental-vision/plan-information/.
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My dentist does not currently participate with the national dental insurance plan that I use. If I sign up for FEDVIP (Federal Employees Dental and Vision Insurance Program) and he does not want to participate, what happens? View more

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 cannot change plans or cancel your enrollment because of your provider's participation. You can review your plan’s brochure at www.opm.gov/healthcare-insurance/dental-vision/plan-information/#url=Dental-Overview.
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Will there be a waiting period before I can use the services? View more

For dental benefits, there is a waiting period for orthodontia services of up to 12 months, for all but one dental plan. Your eligible dependent must be enrolled in the same dental plan/option over the duration of the waiting period to receive orthodontia services. There are no waiting periods for any other dental services or any vision services.
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Can braces be covered for parents? View more

No. Parents are not eligible for coverage under FEDVIP.
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Can I get braces for myself? View more

Yes, most plans offer orthodontic services for children up to age 19 and adults.
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Do any of the FEDVIP ( dental ) plans cover braces? View more

Yes, all FEDVIP dental plans cover orthodontic services (braces). Most plans have a waiting period before you can receive this benefit.
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With FEDVIP (Federal Employees Dental and Vision Insurance Program), Do I have to go to a certain doctor or can I see anyone I choose? View more

Except for Humana Dental, which has a closed network, and Dominion Dental, which will assign a provider, you may go to any doctor. Keep in mind that you will pay less out-of-pocket when you use an in-network dentist.
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