Are You Covered by FEDVIP? Here’s What Federal Employees Need to Know About Dental and Vision Benefits

Socrates Koutsoutis
November 22, 2024

Key Takeaways

The Federal Employee Dental and Vision Insurance Program (FEDVIP) offers valuable supplemental coverage to federal employees and retirees, providing a range of affordable dental and vision plans.
FEDVIP is distinct from FEHB, so if you want comprehensive dental and vision care, it’s important to review your enrollment options carefully.

Why FEDVIP Matters

If you’re a federal employee or retiree, you’re likely aware that health benefits can be complex. Between the Federal Employees Health Benefits (FEHB) Program and Medicare, there’s a lot to manage. But what about dental and vision care? This is where the Federal Employee Dental and Vision Insurance Program, or FEDVIP, comes in. While FEHB may cover some medical services, it generally doesn’t provide comprehensive dental or vision benefits. That’s why many federal employees and retirees consider FEDVIP as a supplemental insurance option.

Here’s a breakdown of what FEDVIP offers and how you can ensure your dental and vision needs are covered.

What FEDVIP Covers

FEDVIP plans provide several coverage options, specifically focused on dental and vision services. These plans are available to active employees, retirees, and eligible family members. Coverage varies based on the plan selected, but generally includes:

Dental Benefits

FEDVIP’s dental plans cover a range of dental care services, including preventive, basic, and major services. This might mean routine cleanings and exams, X-rays, fillings, and even major treatments like root canals and crowns. For those needing orthodontic coverage, many plans include benefits that help with braces and other orthodontic care, though these may have waiting periods or specific eligibility requirements.

Vision Benefits

Vision plans through FEDVIP focus on eye exams, prescription glasses, contact lenses, and discounts on elective procedures like LASIK. Coverage varies by plan but generally includes an annual comprehensive eye exam, along with specific allowances for frames, lenses, or contacts each year. Some plans may also offer discounts on laser eye surgery, which is appealing to those looking for corrective options beyond traditional eyewear.

Who’s Eligible for FEDVIP?

One of the benefits of FEDVIP is its broad eligibility. Most federal employees, retirees, and their eligible family members can participate, and you’re allowed to join even if you aren’t enrolled in an FEHB plan. However, certain groups, such as temporary employees, may not be eligible, so it’s worth checking your specific eligibility before assuming you’re covered.

Additionally, unlike other types of federal benefits, enrollment in FEDVIP isn’t automatic. You need to sign up during the Federal Benefits Open Season, which usually runs from mid-November to mid-December each year. Retirees should be aware that, if you enroll while you’re an active employee, you can generally keep your coverage after retirement.

When Can You Enroll or Make Changes?

If you’re new to federal service or missed the last enrollment period, you’ll be able to join during the next Open Season, or if you experience a Qualifying Life Event (QLE), such as a marriage, birth, or retirement. Enrollment changes are typically limited to Open Season, so it’s essential to review your options before the enrollment window closes.

Choosing a FEDVIP Plan: What to Consider

Selecting a FEDVIP plan that fits your needs involves several factors, from costs to specific services covered. Here’s a closer look at what to think about:

Coverage Level

Different FEDVIP plans offer different coverage levels, so consider how much dental and vision care you need annually. Some plans may provide more comprehensive coverage, while others focus on preventive care. Think about the types of services you’ll need, especially if you or family members have specific dental or vision needs, like orthodontic treatment for children or regular eyeglass updates.

Network Providers

FEDVIP plans often include large provider networks, but each plan has different participating providers. Be sure to check that your preferred dentist or eye doctor is included in your chosen plan’s network. Going out of network can increase your out-of-pocket costs significantly, so it’s essential to choose a plan with network providers convenient to you.

Costs and Premiums

FEDVIP premiums vary based on the level of coverage and the specific plan selected. While higher-tier plans may cost more each month, they could also save you money over time if you need extensive dental or vision care. Keep in mind that FEDVIP premiums are paid on a pre-tax basis if you’re an active federal employee, which can help reduce your taxable income. However, retirees pay FEDVIP premiums post-tax, so this is an important difference to be aware of if you’re nearing retirement.

Understanding Coordination with FEHB and Medicare

For federal employees, it’s important to understand that FEDVIP is entirely separate from FEHB and Medicare. While FEHB plans may cover some minimal dental and vision services, FEDVIP is specifically designed to fill those gaps with comprehensive options. If you’re a retiree with Medicare, you should also know that Medicare generally does not cover routine dental and vision care, so FEDVIP can serve as a valuable addition.

Can FEDVIP Replace FEHB or Medicare?

In short, no. FEDVIP is not a substitute for comprehensive health insurance like FEHB or Medicare. It’s a supplemental benefit that provides targeted dental and vision care only. FEHB plans can cover major medical needs, and Medicare provides basic health coverage for those over 65 or with qualifying disabilities, but neither covers the specialized services that FEDVIP plans offer for teeth and eyes.

Combining FEDVIP with Medicare Advantage

If you’re a retiree using Medicare Advantage, you may find some dental and vision benefits included. However, these are typically limited in scope. By combining FEDVIP with Medicare Advantage, you can create a more comprehensive coverage package, especially if you want access to a wider network or need additional benefits not covered by your Medicare Advantage plan.

How FEDVIP Benefits Affect Retirees

When you retire from federal service, you may want to maintain your FEDVIP benefits. Fortunately, FEDVIP allows you to continue coverage after retirement if you were enrolled as an active employee. However, keep in mind that your premiums will no longer be pre-tax once you’re retired, which could slightly increase your costs.

Retirees also don’t need to meet a minimum number of years of service to retain FEDVIP, unlike other federal benefits, making it a flexible option for those who may have worked fewer years in federal service.

Making the Most of Your FEDVIP Plan

If you’re already enrolled in FEDVIP, making the most of your benefits requires planning ahead and understanding your plan’s specifics. Here are some tips to help you maximize your coverage:

Use Preventive Benefits: Most dental plans cover preventive services like cleanings and exams fully, so take advantage of these visits to catch issues early.
Stay In-Network: Network providers will reduce your out-of-pocket costs, so try to stay in-network whenever possible.
Plan for Major Procedures: If you anticipate needing extensive dental work or specialized vision care, check your plan’s limits on these services, and see if there’s a maximum annual benefit.

Ensuring Your Smile and Sight Are Covered

With FEDVIP, you’re empowered to secure dental and vision benefits that meet your specific needs, from routine checkups to more comprehensive care. Whether you’re nearing retirement, are already retired, or actively working, FEDVIP offers flexible options that support your wellness goals.