Here's what federal employees need to know about their dental benefits

Dental care can be one of the more predictable healthcare expenses, and anticipating your usage gives you an opportunity to plan. Here’s what you need to know about dental coverage from FEHB and FEDVIP plans and how to save on costs.

FEHB Plan Benefits

Start here. You’ll need to know what, if any, dental benefits your FEHB plan offers, so look in section 5(g) of the plan brochure. Almost all plans provide accidental dental injury coverage, but many have nothing else. Most official dental benefits are limited to preventive procedures, and all require you to use in-network providers.

Some plans provide dental savings programs. These “unofficial” dental benefits can be found in the “Non-FEHB benefits available to plan members” section of the brochure. They require you to use a specific provider network, which can be found on the plan’s website. 

FEDVIP Plan Benefits

FEDVIP plans are standalone dental plans managed by Benefeds available to federal employees and annuitants. Unlike in the FEHB program, there is no government contribution to the FEDVIP premium. You’ll be on the hook for the entire sum. However, active employees still receive about a one-third discount by paying the premium pre-tax.

Assuming you use in-network providers, with a FEDVIP plan you’ll pay $0 for covered Class A preventive services, between 20-45% for covered Class B intermediate services, between 50-65% for covered Class C major services, and 50% for Class D orthodontic services. High FEDVIP plans always have lower out-of-pocket costs than Standard FEDVIP plans, but they have higher premiums. FEDVIP brochures show applicable out-of-pocket costs by procedure. If you know what procedure you’ll need, you can compare that percentage across plans.

Here’s what else you need to know about FEDVIP plans:

In-Network vs Out-of-Network Providers

All national FEDVIP plans, besides Humana Dental Standard EPO, provide out-of-network coverage. However, you’ll always pay less staying in-network. Check with your dentist to see which FEDVIP plans they accept or use the provider directory lookup on the plan website to confirm your dentist’s network status. 

Annual Benefit Maximums

High FEDVIP plans have no annual benefit maximums. Standard versions all have a $1,500 per person annual benefit maximum besides Humana Dental Standard EPO, which doesn’t have an annual benefit maximum. If you expect many dental care procedures, you’ll want to consider one of the High FEDVIP plans, but keep in mind their higher premium.

Dependent Coverage

Unlike FEHB plans, dependents can only be covered on a FEDVIP plan until age 22. For those who receive FEDVIP benefits through TRICARE, dependents can be covered until age 21, or up to age 23 if they are enrolled in college.

Orthodontic Coverage

All FEDVIP plans provide orthodontic coverage, and there are no longer any waiting periods to receive these benefits. All national FEDVIP plans have a lifetime per person maximum orthodontic benefit, besides Humana Dental Standard EPO, which ranges from $2,000 to $3,000 for adults and $2,000 to $5,000 for children.

Flexible Spending Accounts

Most federal employees will have out-of-pocket dental expenses each year. Even with FEHB or FEDVIP dental coverage, you’ll still have to pay something out-of-pocket for Class B-D services, or a plan deductible if applicable. Establishing an FSA is a great way to save about 30% on those out-of-pocket expenses. This year, you can elect to have up to $3,200 deducted from your paycheck, and you can roll over up to $640 of unused funds into the following year as long as you stay enrolled in the FSA program.

Employees enrolled in a high deductible health plan (HDHP) with a health savings account (HSA) can’t have a healthcare FSA. However, those with an HSA can take out a limited expense FSA for dental and vision expenses with the same contribution and roll-over amounts as the healthcare FSA.

Unfortunately, only active federal employees are eligible to have an FSA. The FSA Open Season runs in parallel with the FEHB Open Season. FSAFeds has more information, including an eligible expense lookup and savings calculator.

Health Savings Accounts

For federal employees expecting high dental costs, including families paying for orthodontic treatments, HSAs have an even greater savings potential than FSAs. First, the HSA contribution limit is much higher at $8,300. Like FSAs, these contributions are made pre-tax, which results in about 30% savings on qualified healthcare expenses when paid using HSA funds. You can also decide to invest your HSA contributions. Any investment return you receive is tax-free if you use it for a qualified healthcare expense.

HSAs are only available for active federal employees enrolled in an HDHP. 

Don't Forget Flexible Spending Accounts

Federal employees have multiple ways to receive dental coverage. First, consider what’s provided by your FEHB plan, or other FEHB plans. There is no extra premium for dental benefits offered by an FEHB plan. Next, consider enrolling in a FEDVIP plan if you expect to use enough dental services to cover paying the extra premium. 

Checkbook’s Guide to Health Plans allows you to compare all available FEHB and FEDVIP plans in low, average, and high estimated dental cost years. By using these estimates, you can find which plan(s) offer the best value based on your usage scenario.

Finally, all federal employees should be enrolled in an FSA. This is a guaranteed way to save money on dental and other qualified healthcare expenses. For employees looking to save more, consider enrolling in an HDHP to take advantage of the higher contribution limits and triple tax savings available in the HSA.

Kevin Moss is a senior editor with Consumers’ Checkbook. Watch more of his free advice and check if the Guide to Health Plans for Federal Employees is available for free from your agency. You can also purchase the Guide and save 20% with promo code GOVEXEC.