Guide to FEDVIP Dental and Vision Coverage: What’s Included?

Federal employees, retirees, and their families gain access to specialized benefits through the Federal Employees Dental and Vision Insurance Program (FEDVIP). This valuable program offers extensive dental and vision coverage, including routine cleanings, orthodontic treatments, eye exams, and glasses. By understanding FEDVIP-covered procedures, enrollees can make informed choices, reduce costs, and maintain optimal health.

In this guide, we’ll break down FEDVIP’s full range of covered services, from preventive care to specialized treatments. For official plan information, eligibility, and a list of providers, visit the U.S. Office of Personnel Management’s FEDVIP page.

Understanding FEDVIP: An Overview

The Federal Employees Dental and Vision Insurance Program (FEDVIP) offers optional benefits tailored to federal employees, retirees, and their families. The Office of Personnel Management (OPM) partners with leading insurance providers to deliver flexible dental and vision plans. Enrollees can select plans that best match their health and financial priorities. FEDVIP plans work in conjunction with the Federal Employees Health Benefits (FEHB) program, creating a complete benefits package.

FEDVIP members have access to an extensive network and a choice of coverage levels. Let’s explore the specific dental and vision benefits included.

Dental Coverage Under FEDVIP

FEDVIP’s dental coverage offers preventive, basic, and major services to meet a wide range of dental needs. While coverage specifics vary by provider, most FEDVIP plans include common services essential to dental health.

Preventive Dental Services

Preventive care forms the backbone of dental health. FEDVIP plans typically cover these services fully, helping members avoid serious dental issues.

Routine Cleanings and Examinations: Most plans cover cleanings and exams twice a year. These services include plaque removal, polishing, and exams that detect early signs of tooth decay or gum disease.
X-Rays: Diagnostic x-rays, such as bitewing x-rays, are commonly covered. Most plans cover full-mouth x-rays less frequently (often every 3–5 years).
Fluoride Treatments: Many FEDVIP plans provide fluoride treatments for children to strengthen enamel and help prevent cavities.

Basic Dental Services

FEDVIP also covers basic dental services, addressing minor dental concerns that require additional care.

Fillings: Both amalgam (metal) and composite (tooth-colored) fillings are typically covered. This helps members address cavities early.
Extractions: Routine extractions are often covered. This applies to teeth damaged by decay or infection.
Deep Cleanings (Scaling and Root Planing): For gum disease, FEDVIP plans offer partial coverage for deep cleanings, including scaling and root planing.

Major Dental Services

FEDVIP provides partial coverage for major services to help members manage more complex dental needs. While preventive services may be fully covered, these treatments often involve higher out-of-pocket costs.

Crowns: Plans cover a range of crown types, including ceramic and metal crowns, which help restore damaged teeth.
Bridges and Dentures: Coverage typically includes partial payment for both full and partial dentures and bridges to replace missing teeth.
Root Canals: Plans usually cover 50–80% of the cost for endodontic treatment, such as root canals, which restore severely damaged teeth.

Orthodontic Treatments

Orthodontic care is available through most FEDVIP plans, making it appealing for families with children or adults needing alignment corrections.

Braces for Children and Adults: FEDVIP plans offer partial coverage for traditional braces and, in some cases, clear aligners.
Orthodontic Consultations and Adjustments: FEDVIP plans often cover initial consultations and follow-up adjustments to keep treatment on track.

Vision Coverage Under FEDVIP

FEDVIP’s vision plans focus on routine eye care, corrective lenses, and treatment for specific conditions. This coverage supports both preventive and corrective vision needs, helping members protect and improve eye health.

Routine Eye Exams

Eye exams help detect eye health issues early. FEDVIP plans generally cover these exams, making them accessible for all members.

Annual Vision Screening and Prescription Updates: Optometrists perform screenings, update prescriptions, and check for conditions such as glaucoma and cataracts.
Diabetic Eye Exams: For members with diabetes, annual exams are available to monitor retinal health and prevent complications.

Corrective Lenses

FEDVIP plans typically include an allowance for eyeglasses or contact lenses, making it easy to maintain clear vision.

Eyeglass Lenses and Frames: Coverage usually includes single-vision, bifocal, and trifocal lenses. Many plans cover higher-quality lenses, such as polycarbonate and high-index, at reduced rates.
Frames: Most FEDVIP vision plans offer an allowance for frames. This allows members to choose from a wide range of brands, with premium options available at a discount.
Contact Lenses: FEDVIP plans often cover specialty contact lenses, such as toric lenses for astigmatism, and provide an allowance for a year’s supply.

Lens Enhancements

Lens enhancements are also part of many FEDVIP vision plans, helping members enjoy added protection and comfort.

Anti-Reflective Coatings: These coatings reduce glare and eye strain. Most FEDVIP plans provide a discount or partial coverage.
Photochromic or Transition Lenses: Lenses that adjust to light changes are partially covered by many plans, offering flexibility for indoor and outdoor use.
Blue Light Filtering Lenses: With increased screen time, many people find blue light filters essential. FEDVIP plans may offer discounts or partial coverage for blue light-filtering lenses.

Specialized Eye Care Treatments

Some FEDVIP plans cover additional treatments for members who need specific eye care beyond basic corrective measures.

Treatment for Eye Conditions: Plans may cover treatment for conditions like eye infections, injuries, and chronic dry eye.
Surgical Interventions: While most FEDVIP plans do not cover LASIK surgery fully, some offer discounts on laser corrective surgeries.

Selecting the Right FEDVIP Plan

Choosing the right FEDVIP plan requires considering your needs, budget, and preferred providers. Here are some helpful points to keep in mind:

Frequency of Services Needed: If you or your family need frequent dental cleanings or annual eye exams, a plan with robust preventive coverage may offer the best value.
Corrective Lens Requirements: Those who rely on corrective eyewear benefit from plans that offer generous allowances for lenses and frames.
Orthodontic Care: For families with children needing braces, choosing a plan with strong orthodontic coverage can save significantly.
Provider Network: Be sure to check whether the plan’s network includes local dentists and eye care providers for easy access.

Conclusion

The Federal Employees Dental and Vision Insurance Program (FEDVIP) offers federal employees, retirees, and their families valuable dental and vision benefits, supporting both preventive and specialized care needs. Whether you need routine checkups, orthodontic care, corrective lenses, or treatment for specific eye conditions, FEDVIP offers a range of coverage options to fit your health needs and budget. With the right plan, you can access quality care while minimizing out-of-pocket expenses, ensuring a comprehensive approach to your overall well-being.