Dental PPO Plan FAQs
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FEDVIP is the Federal Employees Dental and Vision Insurance Program administered by the U.S. Office of Personnel Management. It is a program where supplemental dental and vision benefits are available to eligible Federal and U.S. Postal Service employees, annuitants, and their eligible family members. Aetna is one of the approved carriers to offer Federal Employees a supplemental dental plan under this program.
No. You can visit any licensed dentist, anywhere. Aetna does have a dental network with over 267,000 dental locations. Your out-of-pocket costs may be lower if you use a dentist in Aetna's dental PPO network and you are not responsible for charges above our network negotiated fees. You can find Aetna network dentists by using our DocFind® online directory.
Basic plan summary:
- Annual Benefit Maximum $10,000 in-network/$2,000 out of network per member (includes Basic, Intermediate and Major Services).
- Visit any licensed dentist, anywhere – without a referral.
- No Deductible
- Preventive/Basic Services 100% covered*
e.g. Cleanings, X-rays, Sealants, Space Maintainer and Fluoride
- Intermediate Services 60% covered*
e.g. Fillings, Therapeutic Pulpotomy, Uncomplicated Extractions, Periodontal Scaling, Denture Adjustment and Repair
- Major Services 40% covered*
e.g. Inlays, Onlays, Crowns, Root Canal, Full & Partial Dentures, Pontics, General Anesthesia/Intravenous Sedation
- Orthodontic Services** 50% covered*
Orthodontic Lifetime Maximum $2,000/member
**A member will be eligible to receive Orthodontic benefits after they have been continuously enrolled in the Aetna Standalone Dental PPO Plan for 12 months.
First you must enroll in the Aetna Standalone Dental plan PPO through the www.benefeds.com website. Once you enroll in the dental plan, premiums are withheld from your paycheck. Premiums are paid on a pre-tax basis (premium conversion) if you are an active employee and your salary is sufficient to make the premium withholding. Pre-tax premiums are not available to annuitants, survivor annuitants or compensationers.
Yes. There is an annual maximum of $10,000 in-network/$2,000 out-of-network per member. The maximum applies to preventative, intermediate and major services. There is also an orthodontia lifetime maximum of $2,000 per member once they have been continuously covered by the Aetna Standalone Dental PPO plan for 12 months.
Only on Orthodontia coverage. A member will be eligible to receive Orthodontic benefits after they have been continuously covered by the Aetna Standalone Dental PPO plan for 12 months.
No, there are no deductibles in our Aetna Standalone Dental PPO plan.
Yes. Orthodontia is covered for all members after a 12 month waiting period.
Implants and implant crowns are covered under the major category at 40%. The tooth being replaced must be extracted while covered under a participating FEDVIP plan.
Yes. Enrolling in the Aetna Standalone Dental PPO plan also gives you access to our Aetna VisionSM Discount program that includes discounts on frames, lenses and Lasik surgery at participating locations. You also get great discounts on gyms, weight loss programs, chiropractic, acupuncture, massage, vitamins, electric toothbrushes, gum, mints, and more!
No, this is a separate standalone plan under FEDVIP.
Once you are an Aetna member, you'll be able to access your personalized, secure member portal on Aetna Navigator®. You can check the status of a claim and view your claim history, view an Explanation of Benefits, replace your membership card- and lots more.
Enroll at www.benefeds.com during open season, November 9 through December 14, 2015, or after a qualifying life event that permits enrollment outside of open season. New employees will have 60 days to enroll.
Claims should be submitted to your medical carrier for consideration first. Your FEDVIP plan will coordinate benefit payments with the payment of benefits under any group health benefits coverage you may have under.
We may request that you verify/identify your health insurance plan(s) annually or at time of service.
You have several options:
- Review the FEDVIP Plan brochure and the dental page on this website
- Visit Aetna Navigator® to see the resources and information available to you when you enroll. Enter the following user name and password:
User name: federal3
- Call Aetna at 1-877-459-6604
Federal employees and annuitants in the United States and overseas are eligible to enroll in our Aetna Standalone Dental PPO under FEDVIP. If you receive covered dental services while overseas, you will need to submit your claims to Aetna. Upon receipt of the claim, Aetna will translate the claim, if necessary, and process it. We use the rate of exchange in effect at the time we process the claim. Claims are paid in U.S. currency. See Section 6 of our federal brochure for more information.