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What is a Federal Dental Plan?

John Lister
John Lister

A federal dental plan is a dental insurance option in the United States available to federal employees. There are a range of plans offered by private insurers through the federal government, offering competitive rates. The rates are often lower than the employees could get elsewhere, effectively acting as a group discount because of the sheer number of potential customers the government has to offer insurers. Employees can only usually enroll in a plan during a specified period.

There is no one specific federal dental plan. Instead, multiple plans come under a scheme known as the Federal Employees Dental and Vision Insurance Program. This allows employees access to a range of plans on a group basis. As well as bringing lower costs, there are usually no limitations on pre-existing conditions.

A woman getting a dental cleaning.
A woman getting a dental cleaning.

Whichever federal dental plan an employee chooses, it will be on an enrollee-pay-all basis. This means that although the government has made arrangements for the plan, it does not contribute toward premiums. The money employees pay toward the plan is deducted from salaries at source, meaning it does not count toward taxable income.

A federal employee faces several choices when selecting a federal dental plan. First, he must choose a provider from those available in his area. For example, an employee may have a choice of five providers. One he choose a provider, he must choose one of several types of plans. These can include a preferred provider organization (PPO), in which the employee can choose any dentist; an exclusive provider organization (EPO), in which the employee can only choose from a designated group of dentists; and a health maintenance organization, which does not require the patient to pay, and then reclaim, the costs of treatment in the same way as the PPO and EPO do.

The employee also must choose who the plan should cover. The options are self-only cover, self plus one, and self and family. Regardless of the choice, the only people the plan can cover other than the employee are the employee's spouse and any unmarried children either aged under 22, or aged 22 or older but incapable of supporting themselves.

Employees can only enroll in a federal dental plan at two times. One is during the 60 days after becoming eligible for coverage, the conditions for which depend on the particular agency where the employee works. The other is during an annual period of six weeks known as "open season," which usually takes place in November and December.

Discussion Comments

Raynbow

@rundocuri- I think that your brother is right, because he is being safe instead of sorry. You never know when dental problems will arise, so it is important to always have dental insurance to help pay to correct them.

Another problem with not staying enrolled in the dental plan is that your brother may not be able to get back into that easily if he skips a year or two. Only the plan administrator can determine this, but regardless, it is probably a good idea to stay in the plan and renew it when it is time.

Rundocuri

I have a brother who is enrolled in a federal dental plan, but he doesn't have any problems with his teeth. I suggested that he skip a few years of coverage so he can save some money, but he said this could affect his coverage when he needs it. Am I right or is he?

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    • A woman getting a dental cleaning.
      By: Trish23
      A woman getting a dental cleaning.