Member FAQs
Why Dental Coverage and the FEP BlueDental Difference

Why should I get dental coverage?

How is FEP BlueDental different than other dental plans?

How does FEP BlueDental work?

How can I learn more about FEP BlueDental?

More About FEP BlueDental Coverage

What's covered with FEP BlueDental?

What's the difference between the Standard and High Options?

Does FEP BlueDental offer a Self Plus One Option?

Is orthodontic treatment (braces) covered?

How many dental visits per year are covered?

Is there a missing tooth clause?

Is my dependent eligible for coverage? Does the Affordable Care Act expand FEDVIP coverage for dependents up to age 26?

What will I pay out-of-pocket? Will I have to pay up front? Is there a deductible?

What if I need emergency care while traveling outside the United States?

Medical, Dental and Vision Options and Coordination

Are FEDVIP rules and FEHB rules different as to eligible age requirements?

How does this coverage differ from the medical coverage included in the Service Benefit Plan Basic or Standard Option?

What is the difference between FEP BlueDental and Federal DentalBlue?

Can I keep Federal DentalBlue coverage?

How will FEP BlueDental coordinate with my medical benefits?

How does FEP BlueDental work with my Flexible Spending Account (FSA)?

Do you offer a package deal for FEP BlueVision and FEP BlueDental?

Dental Providers (Dentists) and Your Dental Care

What kinds of dental providers can my family and I visit?

How many providers does FEP BlueDental offer nationwide? How many providers does FEP BlueDental offer in my state/region?

How do I find in-network dentists?

Should I verify that my dentist is an in-network dentist?

Will I pay more if I use an out-of-network dentist? How much more?

What will I pay out-of-pocket? Will I have to pay up front? Is there a deductible?

How do I know which dentist to select?

How can I make the most of my dental visit?

How do I make decisions about dental procedures?

Signing up for FEP BlueDental

Do you have to be enrolled in the Service Benefit Plan to get FEP BlueDental?

When is coverage effective?

If I don't sign up now during Open Season 2016 (for a 1/1/17 effective date), can I sign up later on in the year? Or will I have to wait until Open Season 2017?

Filing Claims

What do I have to do to submit a dental claim to FEP BlueDental?

What do I do if I have a claims problem or issue?

Customer Service

Who do I call for customer service?

Who do I contact with a change of address?

What information is available on the FEP website? Where do I go online for information about FEP BlueDental?



Why Dental Coverage and the FEP BlueDental Difference

Why should I get dental coverage?
A complete dental examination involves many things including checking the status of the gums, teeth, any restorations (fillings, crowns, veneers, etc.), and oral mucosa of tongue, cheeks, top and bottom of mouth and back of throat. There are many problems that can develop in the mouth that don't hurt until they do, and then the treatment may be more extensive, expensive, or even too late to save a tooth or teeth. In addition, the importance of periodic evaluation of the oral mucosa is to look for lumps, bumps and other irregularities that may even be signs of disease...even cancer.

Dental issues affect other medical conditions you may have - heart disease, diabetes, and pregnancy, to name a few.

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How is FEP BlueDental different than other dental plans?
FEP BlueDental offers several choices to our members. They are as follows:
  • We have Standard Option and High Option.
  • The annual maximum of benefits for in-network High Option is $15,000.
  • The lifetime benefit maximum for High Option for Orthodontic Benefits is $3,500.
  • If you are a Service Benefit Plan (SBP) member, dental claims are submitted on your behalf to the local Plan for processing.

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How does FEP BlueDental work?
If you are a Service Benefit Plan member, and have enrolled in the FEP BlueDental Program and have visited the dentist, the dental provider sends the claim to the local Plan (or other carrier listed on your medical I.D. card) for processing and issuing an Explanation of Benefits (EOB). At the same time, the claim along with any balance will be forwarded to FEP BlueDental. FEP BlueDental will process the claim for secondary payment. The member will also receive an EOB from FEP BlueDental.

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How can I learn more about FEP BlueDental?
You can go to our web site at www.fepbluedental.com.

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More About FEP BlueDental Coverage

What's covered with FEP BlueDental?
Basic services, which include oral examinations, prophylaxis, diagnostic evaluations, sealants and X-rays.

Intermediate services, which include restorative procedures such as fillings, prefabricated stainless steel crowns, periodontal scaling, tooth extractions, and denture adjustments.

Major services, which include endodontic services such as root canals; periodontal services such as gingivectomy; major restorative services such as crowns, oral surgery, and bridges; and prosthodontic services such as complete dentures.

Orthodontic services are also included for both children and adults. A 12-month waiting period applies to the Standard Option only. The High Option does not have a waiting period.

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What's the difference between the Standard and High Options?
See chart below:


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Does FEP BlueDental offer a Self Plus One Option?
Yes, FEP Blue Dental offers a Self Plus One Option.

OPM establishes the options that will be available to Federal Employees. Eligible individuals can enroll in a dental and/or vision plan. They may enroll in a plan for Self Only, Self Plus One, or Self and Family coverage. Eligible family members include your spouse and unmarried dependent children under age 22. This includes legally adopted children and recognized natural children who meet certain dependency requirements. This also includes stepchildren and foster children who live with you in a regular parent-child relationship. Under certain circumstances, you may also continue coverage for a disabled child 22 years of age or older who is incapable of self-support.

FEDVIP rules and FEHB rules for family member eligibility are NOT the same. However, the Service Benefit Plan does offer a Self Plus One Option.

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Is orthodontic treatment (braces) covered?
Yes, orthodontic services treatment and braces are covered for children and adults. A 12-month waiting period applies to Standard Option. The High Option does not have a waiting period. The lifetime maximum amount is up to $3,500 for the High Option, in and out-of-network. Under the Standard Option, the lifetime maximum is up to $2,000 for in-network services and up to $1,000 for out-of-network services.

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How many dental visits per year are covered?
Exams and cleanings are limited to 2 per year. There are no restrictions on the visits per year. There are, however, limits to annual benefit dollars paid as well as lifetime limits on orthodontia.

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Is there a missing tooth clause?
No. Benefits are available to replace missing or broken teeth under Prosthodontic Services.

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Is my dependent eligible for coverage? Does the Affordable Care Act expand FEDVIP coverage for dependents up to age 26?
No, coverage for dependents ends at age 22. Eligible family members include your spouse and unmarried dependent children under age 22. This includes legally adopted children. Stepchildren and foster children who live with you in a regular parent-child relationship are also included. FEHB provides coverage for dependents up to age 26.

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What will I pay out-of-pocket? Will I have to pay up front? Is there a deductible?
There is a $75 deductible per person for Standard Option and $50 deductible per person for High Option when you use an out-of-network provider. A deductible is a fixed amount of expenses you must incur for certain covered services and supplies before we will pay for covered services. You are also required to pay a coinsurance amount after meeting your deductible for out-of-network services and class B and C services. A coinsurance is the percentage of our allowance that you must pay for your care.

In most cases, you will not have to pay anything up front; the provider will bill you for any owed amount.

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What if I need emergency care while traveling outside the United States?
FEP BlueDental plans include international coverage. Members may receive dental treatment from a dentist when they work or travel abroad. This service is available in approximately 100 countries throughout Europe, Africa, North America, South America and Asia. English-speaking customer service representatives are available to help members find a dentist. The list of participating dentists is available on this Web site under Find a Dentist. You are responsible for paying the dentist and submitting your claims to FEP BlueDental. For more information, refer to our International Services web page or call Customer Service at 1-855-504 BLUE (2583) in the U.S. or 1-651-994-2583 collect outside the U.S.

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Medical, Dental and Vision Options and Coordination

Are FEDVIP rules and FEHB rules different as to eligible age requirements?
Yes, FEDVIP age requirements for eligibility are unmarried dependent children under age 22. This includes legally adopted, natural children, stepchildren, and foster children in a regular parent-child relationship. The FEHB rules view unmarried or married children under the age of 26 as eligible.

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How does this coverage differ from the medical coverage included in the Service Benefit Plan Basic or Standard Option?
FEP BlueDental provides comprehensive dental coverage your medical coverage does not provide. For instance, FEP BlueDental will cover a percentage of your charges for services such as crowns, root canals, periodontal scaling, dentures, and orthodontic. Whereas the medical coverage is limited to services such as exams, cleanings, some X-rays, etc.

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What is the difference between FEP BlueDental and Federal DentalBlue?
With FEP BlueDental, you automatically pay premiums through payroll deductions using pre-tax dollars. Annuitants automatically pay premiums through annuity deductions using post-tax dollars. The FEDVIP rules are not applicable to Federal DentalBlue.

FEP BlueDental is a nationwide program and also covers overseas employees. Federal DentalBlue is only offered in a few states.

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Can I keep Federal DentalBlue coverage?
Yes, you can keep your Federal DentalBlue coverage, but it will not be subject to payroll deductions and unlike FEP BlueDental, it will not have the tax advantages.

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How will FEP BlueDental coordinate with my medical benefits?
Simple! If you have our medical coverage your benefits will automatically be coordinated with FEP BlueDental. Just show your dental I.D. card and your medical I.D. card to your dentist. Your dentist will file directly with the local BCBS Plan (or other medical carrier listed on your medical coverage I.D. card) for primary coverage and then the claim will be sent to FEP BlueDental making it seamless to you and your dentist.

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How does FEP BlueDental work with my Flexible Spending Account (FSA)?
You can submit your FEDVIP co-payments/deductibles as eligible expenses against your FSA account. However, FEDVIP insurance premiums are not reimbursable under an FSA.

The Paperless Reimbursement (PR) is an optional program available to FEP BlueDental participants who have elected to participate in the FSAFEDS program. Participants can have their out-of-pocket dental expenses sent electronically from FEP BlueDental to FSAFEDS for processing towards their health care FSA account. To enroll in PR, visit www.FSAFEDS.com and log into "My Account Summary", then Paperless Reimbursement. You may also contact FSAFEDS at 1-877-FSAFEDS (372-3337), TTY: 1-800-952-0450, Monday through Friday, 9 AM- 9 PM EST.

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Do you offer a package deal for FEP BlueVision and FEP BlueDental?
No

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Dental Providers (Dentists) and Your Dental Care

What kinds of dental providers can my family and I visit?
You can obtain care from any licensed dentist in the United States or overseas. You are not required to select a primary care dentist. Members are free to select the dentist of their choice. If you use an in-network provider, you are responsible only for covered charges up to our negotiated plan allowance per procedure.

If the dentist you use is not part of our network, benefits will be considered out-of-network. Because these providers are out of our network, we pay for their services based on an out-of-network plan allowance. You are responsible for the difference between the plan's payment and the amount billed.

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How many providers does FEP BlueDental offer nationwide? How many providers does FEP BlueDental offer in my state/region?
There are over 270,000 access points nationwide (includes providers and locations). To find a provider in your area, please visit www.fepbluedental.com and click on Find A Dentist or call 1-855-504-BLUE (2583).

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How do I find in-network dentists?
You can find the in-network dentists on our website - www.fepbluedental.com and click on Find A Dentist or call 1-855-504-BLUE (2583).

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Should I verify that my dentist is an in-network dentist?
Yes. By checking with your dentist or looking on www.fepbluedental.com (click on Find a Dentist), you are assured that your dentist is still participating in the network. Consult your FEP BlueDental Brochure for more information regarding your plan design.

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Will I pay more if I use an out-of-network dentist? How much more?
Yes, generally you will pay less out of your pocket if you use our in-network dentists. Additionally, if you use an out-of-network dentist you may have to pay the dentist first, and then submit the claim to FEP BlueDental.


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What will I pay out-of-pocket? Will I have to pay up front? Is there a deductible?
There is a $75 deductible per person for Standard Option and $50 deductible per person for High Option when you use an out-of-network provider. A deductible is a fixed amount of expenses you must incur for certain covered services and supplies before we will pay for covered services. You are also required to pay a coinsurance amount after meeting your deductible for out-of-network services and class B and C services. A coinsurance is the percentage of our allowance that you must pay for your care.

In most cases, you will not have to pay anything up front; the provider will bill you for any owed amount.

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How do I know which dentist to select?
Get recommendations from friends, neighbors, coworkers and family members to find a dentist who matches your needs and values. A convenient location and clinic hours, possibly including Saturday and evening hours, may also be important considerations for you.

Having a dentist whom you visit regularly and feel comfortable with is important to your overall oral health. The dentist you select should be someone you can talk to, who will listen to your questions and concerns and who will answer your questions fully. Here are some questions to ask when selecting a dentist:
  • How are after-hour emergencies handled?
  • Does the dentist have multi-office locations?
  • How long will you have to wait to get an appointment for routine exams and cleanings? Urgent or same-day care? Specialty services?
  • Is the office staff friendly and helpful? Do they enjoy working with children?

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How can I make the most of my dental visit?
  • Show your FEP BlueDental I.D. card and medical I.D. card at the time of each dental visit.
  • To assure that you receive full plan benefits, verify that your dentist participates in the FEP BlueDental network as indicated on your I.D. card.
  • Discuss treatment options and costs with your dentist to help you select the best course of treatment.
  • Ask in advance if all recommended services are necessary and if there are alternatives available.
  • Check your Explanation of Benefits statement to make sure you received the services on this statement.
  • Finally, make sure you understand your particular benefit plan and are familiar with the specific benefits that it covers.

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How do I make decisions about dental procedures?
Start by asking questions. Having more information puts you in a better position to make informed decisions. Depending on your situation, you might consider asking the following questions:
  • How much discomfort should I expect?
  • Can I expect all my symptoms to go away? When?
  • Will I need to make any changes in my lifestyle?
  • What is the cost of the treatment? What will the cost be to me?
  • What alternatives are available?
  • How many times have you done this procedure? How do your results compare with other dentists?
  • Will you send a treatment plan to FEP BlueDental for an estimate of benefits? How long will it take to get the pre-estimate back?
  • What kind of follow-up care do I need?
  • How will I look when the procedure has been completed?
  • What could happen if I delay this treatment?
  • How can I best care for my mouth after the treatment?

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Signing up for FEP BlueDental

Do you have to be enrolled in the Service Benefit Plan to get FEP BlueDental?
No. If you are currently eligible for enrollment under the FEHB program, (even if you are not currently enrolled) you are eligible to enroll in FEDVIP. Eligible family members include your spouse and unmarried, dependent children under age 22, or over age 22 if incapable of self-support.

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When is coverage effective?
If you sign up for FEP BlueDental during the 2016 Open Season, your coverage will begin on January 1, 2017. Premium deductions will start with the first full pay period beginning on/after January 1, 2017.

You may also enroll within 60 days after you become eligible as:
  • New employee
  • Previously ineligible employee who transferred to a covered position
  • Survivor annuitant if not already covered under FEDVIP
  • An employee returning to service following a break in service of at least 31 days

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If I don't sign up now during Open Season 2016 (for a 1/1/17 effective date), can I sign up later on in the year? Or will I have to wait until Open Season 2017?
The time for you to sign up for FEP BlueDental is Open Season.

You may also enroll within 60 days after you become eligible as:
  • New employee
  • Previously ineligible employee who transferred to a covered position
  • Survivor annuitant if not already covered under FEDVIP
  • An employee returning to service following a break in service of at least 31 days

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Filing Claims

What do I have to do to submit a dental claim to FEP BlueDental?
If you go to a Dentist that participates with FEP BlueDental, your Dentist will submit the claim on your behalf.

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What do I do if I have a claims problem or issue?
You can reach our dedicated Customer Service department at 1-855-504-BLUE (2583) 8 a.m. - 8 p.m. Eastern Time, Monday - Friday.

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Customer Service

Who do I call for customer service?
You can reach our dedicated Customer Service department at 1-855-504-BLUE (2583) 8 a.m. - 8 p.m. Eastern Time, Monday - Friday.

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Who do I contact with a change of address?
Report your new address to BENEFEDS by visiting www.BENEFEDS.com or calling 1-877-888-FEDS (3337), TTY 1-877-889-5680. BENEFEDS will forward your address change to us. And, when visiting your dentist, make sure they have your correct address to use when submitting claims.

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What information is available on the FEP website? Where do I go online for information about FEP BlueDental?
You can go to our website, www.fepblue.org to get all the information about our products, including FEP BlueDental.

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