The Federal and Dental Vision Insurance Program carries some special provisions of interest to late career employees and retirees that make the offerings worth a look even beyond their potential for filling in troublesome gaps in FEHB health insurance coverage.
For example, all annuitants are eligible for FEDVIP regardless of their eligibility for FEHB. This benefits retirees who for various reasons are not eligible for FEHB—for example, because they did not have FEHB for the five years before retirement, because they dropped FEHB after retirement, or because they took discontinued service retirement that made them ineligible for FEHB. Those separated with eligibility for a deferred annuity are not eligible for FEDVIP.
Individuals need not be enrolled in FEDVIP five years before retiring to continue enrollment into retirement. There is no service requirement as there is with FEHB and FEGLI.
However, active employees pay premiums with pre-tax money, although annuitants may not. That effectively makes FEDVIP more expensive in retirement than during active service, in the same way that FEHB becomes more expensive.
The relationship between the two programs also is worth bearing in mind. FEDVIP benefits are offered through several health insurance carriers chosen by the OPM, some of them part of or affiliated with FEHB carriers. However, it is not necessary to choose a vision or dental plan offered by an FEHB carrier in which the employee is enrolled. Carriers under the program are secondary payors and are responsible for coordination of benefits with FEHB plans, which will provide primary benefits. For example, if a procedure cost $100 and the FEHB plan covers $25 of that, the FEDVIP carrier would pay on the remaining $75, at whatever rate it pays. In general, for those in that situation, officials advise that it would be wise to use the FEHB plan’s in-network provider, assuming that a provider is not in both networks.
An eligible individual may enroll in a benefits plan for self-only, self and family, or self plus one (the “one” must be someone who would be eligible for coverage as an FEHB family member, such as the minor child of a single parent). This provision also could be of special interest to married older employees and annuitants, many of whom no longer have children who qualify for FEHB family coverage. Rather than taking out dental and/or vision coverage at family rates for just themselves and their spouses, both of them can be covered at the self plus one rate, which is lower than the family rate.