My family includes myself, my husband and a son who is 20 years old. We have had dental coverage through the Federal Employees Dental and Vision Insurance Program (FEDVIP) for the past two years. The first year we got back more than we spent. This year the insurance company will receive almost $500 more in premiums than they sent us -- so far. (We each have had only one dental appointment this year). We go to a dentist who does not participate in any insurance plan, so we chose a plan that does not require us to use a participating provider.
The premiums this year were $40.12 per pay period (premiums will go up by $2.23 biweekly next year). The total premium for 26 pay periods is $1,043.12 for family coverage. If we had each gone to the dentist twice for cleanings and exams and once for X-rays, we would have been reimbursed $906 from our dental plan. We have one more visit included with our dental coverage for this year, so we should take advantage of that to make our coverage worthwhile -- and, of course, to keep our teeth healthy.
Since for us, the premiums are pre-tax (employees, but not annuitants, have "premium conversion" benefits for FEDVIP plans), we have saved federal, state, and Social Security taxes on the amount we paid in premiums, so the net cost of the insurance is more like $750 per year.
My Evaluation Our health insurance plan provides minimal coverage for dental services. The health plan is the primary payer, and the dental plan will pay the scheduled amount minus the amount we have been reimbursed by our health plan.
In some years, we've had only preventative care expenses. But at other times, we've had substantial additional costs. Crowns, an occlusal guard (a device that prevents nighttime teeth grinding) and fillings can add to our normal monthly expenses. When we incur these costs, it is nice to have dental coverage, because its cost is spread evenly throughout the year.
It's been relatively easy to file claims under our plan, but we have had to mail in our forms since our dentist doesn't participate. The small amount of additional out-of-pocket expenses that aren't covered by our insurance can be included in our flexible spending account allotment.
Taking all of that into account, I think we'll continue our dental plan for 2009. You never know when a big dental expense might come up. My husband and I have teeth that are more than 50 years old, so it is a good bet that higher dental expenses are in our future.
Here are some of the basic questions that will help you evaluate your needs:
- How often do you visit the dentist?
- Are you willing to use a participating dentist to save money?
- How much does your health plan pay for dental services?
- Are you still employed so that you can take advantage of premium conversion tax benefits?
- Do you have any major dental expenses coming up? Look at the maximum annual benefit if you are likely to need multiple services next year. GEHA's high-option annual benefit maximum will increase to $3,500 per person. MetLife's and Aetna's high options also have a $3,000 per person annual maximum. Some plans limit coverage to $1,200 per person annually.
Here are the FEDVIP dental plans you can choose from next year:
- Aetna High Option PPO (in- and out-of-network benefits)
- GEHA PPO (high and standard options available, in- and out-of-networkbenefits)
- MetLife PPO (high and standard options available, in- and out-of-network benefits)
- United Concordia PPO (in-network benefits only, except for emergency)
- Humana/Comp Benefits (regional plan)
- GHI PPO (regional plan)
- Triple S PPO (regional plan)
Have more questions? Check the FEDVIP frequently asked questions page.
Tammy Flanagan is the senior benefits director for the National Institute of Transition Planning Inc., which conducts federal retirement planning workshops and seminars. She has spent 25 years helping federal employees take charge of their retirement by understanding their benefits.
For more retirement planning help, tune in to "For Your Benefit," presented by the National Institute of Transition Planning Inc. live on Monday mornings at 10 a.m. ET on federalnewsradio.com or on WFED AM 1500 in the Washington metro area.