How to Save Money on Dental Care this Open Season

Dental costs can be one of the more predictable healthcare expenses for families. An annual exam and cleanings are scheduled events, and even restorative procedures like crowns are often planned in advance. Knowing your anticipated dental care needs gives you an opportunity to plan the best way to pay for them. 

There are three ways federal employees can save on dental expenses: through a Federal Employees Health Benefit (FEHB) plan benefit, through a Federal Employee Dental and Vision Insurance Program (FEDVIP) benefit, or through a flexible spending account (FSA).

FEHB Plan Benefits 

First start with your FEHB plan. You’ll need to know what, if any, dental benefits your plan offers. Look in section 5(g) of the plan brochure. Virtually all FEHB plans provide coverage of accidental dental injuries, but many state that they have no other dental benefits. This is not always a complete story because it refers only to “official” plan benefits. Most official benefits are limited to preventative procedures, but some are more generous.

Some plans provide a dental savings program described in the “Non-FEHB benefits available to plan members” section of the plan brochure. These “unofficial” benefits always require the plan member to use a specific provider network, and you’ll need to contact the plan to find a list of participating providers and to learn more about available discounts.

FEDVIP Plan Benefits 

Federal Employee Dental and Vision Insurance Plans are stand alone dental plans available to federal employees and managed by Benefeds. In contrast to FEHB plans, there is no government contribution to the premium. Employees pay the full premium, although active employees pay the premium pre-tax, which provides about a one-third discount. 

In a FEDVIP plan, assuming your dentist is in-network, you’ll pay $0 for preventive and diagnostic  procedures, somewhere between 20%-45% for intermediate procedures, and 50%-65% for major procedures. The High FEDVIP plan options always have lower out-of-pocket costs for enrollees than the Standard plan options. The FEDVIP brochures show the applicable out-of-pocket cost for each procedure, so if you know you will need a particular procedure you can compare the percentage that will apply in each plan.

Here are a few more things to know about how FEDVIP plans work:

1. In-Network vs. Out-of-Network – FEDVIP plans have preferred networks, and you’ll always pay less if you stay in-network. Check with your dentist to see which FEDVIP plans they participate with now and in 2022. If you’re out-of-network, FEDVIP plans make less financial sense.
2. Annual Benefit Maximum – About half of the FEDVIP plan options impose an annual benefit maximum. If you’re expecting heavy dental usage next year, make sure to check the FEDVIP plan brochure to see if there is an annual benefit maximum. You can expect to pay a higher premium for plans without an annual maximum. 
3. Orthodontic Benefits – Most FEDVIP plans provide an orthodontic benefit, usually limited to children. Some of these plans impose an annual or lifetime benefit maximum for orthodontic services. Once you reach a certain threshold, $1,500 for example, you’re responsible for all other charges. Some impose a waiting period of a year or more after you join the plan before you are eligible for orthodontic services.

Flexible Spending Accounts 

Most enrollees will probably have some out-of-pocket dental expenses next year. Even if you’re with an FEHB plan with some dental benefits or you have a FEDVIP plan, you’ll likely be paying something out of pocket. Establishing an FSA is a great way to save about 30% on those costs. In 2022, you can elect to have up to $2,850 deducted from your paycheck pre-tax and you can roll over up to $570 of unused funds into the following year. Employees enrolled in a high deductible health plan (HDHP) with a health savings account (HSA) can take out a limited expense FSA (LEXHCFSA) for dental and vision expenses with the same contribution and rollover amounts of regular FSAs. Unfortunately, only active employees, not annuitants, are eligible to create an FSA. The FSA Open Season runs in parallel with the FEHB Open Season and is the only time during the year that you can enroll.

How to Compare Dental Costs From FEHB and FEDVIP Plans 

To see how dental coverage differs between FEHB plans and FEDVIP plans, the “Checkbook Guide to Health Plans” provides a yearly cost estimate for low, average, and high-cost dental expenses. The three examples below are for a family of four in the Washington D.C. area.

Low Dental Care Usage: We define low dental care usage as preventive services only and include annual exams, x-rays, fluoride treatment, and cleanings. For employees anticipating this next year, joining a FEDVIP plan and paying that extra premium will be more expensive than joining one of the FEHB plans that cover preventative care, even though the FEDVIP plans provide free preventative care.

Average Dental Care Usage: Average dental care usage includes preventive services in addition to some restorative services, such as fillings. For employees anticipating average usage next year, a FEDVIP plan can be the cheapest option, but there are still some FEHB plans that have good coverage and are not far behind.

High Dental Care Usage: High dental care usage includes preventive services and restorative services like fillings, crowns, and dentures. If employees know they’ll face high usage next year, most FEDVIP have lower estimated costs. However, a few FEHB plans will still have lower cost estimates than some FEDVIP plans. High usage is on average much more common among older workers and annuitants than among younger families.

Kevin Moss is a senior editor with Consumers’ Checkbook, the publisher of the 2022 Guide to Health Plans for Federal Employees. Check here to see if your agency provides free access. The Guide is also available for purchase and Government Executive readers can save 20% by entering promo code GOVEXEC at checkout.