Federal Dental Plans 101
Federal dental plans can be added, dropped or changed during each annual enrollment period. Federal employees, federal annuitants, survivor annuitants, TRICARE eligible individuals, and compensationers are eligible to receive dental benefits through the program.
Family members can be included in the plan as well. Eligible family members include a spouse and unmarried dependent children under age 22 or unmarried TRICARE-eligible dependent children under age 21 (non-student) or age 23 (full-time student). Child dependents include legally adopted children and recognized natural children, including stepchildren and foster children.
How to Chose a Federal Dental Plan
When choosing a dental plan, you will want to consider several things, including copays and coinsurance, in-network and out-of-network benefits, and how specific services are covered.
Typically, dental services are classified into three categories: preventative, intermediate, and major.
- Preventative dental services include routine oral exams, x-rays, cleanings, sealants, and fluoride treatments.
- Intermediate services include procedures like fillings, routine tooth extractions and some kinds of periodontal treatment.
- Major services include higher-priced, less frequently-performed procedures like crowns, bridges, complex extractions, caps, and root canals.
Dental plans will also list an annual maximum benefit. This is the maximum amount that the insurance company will pay in a given year. Once the insurance company has paid this amount, the remainder of any dental services provided will be completely out of pocket for you.
If orthodontic services are covered by a plan, that will be indicated and listed separately. The plan will state the lifetime maximum that is covered for orthodontic services and whether there are age limits on the coverage.
Supplemental Dental Insurance Plans: A Flexible Option
Supplemental dental insurance plans are designed to provide additional dental coverage or fill gaps in existing dental insurance plans. They can be especially beneficial for those who need more comprehensive coverage than what their current plan offers or for those who missed the enrollment period for federal dental plans. Here’s what you should know about these plans:
- Availability and Enrollment: Unlike federal dental plans, supplemental dental plans often allow enrollment at any time of the year, offering greater flexibility. This makes them an ideal choice for individuals who have missed the open enrollment period or have experienced changes in their dental health needs.
- Coverage: Supplemental dental plans can vary significantly in terms of what they cover. Even if you have a federal dental plan, they can help cover costs that are not fully covered by your primary dental insurance, such as co-pays, deductibles, or non-covered services. Some plans may offer extensive coverage for procedures like orthodontics, cosmetic dentistry, or advanced periodontal treatments.
- Coordination of Benefits: If you have a primary dental insurance plan, it’s important to understand how the supplemental plan will coordinate with it. This involves understanding which plan pays first and how the benefits from both plans can be combined to maximize your coverage.
Take the Next Step: Connect with a United Benefits Specialist Today
Are you ready to secure the dental coverage for you and your family? Reach out to a United Benefits Specialist today to explore your dental insurance options. Make an informed decision and enjoy the peace of mind that comes with comprehensive dental coverage.