Understanding the landscape of federal employee benefits can be complex, especially when navigating programs like the Federal Employees Health Benefits (FEHB) Program, TRICARE, and the Federal Employees Dental and Vision Insurance Program (FEDVIP). A common question arises: Is the Federal Employees Health Benefits Program the same as TRICARE? The short answer is no. While both provide valuable health benefits, they cater to different groups and offer distinct types of coverage. This article will clarify the differences, focusing particularly on FEDVIP and its relationship to both FEHB and TRICARE.
What is FEDVIP?
The Federal Employees Dental and Vision Insurance Program (FEDVIP) was established following the Federal Employee Dental and Vision Benefits Enhancement Act of 2004. Administered by the Office of Personnel Management (OPM), FEDVIP offers supplemental dental and vision benefits to eligible federal employees, retirees, and their families. Initially, FEDVIP was exclusively for federal and postal employees, retirees, and their eligible family members. However, a significant expansion occurred with Section 715 of the National Defense Authorization Act for Fiscal Year 2017. This act extended FEDVIP eligibility to certain TRICARE-eligible individuals starting in 2019, coinciding with the discontinuation of the TRICARE Retiree Dental Program.
FEDVIP operates on a group insurance model, which translates to competitive premiums and the advantage of no pre-existing condition limitations. For federal and postal employees, premiums are conveniently withheld from their salary on a pre-tax basis, offering additional savings.
FEDVIP Eligibility: Federal Employees and TRICARE
Eligibility for FEDVIP is broad, encompassing different categories of individuals. Federal employees who are eligible for the FEHB Program are also eligible to enroll in FEDVIP, regardless of whether they are actually enrolled in FEHB. This is a crucial distinction: FEHB eligibility, not enrollment, is the key for active federal employees. Retirees, or annuitants, have a different rule set; they do not need to be eligible for or enrolled in FEHB to qualify for FEDVIP.
The expansion of FEDVIP eligibility to “certain TRICARE-eligible individuals” is a significant point. This means that individuals who are eligible for TRICARE, particularly retirees and their families who lost dental coverage with the TRICARE Retiree Dental Program cessation, gained access to FEDVIP’s dental and vision plans. This expansion aimed to provide a seamless transition and continued access to affordable dental and vision care for this specific group.
Key Differences: FEDVIP, FEHB, and TRICARE
While FEDVIP now includes some TRICARE-eligible individuals, it’s essential to understand that it is not the same as either FEHB or TRICARE.
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FEHB (Federal Employees Health Benefits Program): FEHB is a comprehensive health insurance program offering a wide range of health plans, including medical, surgical, and hospital coverage. It’s a broad healthcare program. FEDVIP, in contrast, is specifically focused on dental and vision insurance. You can think of FEDVIP as a supplement to FEHB, covering areas FEHB might not fully address, or offering more specialized options for dental and vision care.
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TRICARE: TRICARE is the healthcare program for uniformed service members, retirees, and their families worldwide. It provides comprehensive health coverage similar in scope to FEHB, but for a different population. While some TRICARE beneficiaries are now eligible for FEDVIP, TRICARE itself is a complete healthcare system, not just dental and vision. FEDVIP for TRICARE-eligible individuals fills a specific gap in dental and vision coverage that existed after the TRICARE Retiree Dental Program ended.
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Family Member Eligibility: It’s important to note that FEDVIP and FEHB have different rules regarding family member eligibility. Changes in dependent eligibility under the Affordable Care Act, for instance, do not affect FEDVIP eligibility for children. Furthermore, FEDVIP has specific definitions for eligible family members, including spouses and unmarried dependent children (with age limits varying based on student status and TRICARE eligibility). These FEDVIP family eligibility rules are not the same as FEHB rules, adding another layer of distinction between the programs.
Enrolling in FEDVIP
Enrollment in FEDVIP typically occurs during the annual Federal Benefits Open Season in November and December. New employees, or those newly eligible, can enroll within 60 days of becoming eligible. Individuals can choose to enroll in either a dental plan, a vision plan, or both. Coverage options include Self Only, Self Plus One, or Self and Family, allowing for tailored coverage to meet individual and family needs.
For any enrollment or premium-related questions regarding dental and vision insurance under FEDVIP, BENEFEDS is the primary point of contact. They can be reached at 1-877-888-3337, or you can visit their website at www.BENEFEDS.com to enroll and find more information.
In conclusion, while FEDVIP and TRICARE now have an overlap in terms of eligibility for certain individuals, and while FEDVIP eligibility for federal employees is linked to FEHB eligibility, these are distinct programs serving different purposes and populations. FEDVIP is a specialized dental and vision benefit program designed to enhance the overall benefits package available to federal employees, retirees, and specific TRICARE-eligible individuals, offering valuable and affordable coverage in these crucial areas of health.
