Before making your final enrollment decisions, always refer to the individual FEHB and FEDVIP brochures a

FREQUENTLY QUESTIONED SERVICES

This chart lists items the Office of Personnel Management often receive inquiries on as to how, or if, the items are cove

Programs. Links to Program materials are on the last page of this document.

If an item on this list is important to you:

1) Review your health insurance coverage under the Federal Employees Health Benefits (FEHB) Program to determ

current health plan does not meet your needs, then you may want to consider another FEHB plan;

2) Consider dental or vision coverage under the Federal Employees Dental and Vision Insurance Program (FEDVIP) 

not meet your needs (if your current dental and/or vision plan does not meet your needs, then you may want t

plan); and

3) Consider a flexible spending account (FSAFEDS) to save money and pay for eligible health care expenses that ar

under FEHB or FEDVIP. FSAFEDS allows you to contribute money from your salary before taxes are withheld, to you after you incur eligible out‐of‐pocket dependent care and/or healthcare expenses.

If the following services are

important to you and/or

your family...

review your health insurance coverage... consider dental or vision coverage... conside

Alternative medicine suchas chiropractic care,

acupuncture, massagetherapy

Some alternative medicine services may becovered by your FEHB plan.

Review your plan’s current brochure for the

services that are covered.

N/A Acupunctu

eligible.Massage th

a physician 

trauma or A letter of 

Artificial insemination orother infertility treatment

Artificial insemination is covered by FEHB Health

Maintenance Organization (HMO) plans and

may be covered by other types of FEHB plans.Review your plan’s current brochure forlimitations or exclusions (such as the cost of

donor sperm).

N/A Artificial in
If the following services are

important to you and/or

your family...

review your health insurance coverage... consider dental or vision coverage... conside

Assisted reproductive

technology (ART)

procedures such as in vitrofertilization

Assisted reproductive services may be covered

by your FEHB plan.

Review your plan’s current brochure for services

that are covered.

N/A Assisted re

Charges above the Plan’sallowance

Charges above the plan’s allowance will not be

paid by the plan.

If you use a plan’s participating or preferred

provider, you will not be responsible for these

charges.

For in‐network providers,

charges above the plan’s

allowance will not be paid bythe plan. In some plans, out‐

of‐network provider paymentsare based on usual and

customary fees, not the planallowance.

Medical ex

FEDVIP pla

Dental services Common services such as: diagnostic services,

preventive services, exams, x‐rays, cleanings,

and care for accidental injury may be covered by

your FEHB plan.Review your plan’s current brochure for the

dental services that are covered.

FEDVIP dental plans cover

services that FEHB plans may

cover plus: fillings, extractions,

periodontal scaling, completedentures and adjustments,root canals, crowns, oralsurgery, and bridges.Orthodontic services fordependent children youngerthan 19 are also covered underthe dental FEDVIP plans.

Non‐cosme

Diabetic testing supplies Diabetic testing supplies are covered.

Review your plan’s current brochure for the

level of reimbursement.

N/A Diabetic te

Before making your final enrollment decisions, always refer to the individual FEHB and FEDVIP brochures a
Before making your final enrollment decisions, always refer to the individual FEHB and FEDVIP brochures a

If the following services are

important to you and/or

your family...

review your health insurance coverage... consider dental or vision coverage... conside

First aid kits/supplies Dressings, antiseptics and other first aid supplies

generally are not covered, but some plans mayoffer additional benefits that are not part of the

FEHB contract.Check your FEHB plan’s brochure for details onnon‐FEHB benefits.

N/A First aid kit

Gym memberships Gym memberships generally are not covered

under regular FEHB benefits, but some plans

may offer additional benefits that are not part

of the FEHB contract.

Check your FEHB plan’s brochure for details on

non‐FEHB benefits.

N/A Fees paid f

eligible exp

physician a

statement 

alleviate a 

medical ne

Hearing aids Hearing aids may be covered by your FEHB plan.

Review your plan’s current brochure for services

that are covered.

N/A Hearing aid

expenses.

Lead based paint removal Paint removal is not a covered service under

FEHB plans.

N/A Expenses f

from surfa

child who h

having lead 

are eligible

repair and 

Orthodontics Orthodontic services may be covered by your

FEHB plan.Review your health plan’s current brochure for

the orthodontic services that are covered.

FEDVIP dental plans provide

orthodontic care fordependent children youngerthan 19.Dental plans may have awaiting period and a lifetime

maximum for orthodontic

services.

Orthodont
If the following services

are important to you

and/or your family...

review your health insurance coverage... consider dental or vision coverage... conside

Over‐the‐counter (OTC)

medicine and supplies

Drugs that do not require a prescription for theirpurchase are generally excluded from coverage.

N/A Over‐the‐c

medicines 

allergy and 

are not elig

you have a 

written by 

Items that 

not require 

Prescription drugs(including maintenancemedications)

Prescription drugs are covered.

Review your plan’s current brochure for the

level of reimbursement and any categories of

drugs that are excluded from coverage.

Prescription drugs obtainable

at a pharmacy are not covered.

Deductible

as well as c

eligible.

Speech generating devices Speech generating devices may be covered by

your FEHB plan.Review your plan’s current brochure for servicesthat are covered.

N/A Speech gen

adaptive e

disability a

daily living medical ne

Transportation for medical

care

Ground transportation by ambulance is covered

when medically appropriate.Air transportation by ambulance when required

because of a medical emergency may also be

covered.Transportation costs other than for ambulance

services are generally not covered.

N/A Costs of tra

medical careimburserequireme

Before making your final enrollment decisions, always refer to the individual FEHB and FEDVIP brochures a
Vision services Diagnosis and treatment of medical conditions, FEDVIP vision plans cover Vision care 

such as glaucoma and cataracts, are covered.Common services such as: examinations,eyeglasses, contacts and replacement lenses

services that FEHB plans may

cover plus: frames, lenses

(bifocal, trifocal, lenticular) and

laser vision correction

exams, visvision therlenses).

may be covered by your FEHB plan. discounts.

Review your plan’s current brochure for the

vision services that are covered.

 Program information may be found on our website at www.opm.gov/insure Go to www.opm.gov/insure/fastfacts to read FastFact highlights on each of these benefit Programs Health insurance plan brochures are at www.opm.gov/FEHBbrochures Dental insurance plan brochures are at www.opm.gov/insure/dental/planinfo

 Vision insurance plan brochures are at www.opm.gov/insure/vision/planinfo For information on FSAFEDS, please visit the FSAFEDS website at www.fsafeds.com

Before making your final enrollment decisions, always refer to the individual FEHB and FEDVIP brochures a