Frequently Questioned Services 

This chart lists items the Office of Personnel Management often receives inquiries on as to how, or ifcovered under our benefit Programs. Links to Program materials are on the last page. If an item on this list is important to you,
 1) review your health insurance coverage under the Federal Employees Health Benefits (FEHB) Progis sufficient (if your current health plan does not meet your needs, then you may want to consider a2) consider dental or vision coverage under the Federal Employees Dental and Vision Insurance ProgFEHB coverage does not meet your needs (if your current dental and/or vision plan does not meet ymay want to consider another FEDVIP plan); and
 3) consider a flexible spending account (FSAFEDS) to save money and pay for eligible health care excovered or reimbursed under FEHB or FEDVIP. FSAFEDS allows you to contribute money from your are withheld, to an account that reimburses you after you incur eligible out-of-pocket dependent carexpenses.
 

If the following 

services are 

important to you 

and/or your 

family... 

review your health insurance 

coverage... 

consider dental or vision 

coverage... 

consid

Alternative medicine such as chiropractic care, acupuncture, massage therapy 

Some alternative medicine services may be covered by your FEHB plan. Review your plan’s current brochure for the services that are covered. 

N/A Acupunctur

are eligibleMassage thby a physicinjury, traumeligible. A lrequired. 

Assisted reproductive technology (ART) procedures such as in vitro fertilization 

Assisted reproductive services may be covered by your FEHB plan. Review your plan’s current brochure for services that are covered. 

N/A Assisted rep

eligible. 

Always refer to the individual FEHB and FEDVIP brochures and the www.FSAFEDS.com website befor

enrollment decisions. 
If the following 

services are 

important to you 

and/or your review your health insurance consider dental or vision consid

family... coverage... coverage... 

Artificial Artificial insemination is covered by FEHB N/A Artificial ininsemination or Health Maintenance Organization (HMO) eligible. 

other infertility plans and may be covered by other types of treatment FEHB plans. 

Review your plan’s current brochure for 

limitations or exclusions (such as the cost of donor sperm). 

Charges above Charges above the plan’s allowance will not For in-network providers, charges Medical exp

the Plan’s be paid by the plan. above the plan’s allowance will or FEDVIP 

allowance 

If you use a plan’s participating or preferred 

provider, you will not be responsible for these charges. 

not be paid by the plan. In some plans, out-of-network provider payments are based on usual and customary fees, not the plan allowance. 

eligible. 

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, complete dentures and adjustments, root canals, crowns, oral surgery, and bridges. Orthodontic services for dependent children younger than 19 are also covered under the dental FEDVIP plans. 

Non-cosmet

Diabetic testing supplies 

Diabetic testing supplies are covered. Review your plan’s current brochure for the level of reimbursement. 

N/A Diabetic tes

Always refer to the individual FEHB and FEDVIP brochures and the www.FSAFEDS.com website befor

enrollment decisions. 
If the following 

services are 

important to you 

and/or your 

family... 

review your health insurance 

coverage... 

consider dental or vision 

coverage... 

consid

First aid kits/supplies 

Dressings, antiseptics and other first aid supplies generally are not covered, 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 First aid kits

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 fo

eligible expphysician anstatement thalleviate a mmedical nec

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 fo

from surfacechild who hhaving lead are eligible. repair and w

Orthodontics Orthodontic services may be covered by your 

FEHB plan. 

FEDVIP dental plans provide orthodontic care for dependent children younger than 19. 

Orthodontic 

Always refer to the individual FEHB and FEDVIP brochures and the www.FSAFEDS.com website befor

enrollment decisions. 
If the following 

services are 

important to you 

and/or your review your health insurance consider dental or vision consid

family... coverage... coverage... 

Review your health plan’s current brochure 

for the orthodontic services that are covered. 

Dental plans may have a waiting period and a lifetime maximum for orthodontic services. 

Over-the-counter Drugs that do not require a prescription for N/A Over-the-co(OTC) medicine their purchase are generally excluded from medicines o

and supplies coverage. and cold me

eligible for r

have a prescyour physicItems that anot require a 

Prescription drugs (including maintenance medications) 

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. 

Deductiblesas well as coeligible. 

Speech generating devices 

Speech generating devices may be covered by your FEHB plan. Review your plan’s current brochure for services that are covered. 

N/A Speech gene

adaptive equdisability andaily living medical nec

Transportation Ground transportation by ambulance is N/A Costs of tran

for medical care 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. 

medical care reimbursemrequirement

Always refer to the individual FEHB and FEDVIP brochures and the www.FSAFEDS.com website befor

enrollment decisions. 
If the following 

services are 

important to you 

and/or your 

family... 

review your health insurance 

coverage... 

consider dental or vision 

coverage... 

consid

Vision services Diagnosis and treatment of medical 

conditions, such as glaucoma and cataracts, are covered. Common services such as: examinations, eyeglasses, contacts and replacement lenses may be covered by your FEHB plan. Review your plan’s current brochure for the vision services that are covered. 

FEDVIP vision plans cover services that FEHB plans may cover plus: frames, lenses (bifocal, trifocal, lenticular) and laser vision correction discounts. 

Vision care 

exams, visivision theralenses). 

Program information is 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 PrHealth insurance plan brochures are at www.opm.gov/insure/health/planinfo. 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. 

Always refer to the individual FEHB and FEDVIP brochures and the www.FSAFEDS.com website befor

enrollment decisions.