Before making your final enrollment decisions, always refer to the individual FEHB and FEDVIP brochures and www.FSAFEDS.com. 

1

FREQUENTLY QUESTIONED SERVICES 

This chart lists items the Office of Personnel Management often receives inquiries on as to how, or if, the items are covered under our benefit 

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 determine if it is sufficient. If your 

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) if your FEHB coverage does 

not meet your needs (if your current dental and/or vision plan does not meet your needs, then you may want to consider another FEDVIP 

plan); and 

3) Consider a flexible spending account (FSAFEDS) to save money and pay for eligible health care expenses that are not covered or reimbursed 

under FEHB or FEDVIP. FSAFEDS allows you to contribute money from your salary before taxes are withheld, to an account that reimburses 

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...

consider a flexible spending account.

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 Acupuncture and chiropractic expenses are 

eligible. 

Massage therapy expenses if prescribed by 

a physician for a specific illness, injury, 

trauma or condition are potentially eligible. 

A letter of medical necessity is required. 

Artificial insemination or 

other 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 for 

limitations or exclusions (such as the cost of 

donor sperm).

N/A Artificial insemination expenses are eligible.
Before making your final enrollment decisions, always refer to the individual FEHB and FEDVIP brochures and www.FSAFEDS.com. 

2

If the following services are 

important to you and/or 

your family...

review your health insurance coverage...

consider dental or vision 

coverage...

consider a flexible spending account. 

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 reproductive expenses are eligible. 

Charges above the Plan’s 

allowance

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 by 

the plan. In some plans, outof-network provider payments 

are based on usual and 

customary fees, not the plan 

allowance.

Medical expenses in excess of your FEHB or 

FEDVIP plan’s allowance may be 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-cosmetic dental expenses are eligible. 

Diabetic testing supplies Diabetic testing supplies are covered.

Review your plan’s current brochure for the 

level of reimbursement. 

N/A Diabetic testing supplies are eligible.
Before making your final enrollment decisions, always refer to the individual FEHB and FEDVIP brochures and www.FSAFEDS.com. 

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If the following services are 

important to you and/or 

your family...

review your health insurance coverage...

consider dental or vision 

coverage...

consider a flexible spending account. 

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/supplies are eligible. 

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 for a gym membership may be 

eligible expenses if prescribed by a 

physician and substantiated by his or her 

statement that membership is necessary to 

alleviate a medical condition. A letter of 

medical necessity is required. 

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 aids and batteries are eligible 

expenses. 

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

FEHB plans.

N/A Expenses for removing lead-based paint 

from surfaces in your home to prevent a 

child who has, has had, or is in danger of 

having lead poisoning from eating the paint 

are eligible. The surfaces must be in poor 

repair and within a child’s reach.

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 for 

dependent children younger 

than 19. 

Dental plans may have a 

waiting period and a lifetime 

maximum for orthodontic 

services. 

Orthodontic expenses are eligible. 
Before making your final enrollment decisions, always refer to the individual FEHB and FEDVIP brochures and www.FSAFEDS.com. 

4

If the following services 

are important to you 

and/or your family...

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

coverage...

consider a flexible spending account. 

Over-the-counter (OTC) 

medicine and supplies

Drugs that do not require a prescription for their

purchase are generally excluded from coverage.

N/A Over-the-counter products that are 

medicines or drugs (acne treatments, 

allergy and cold medicines, antacids, etc.) 

are not eligible for reimbursement – unless

you have a prescription for that item 

written by your physician. 

Items that are not medicines or drugs do 

not require a prescription. 

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.

Deductibles, copayments and coinsurance 

as well as costs for prescription drugs are 

eligible. 

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 generating devices and other 

adaptive equipment used for a major 

disability and to assist with activities of 

daily living may be eligible. A letter of 

medical necessity is required. 

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 transportation to/from locations of 

medical care may be eligible for 

reimbursement provided certain 

requirements are met. 
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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 expenses are eligible (i.e. eye 

exams, vision correction procedures, 

vision therapy, eyeglasses and contact 

lenses).

Program information may be found on our website at www.opm.gov/insure

Go to www.opm.gov/healthcare-insurance/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/healthcare-insurance/dental-vision/plan-information/#url=Dental-Overview 

Vision insurance plan brochures are at www.opm.gov/healthcare-insurance/dental-vision/plan-information/#url=Vision-Overview 

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 and www.FSAFEDS.com.