2023 GEHA Dental Benefits Guide

Definitions

Term

Definition

BENEFEDS is the government-authorized and U.S. Office of Personnel Management (OPM)-sponsored enrollment portal that eligible participants use to enroll in the Federal Employees Dental and Vision Insurance Program (FEDVIP). benefeds.com

BENEFEDS

Calendar year deductible

What you pay each year before the plan begins to pay out benefits.

Calendar year maximum

The maximum benefits that the plan will pay per person each calendar year.

Basic services that include preventive care such as oral exams, cleanings, diagnostic services, sealants and radiographic images.

Class A services

Intermediate services that include restorative procedures such as fillings, prefabricated stainless steel crowns, periodontal scaling, tooth extractions and denture adjustments. Major services that include endodontic services such as root canals, periodontal services such as gingivectomy, major restorative services such as crowns, oral surgery, bridges, implants and prosthodontic services such as complete dentures.

Class B services

Class C services

Class D services

Orthodontic services (braces).

Coinsurance

The percentage of covered expenses you must pay.

Any procedure or portion of a procedure performed primarily to improve physical appearance or performed for psychological purposes.

Cosmetic procedure

Any licensed dentist who is a part of GEHA’s provider network. To search for a provider, visit geha.com/Find-Care

In-network provider

The maximum benefits that the plan will pay per person. Orthodontic care on our Standard and High plans is subject to a lifetime maximum.

Lifetime maximum

The maximum amount the plan will pay for a specific procedure. The plan allowance may vary by geographic location and/or an in-network provider’s contracted fee schedule. When you use an out-of-network provider, you are responsible for the difference between the plan’s payment amount and the provider’s billed amount.

Plan allowance

The total amount paid to an insurance company for coverage, typically paid biweekly or monthly.

Premium

Visit geha.com/GetInTouch for ways to connect with a GEHA Benefits Adviser.

This is a brief description of services covered under the GEHA Connection Dental Federal plan. For a complete list of plan limitations and exclusions, please refer to the GEHA Connection Dental Federal plan brochure available online at geha.com/PlanBrochureDental

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2023 GEHA dental plans

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