FEDVIP Dental Program | EmblemHealth

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The EmblemHealth FEDVIP Dental Program

At EmblemHealth, we believe your dental health is key to your overall health.

That’s why we offer a great dental plan through the Federal Employees Dental and Vision Insurance Program (FEDVIP).

The EmblemHealth FEDVIP Dental Program is a unique program created especially for federal employees and retirees. The program is available only to eligible federal employees who live or work in New York, New Jersey, Pennsylvania, and Connecticut, in the following counties:

  • New York State: All counties.
  • New Jersey: Bergen, Essex, Hudson, Middlesex, Monmouth, Morris, Passaic, Somerset, Sussex, and Union.
  • Pennsylvania: Monroe and Pike.
  • Connecticut: Fairfield, Litchfield, and New Haven.

As a FEDVIP member, you can choose from any of our thousands of network dentists. Plus, it’s easy to receive the dental care you need because you don’t need any referrals with this plan.

Our FEDVIP plan stands out because it offers:

• Low cost-sharing.

• Great benefits. Our plan includes 100% in-network dental coverage for preventive dental services and complex procedures.

We encourage you to visit BENEFEDS.com for a comparison between our program and the dental options offered by other insurers. At BENEFEDS.com, you can sign up for the EmblemHealth FEDVIP Dental Program. Or, you can call BENEFEDS at 877-888-3337 for assistance.

We’re committed to creating healthier futures for our members and our community.

Enrollment: 1-877-888-3337. You must contact BENEFEDS to enroll.

Customer Service: 877-842-3625 (TTY: 711) from 8 a.m. to 6 p.m., seven days a week (excluding major holidays).

FEDVIP Dental Program | EmblemHealth

Benefits at a Glance: EmblemHealth FEDVIP Dental Program

Preventive and Diagnostic Services

Covers services meant to maintain good dental health, including exams, x-rays, cleanings, and fluoride treatments. Two exams and two cleanings per covered person are payable in a calendar year.

Paid in full in-network. Deductible applies to out-of-network benefits only.

Intermediate Services and Periodontal and Endodontic Services

Covers fillings, extractions, denture/crown/bridge repair, emergency treatments, oral surgery, anesthesia/IV sedation, and specialist consultations.

Paid in full in-network. Deductible applies to out-of-network benefits only.

Major Services

Covers root canals, crowns, gingivectomy periodontal surgery, fixed bridgework, and dentures.

 

 

Implants (includes crowns)

Paid in full in-network. Deductible applies to out-of-network benefits only.

 

High Option: $4,500
Standard Option: $3,000
maximum allowance. Deductible applies to out-of-network benefits only.

Calendar Year Deductible

Applies to intermediate and major services received out-of-network only.

In-network: $0 individual/$0 family

Out-of-network: $50 individual/$150 family

Maximum Benefit Payout

Annual maximum per covered member (not including orthodontia)

 

 

Lifetime orthodontia maximum per covered member. (Orthodontia benefits are effective at the time coverage begins. Adults are covered for orthodonthia.)

Unlimited

 

 

 

High Option: $4,000
Standard Option: $3,000

Out-of-Network Reimbursement

The member pays the difference between EmblemHealth’s payment and the provider’s charge.

Refer to the plan’s Preferred Schedule.

 

Note that you must live or work in the following counties where we have network providers in order to be eligible for this program:

  • New York State: All counties.
  • New Jersey: Bergen, Essex, Hudson, Middlesex, Monmouth, Morris, Passaic, Somerset, Sussex, and Union.
  • Pennsylvania: Monroe and Pike.
  • Connecticut: Fairfield, Litchfield, and New Haven.

EmblemHealth FEDVIP Dental Program RI Download (PDF)

For easy access to information about your dental benefits, claim status, benefits eligibility, and more, simply visit emblemhealth.com and register for your personal account.

2024 EmblemHealth FEDVIP Dental Program

It’s easy to receive care when you have our FEDVIP Dental plan. You’ll be able to choose from any of our thousands of network dentists and specialists in New York, New Jersey, Pennsylvania, and Connecticut without ever needing a referral or to fill out paperwork.

You’ll even receive reimbursement for covered services performed by out-of-network dentists based on the plan’s in-network allowance. Should you choose to receive care from out-of-network dentists, just submit a claim to us. We’ll send you a check for the amount we cover. Please be aware, however, that since we don’t have a payment contract with out-of-network dentists, the amount we pay you may not be the full amount the dentist charged.

Need to see a dentist?

To find a dentist in your plan’s network, go to our Find a Doctor tool. You can use the handy Map and Directions tool to locate a dentist’s office when you click on his or her name in our directory. 

 

Choosing FEDVIP Dental

If you’d like to enroll in the EmblemHealth FEDVIP Dental Program, it’s easy to do — just register and log on at BENEFEDS.com and select the EmblemHealth FEDVIP dental option. You can also call BENEFEDS at 877-888-3337 for assistance.

Make sure to include the EmblemHealth FEDVIP Dental Program enrollment codes as shown on the Enrollment Codes and Rates section of this page.

If you’re already in the EmblemHealth FEDVIP Dental Program, you don’t need to do anything. Your coverage will continue automatically.    

Provider Coverage

With our robust network of quality doctors, you can get care from many of the region’s leading doctors, clinicians and facilities, including hospitals and urgent care centers.

A partner in wellness

The Right Care, Right in Your Neighborhood

AdvantageCare Physicians are the newest addition to the EmblemHealth family and are now one of the largest primary and specialty care practices in New York City. With 37 locations throughout New York City and Long Island, you can find a convenient location near home or work.