Before You Schedule That Dentist Appointment, Read This FEDVIP Update That Might Affect Your Costs

Key Takeaways

• The 2025 FEDVIP program update affects both retirees and active public sector workers, with changes in coverage tiers, premiums, and enrollment rules.

• Understanding how your dental or vision plan interacts with Medicare, PSHB, and retirement status is crucial before scheduling any healthcare service this year.

What You Need to Know About FEDVIP in 2025

As a government employee or retiree, your dental and vision coverage through the Federal Employees Dental and Vision Insurance Program (FEDVIP) plays a critical role in your overall healthcare planning. And in 2025, several updates to FEDVIP are quietly reshaping what coverage looks like, especially if you are retired or nearing retirement. If you’re planning a routine dental cleaning or a new set of glasses, it’s important to check your coverage details first. Here’s what you should be paying attention to this year.

FEDVIP Remains Separate from PSHB and FEHB

FEDVIP is not merging into the new Postal Service Health Benefits (PSHB) program or the existing Federal Employees Health Benefits (FEHB) program. It remains a standalone program. This means:

• You must enroll in FEDVIP separately during Open Season (November to December) or after a Qualifying Life Event.

• Enrollment is not automatic when you retire. If you want to keep your dental and vision benefits, you need to elect FEDVIP coverage.

• Premiums are paid post-tax for retirees and pre-tax for employees under premium conversion.

Who Is Eligible in 2025?

Eligibility hasn’t changed significantly in 2025, but there are nuances to understand:

• Active government employees eligible for FEHB can enroll in FEDVIP.

• Retirees with an immediate annuity are eligible.

• Survivor annuitants remain eligible.

• Former spouses are not eligible for FEDVIP, even if they receive a portion of your annuity.

• Family members (spouse and children under 22) are covered under family plans but not after divorce or age-out unless covered by a separate provision.

How FEDVIP Works with Medicare and PSHB

Many retirees in 2025 are also enrolled in Medicare. Here’s how FEDVIP interacts with your other coverage:

• FEDVIP does not coordinate with Medicare, since dental and vision services are generally not covered by Medicare Parts A or B.

• If you are also in PSHB and enrolled in Medicare Part B, your PSHB plan may waive deductibles or offer reduced copayments, but FEDVIP coverage is unaffected.

• There is no requirement to enroll in Medicare to maintain FEDVIP coverage.

This means if your vision or dental needs are not being met through Medicare or PSHB, you must keep your FEDVIP plan active.

Enrollment Rules and Reminders for 2025

There are no mid-year changes allowed unless you experience a Qualifying Life Event. The primary enrollment periods are:

• Open Season: Held every year from November to December. In 2025, the period remains unchanged.

• QLEs (Qualifying Life Events): Include retirement, marriage, divorce, birth, death of a family member, or loss of other coverage. You have 60 days from the event to make a change.

Make sure your enrollment reflects your retirement status, family composition, and coordination with other insurance.

General Costs You Should Prepare For

While exact premiums vary, there are some general financial aspects that are common across plans in 2025:

• Monthly premiums are higher for Self Plus One and Self and Family options.

• Copayments and coinsurance apply for most services, like fillings, root canals, and prescription lenses.

• Annual maximums are typical in dental plans, capping how much the insurer will pay each year.

• Orthodontic benefits for adults may be limited or not covered at all, depending on the plan.

• Vision plans generally include a fixed copay for eye exams and an allowance for glasses or contact lenses.

Knowing these cost structures helps you avoid surprises when scheduling services.

What Changed in 2025?

1. Expanded Plan Options for Some Areas
   Some regions now have more plan options than in previous years, giving you greater flexibility to choose coverage tailored to your needs. This also introduces new variations in network providers.

2. Network Participation Fluctuations
   Some providers who previously accepted FEDVIP plans may no longer be in-network, especially among dental chains. Before booking an appointment, confirm provider participation.

3. Increased Emphasis on Preventive Care
   More plans are now covering 100% of preventive services such as cleanings, fluoride treatments, and basic eye exams, without applying it toward the annual maximum. This change benefits proactive enrollees.

4. Digital Tools and Enhanced Member Portals
   FEDVIP carriers have improved their online tools for tracking benefits, comparing costs, and estimating out-of-pocket expenses. Use your member portal before scheduling any procedures.

5. More Targeted Communication
   Enrollees now receive more personalized reminders via email or mail if they haven’t used key benefits in the first half of the year. This is especially true for vision plan holders who skip exams.

Don’t Confuse FEDVIP with PSHB Dental Add-ons

Some PSHB plans offer limited dental benefits as add-ons for certain services like extractions or hospital-based oral surgery. These are not a replacement for full FEDVIP dental coverage. Relying solely on PSHB dental riders may leave you:

• Without coverage for routine cleanings or fillings

• Exposed to high out-of-pocket costs for crowns or root canals

• Unable to access orthodontic services

To ensure complete dental coverage, you must remain enrolled in FEDVIP regardless of your PSHB plan.

Planning Around Retirement

If you are planning to retire in 2025 or recently did, make sure you:

• Elect FEDVIP during Open Season prior to retirement or immediately after via a QLE.

• Continue paying premiums to maintain uninterrupted coverage.

• Understand that you can continue FEDVIP for life, as long as you meet eligibility and payment requirements.

• Evaluate your dental and vision needs for the next 5 to 10 years, since post-retirement dental costs can be significant.

Reviewing Your Plan Annually Matters

You might have the same FEDVIP plan you’ve had for years, but with changing coverage and costs, automatic renewal could lead to:

• Higher-than-expected out-of-pocket costs

• Loss of access to preferred providers

• Missing new benefits or lower-cost alternatives

Every year during Open Season, review:

• Plan brochures and benefit summaries

• Network directories to confirm provider access

• Coordination with PSHB or Medicare

• Expected dental or vision care needs in the upcoming year

Taking Action Can Prevent Overpaying

It’s easy to assume your FEDVIP plan is working well just because you haven’t had major issues. But with the growing complexity of healthcare in retirement, small changes can have big financial consequences. Don’t wait until you’re in the dental chair to realize your coverage changed.

Instead:

• Log into your FEDVIP plan portal and review benefit details

• Contact the customer service line for questions about coverage

• Compare at least two plan options before Open Season ends

Even if you decide not to change plans, confirming the details now helps you make informed choices all year.

Staying Covered and Informed in Retirement

In 2025, your dental and vision care are more than just a personal health issue. They’re a financial planning issue. As more public sector retirees rely on fixed incomes and Medicare for their general healthcare, programs like FEDVIP become increasingly essential for maintaining quality of life.

Keep this checklist in mind:

• Enroll or re-enroll during Open Season or after a QLE

• Review your plan every year, not just once at retirement

• Confirm provider participation before appointments

• Understand what is and isn’t covered

• Know how your other insurance integrates

If you’re unsure whether your current plan meets your long-term needs, it’s time to ask for help.

Make the Most of Your FEDVIP Choices This Year

You’ve worked hard for your benefits. Now is the time to make sure they’re working just as hard for you. Don’t let small missteps in dental or vision coverage turn into big expenses.

To protect your retirement health budget and avoid costly surprises, speak with a licensed professional listed on this website who can walk you through your options, help you review your current plan, and ensure your next dental or vision appointment won’t bring unexpected bills.