Dental Standard Option 2021

No deductibles. No waiting periods.1


View the 2022 Standard Option Dental plan

Why you might like Standard Option:

  • GEHA’s lowest premium dental plan.
  • Includes $2,500 in-network annual maximum benefit per person.
  • No waiting periods, except for orthodontic services.

To compare the Standard Option side by side with the High Option, click Choose & Compare Plans.

1 No waiting period for Class A, Class B or Class C services. 12-month waiting period for Class D orthodontic services, Standard Option plan only.


2021 Plan Year Standard Option Benefit Schedule
What the plan pays In-network or out-of-network1
Class A – Basic
Two exams, two cleanings and one X-ray per calendar year
100%
Class B – Intermediate
Fillings, extractions and periodontal maintenance
55%
Class C – Intermediate
Root canals, crowns, bridges, dentures, periodontal surgery (implants limited to $2,500 per person/year)
35%
Class D – Orthodontics
Adults and children
70%
12-month waiting period
$2,500 lifetime maximum
Calendar year maximum
for Class A, B and C services
$2,500 per person
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.

1 There is no waiting period for Class A, Class B or Class C services. There is a 12-month waiting period for Class D orthodontic services on the Standard Option plan only.

2 If your out-of-network dentist charges more than GEHA’s agreed-upon plan allowance for a specific service, you are responsible for the difference between the plan allowance and the out-of-network dentist’s charge plus regular coinsurance.

Coordination of benefits – As with all FEDVIP plans, dental benefits available from your FEHB carrier will be considered before we calculate benefits paid by GEHA.

Orthodontic services – GEHA does not cover orthodontic services previously started with another carrier, except for High Option members with orthodontics started under TRICARE.

Choosing a dentist – You have the choice of providers. However, for many services, your out-of-pocket costs may be lower when you visit in-network locations. Network providers will not bill you more than the Plan's maximum allowable charge for covered services.

Claim forms – No special claim forms are required. Just send in the itemized bill from your provider.

Limitations and exclusions – This plan has certain limits on dental coverage in order to keep plan rates affordable for you and your dependents. A complete list of plan limitations and exclusions may be found in the Plan Brochure.

2021 GEHA Dental Plan Rates

For benefit year 2021 rates, refer to the Rate Information section of the 2021 plan brochure.


Included benefits & discounts

eye

Vision discount

You get discounts on eye exams, frames and lenses through EyeMed℠. The EyeMed network includes LensCrafters, Target Optical, independent eye doctors and top optical retailers. Members also save on LASIK at participating U.S. Laser Network locations.
assistive listening systems

Hearing aid discount

Get discounts through TruHearing on hearing aids. Most members save 30% to 60% off their hearing aids, averaging more than $2,500 per pair.
dental high option

Electric toothbrush discount

Save more than 70% off a premium electric toothbrush by cariPRO™. The cariPRO premium electric toothbrush helps reduce plaque buildup and improve gum health.1
tooth

Teeth whitening discount

Receive a 20% discount on the lowest published price on all Smile Brilliant home teeth whitening products. Includes custom-fitted trays, whitening gel and desensitizing gel.
heartbeat

Medical alert system

Get free activation, plus a 10% monthly discount, for responsive emergency help from Life Alert.

1 The cariPRO™ premium toothbrush removes seven times more plaque than a regular brush, is completely waterproof and comes with a two-year manufacturer‘s warranty. Replacement brush heads with high-quality DuPont™ bristles are also available at this exclusive, member-only price.