Standard dental 2024

Out-of-network deductible for Class B and C services is $25 Standard Self Only, $50 Standard Self Plus One and $75 Standard Self and Family.

¹ 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.

² Two bitewings covered annually for members 22 and under. One set of bitewings is covered per year for members ages 23+.

³ Implants on Standard are limited to $2,500 per person per year in-network, or $2,000 per person per year out-of-network.

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.

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.