Services Not Covered

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Table of Contents

Changes for 2025

FEDVIP Program Highlights

Section 1 Eligibility

Section 2 Enrollment

Section 3 How You Obtain Care

Section 4 Your costs for Covered Services

Section 5 Dental Services and Supplies Class A Basic

Class B Intermediate

Class D Orthodontic

General Services

Section 6 International Services and Supplies

Section 7 General Exclusions - Things We Do Not Cover

Section 8 Claims Filing and Disputed Claims Process

Section 9 Definitions of Terms We Use in This Brochure

Tools and Resources

Summary of Benefits

Stop Health Care Fraud!

Rate Information

Blue Cross Blue Shield FEP Dental Brochure - 2025

Blue Cross Blue Shield FEP Dental
Section 5 Dental Services and Supplies Class A Basic

Services Not Covered

Refer to Section 7 for a list of general exclusions

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