The Federal Employees Health Benefits (FEHB) program is a group health insurance program for those who work for the federal government or certain tribal organizations.
How to Enroll:
As a new employee, you may enroll during a 60-day period from when you become eligible for healthcare benefits. Eligibility typically means you have worked for at least 90 days with more than 130 hours per month. You may enroll in or switch plans every year during a period called open season (similar to the Marketplace’s open enrollment), which begins in November and ends in December. You may also enroll outside of open season with a qualifying life event such as a change in household or employment status.
Similar to other employee group plans, a portion of a federal employee’s salary is deducted for premiums. The government shares the cost of the premium with you, typically around 70%.
To enroll, visit the government website for your division. Many employees use Employee Express to sign up or change their plans. While online electronic services are the main way to enroll, over-the-phone resources are also available. For example, U.S. Postal Service employees may enroll by calling their Employee Service Line. The Office of Personnel Management has a comprehensive list of the different websites here.
Health Benefits:
FEHB plans are approved by the Office of Personnel Management (OPM) and include fee-for-service, PPO, and HMO plans. Plans are offered by private insurers, such as BlueCross BlueShield. Plans differ by state and can be checked here. The OPM also has a plan comparison tool to help you get started.
FEHB plans are ACA-compliant, meaning enrollees enjoy the same rights guaranteed by the Affordable Care Act.
Some, but not all, FEHB plans include dental and vision benefits. Most FEHB enrollees purchase separate dental and vision benefits through the Federal Employees Dental and Vision Insurance Program (FEDVIP). You must be eligible for FEHB plans to be eligible for FEDVIP.
Terminating Coverage:
You are guaranteed a 31-day extension of coverage without cost to you if you leave your employment. If you would like to continue your FEHB plan, there are two options to do so:
For those who are retiring, you can continue with your coverage but premiums will be deducted from your annuity. This is only available to those who have had FEHB for at least five years before retirement.
And finally, if you would like to buy individual health coverage on the Marketplace, you must use up your TCC eligibility.
FEHB and Medicare:
FEHB and Medicare plans can be coordinated depending on your needs and preferences. Yes, there may be more insurance carriers to keep track of, but keeping your FEHB plan while also enrolling in Medicare might provide a more comprehensive provider network and healthcare coverage. For example, Medicare doesn’t have an out-of-pocket limit for drug costs, but FEHB plans do. Additionally, while some FEHB plans cover dental and vision services, Original Medicare does not. FEHB plans also provide prescription drug coverage, so Medicare enrollees will not need to purchase a Part D plan. However, if you enroll in a Medicare Advantage or Medigap plan, you must suspend your FEHB.
Most people who have retiree coverage must enroll in Medicare Part A and Part B when first eligible. If they don’t enroll, their retiree plan may pay only a small amount – or nothing – for their care. However, Medicare’s rules are different if you’re a federal retiree. As a federal retiree, if you don’t enroll in Medicare, your FEHB plan will act as your primary insurer.
However, if you choose to delay your enrollment in Part B (which has a monthly premium), you may find that you’re subject to a late enrollment penalty if you eventually decide later on that you’d like to enroll in Part B. If you continue working past age 65, you can safely delay Part B while you’re still enrolled in FEHB coverage as an active employee. But once you transition to retiree coverage, you have an eight-month window during which you can enroll in Part B at any time without a penalty. But after that window ends, your opportunity to enroll in Part B will be limited to the January - March General Enrollment Period, and you would be subject to a late enrollment penalty for Part B if you delay your enrollment for 12 months or longer.
If you need additional help determining what your optimal health plan coverage options are, reach out to your financial advisors to request a HealthPlanning Analysis!
Learn more:
Healthcare & Insurance | OPM.gov
Last Revised June 6th, 2023
