Learn: How Retirees Can Keep Federal Employee Health Benefits – FEHB

Oct 13, 2022 By Triston Martin


The Federal Employees Health Benefits (FEHB) programme is the world's largest employer-sponsored health insurance programme. More than 8 million current and former Federal employees, retirees, former employees, family members, and ex-spouses are covered by the programme, making it the largest health insurance programme in the world sponsored by an employer. The Federal Employees Health Benefits Program (FEHB) provides participants access to various alternative health insurance options, including high-deductible and consumer-directed health care plans and PPO and HMO health care plans.

When it comes to acquiring coverage or services and making payments, each plan has its particulars that must be followed. Some of the features included in all plans are hospitalisation, surgical care, inpatient and outpatient care, obstetrics care, mental health and substance addiction care, and coverage for prescription drugs. You will not be subject to any waiting periods or restrictions based on a person's health status at the time of plan enrollment or plan change if you have coverage through the FEHB.

What Conditions Must You Satisfy to Maintain FEHB After Retirement?

Even if it has been less than five years since you initially satisfied the program's eligibility standards, you may still be eligible for coverage under the Federal Employees Health Benefits (FEHB) if you or a member of your family have maintained continuous coverage under the FEHB since that time. You may be eligible to enrol in the FEHB plan of a family member if they have been continually enrolled in the programme, even if you have not been participating in it yourself.

There is a possibility that time spent on a family member's plan could count toward the five-year limit; however, the five-year rule will still be enforced. If you take a break from your duties at any point throughout the five-year vetting period, you must investigate whether or not you are still eligible. Those who have had gaps in their service may be eligible for exemptions from the requirement that they have served continuously for the past five years. The website is maintained by the United States Office of Personnel Management. It provides information regarding who is eligible for coverage under the Federal Employees Health Benefits (FEHB) programme and who is not eligible for such coverage.

Automatic Transfer of FEHB

Standard Form 3107 must be filled out in its whole for you to be eligible for retirement with an instant annuity. When you submit your retirement application, OPM should automatically transfer your FEHB coverage without requiring any further action from you. Even while it is likely that you will not be required to do any further steps to maintain your FEHB, it is still a good idea to check in with OPM to be on the safe side.

How Can You Add Family Members?

You are eligible to apply to join the health plan of a new spouse or child that you acquire after retirement, provided that you meet all of the requirements for doing so. You have the option during a Federal Benefits Open Season to switch from a Self-Only plan to a Self-and-Family plan if you are currently enrolled in the former. The first week of November and the second week of December are when the vast majority of FBOs take place.

What Is the Cost of Retirement?

A significant advantage of the Federal Employees Health Benefits Program (FEHB) for retirees is that the premiums remain the same year after year, in contrast to private health insurance. The government will continue to pay a portion of the costs associated with your health insurance premiums. This can lead to significant cost savings due to the Federal Employees Health Benefits Program's coverage of 72% and 75% of medical expenses.

This is a major benefit, especially when compared to the coverage provided by private employers. Many private firms, like the Federal Employees Health Benefits Program (FEHB), will pay for a portion of their employees' health insurance premiums while employed by that company. However, after they leave their jobs in the private sector, retirees almost often lose access to the health insurance policies that their employers provide. You will, rather, be required to transition to either a standalone health insurance coverage or, if you meet the requirements, Medicare.

Because of this change, the premiums you pay for your health insurance when you retire may go up. If you have Federal Employees Health Benefits (FEHB), you could see a change in the timing or amount of your retirement annuity payments. On the other hand, the total price that you have to spend should not go up. You, your spouse, your domestic partner, and your dependents may be able to reduce the amount of money you pay each month for health insurance premiums if they are eligible for coverage under your FEHB.


For you to be successful, you have to be skilled in the use of these methodologies. Insurance premiums paid when an individual is self-employed are not tax deductible. On the most recent version of your Leave and Earnings Statement, you will see "above the line" the amount deducted for your health insurance premiums, for which you are the primary insured. Your premium is shared between you and your employer, with your employer covering the vast majority. Payments received before taxes are given to employees while they are still actively working for their employer. After retirement, you lose the ability to deduct the cost of your medical insurance premiums. The premiums paid during retirement for the FEHB health insurance plan are not eligible for a tax deduction.

Related Articles