The Federal Employees Health Benefits (FEHB) program is often considered one of the most valuable benefits available to federal employees in retirement, particularly because the federal government subsidizes up to 75% of the premium. It is crucial to stay informed about the requirements for retaining FEHB coverage in retirement, as losing this coverage means you will not have the opportunity to re-enroll.
Eligibility Requirements for Continuing FEHB Coverage in Retirement
To maintain your FEHB coverage into retirement, you must meet the following criteria:
Retire on an Immediate Annuity: You must retire on an immediate annuity as a civilian employee, including those under the Federal Employees Retirement System (FERS) Minimum Retirement Age (MRA) + 10 provisions. This means your annuity must begin accruing no later than one month after your final separation from service.
Continuous Enrollment Requirement: You must have been continuously enrolled in any FEHB Program plan (it does not need to be the same plan) for the five years immediately preceding your retirement, or, if you have less than five years of service, for all periods of service since your first opportunity to enroll. Time covered under TRICARE also counts toward this five-year requirement, provided you are enrolled in FEHB at the time of retirement.
Changing FEHB Enrollment at Retirement
It is important to note that retirement is not considered a qualifying life event (QLE) for the purposes of changing your FEHB enrollment. Therefore, you cannot change your FEHB plan when you retire. Changes to your FEHB enrollment can only be made during the annual Open Season or if you experience a QLE.
FEHB Coverage and Premiums in Retirement
Your FEHB coverage and premium will remain unchanged when you retire. The federal government continues to subsidize the same portion of your premium, up to 75%, based on a formula established by law. As a retiree, you are typically responsible for covering the remaining portion, which is usually about 30%. Premium payments will be deducted from your monthly pension on a post-tax basis. If your pension does not fully cover the premium cost, you may pay your premiums through automatic bank withdrawals.
Cancellation and Reenrollment of FEHB Coverage After Retirement
If you cancel your FEHB enrollment after retiring, you will not be able to re-enroll in the future. However, you may suspend your FEHB enrollment to enroll in a Medicare Advantage plan, TRICARE, CHAMPVA, or Medicaid. For further information on suspending your enrollment, contact the Office of Personnel Management’s (OPM) Retirement Information Office at 1-888-767-6738.
Continuing FEHB Coverage for Family Members After Your Death
If you are enrolled in a Self Plus One or Self and Family plan at the time of your death, your family members may continue FEHB coverage, provided at least one family member is entitled to a survivor annuity under the Federal Employees Retirement System (FERS) or Civil Service Retirement System (CSRS).
For additional details, refer to the FEHB Fast Facts and the FEHB Handbook.
