Choose from the subcategories below to review the Frequently Asked Questions. Click on a question to expose the answer below.
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Choose from the subcategories below to review the Frequently Asked Questions. Click on a question to expose the answer below.
To return to the main FAQ page, just CLICK HERE.
Federal retirees and their surviving spouses retain their eligibility for FEHB health coverage at the same cost as current employees.
While we can't say that FEHB premiums won't go up in retirement, they won't go up BECAUSE you have retired. Both employees and retirees pay the same premium for a given plan.
There is a notable exception for postal workers who pay a lower premium than the average employee while working. They will switch to the normal premium upon retiring from federal service.
No. Your FEHB premiums are not dependent on whether you decide to enroll in Medicare Part B or not.
During the annual FEHB Open Season, anyone eligible to participate in the FEHB Program may enroll, change health plans or options, cancel your FEHB enrollment, and change participation in premium conversion (waive or begin participation).
Outside of Open Season, newly eligible employees may enroll within 60 days of their becoming eligible for the program, members who move outside of the area covered by their plan may enroll in a different plan covering their new location, and OPM may announce special Open Seasons affecting members of specific plans only. There are also a number of other circumstances which can make you eligible to enroll or change your FEHB coverage outside of Open Season.
For more intricate details, see the Table of Permissible Changes.
No. As long as you qualify to keep FEHB in retirement, your coverage will continue unless you change it.
For the most up-to-date plan options, review the current year plan brochures.
For a table of rates, visit the current year premium charts.
Yes. Retirees are permitted to change carriers and plans during Open Season.
No. Retirees are not permitted to enroll in FEHB. They must have already been covered for the 5-year period immediately prior to retirement in order to keep the coverage in retirement.
Self Only
A Self Only enrollment provides benefits only for you as the enrollee. You may enroll for Self Only even though you have a family, but they will not be eligible for FEHB coverage (even upon your death or disability).
Self Plus One
A Self Plus One enrollment provides benefits for you and one eligible family member you designate to be covered. You may enroll in Self Plus One even though you have more than one eligible family member, but family members who are not covered will not be eligible for FEHB coverage (even upon your death or disability).
Self Plan Family
A Self and Family enrollment provides benefits for you and your eligible family members. All of your eligible family members are automatically covered, even if you didn't list them on your Health Benefits Election Form (SF 2809) or other appropriate request. You cannot exclude any eligible family member and you cannot provide coverage for anyone who is not an eligible family member.
You may enroll for Self and Family coverage before you have any eligible family members. Then, a new eligible family member (such as a newborn child or a new spouse) will be automatically covered by your family enrollment from the date he/she becomes a family member. When a new family member is added to your existing Self and Family enrollment, you do not have to complete a new SF 2809 or other appropriate request, but your carrier may ask you for information about your new family member. You will send the requested information directly to the carrier. Exception: if you want to add a foster child to your coverage, you must provide eligibility information to your employing office.
If Both Spouses Eligible to Enroll
If both you and your spouse are eligible to enroll, one of you may enroll for Self and Family to cover your entire family. If you have no eligible children to cover, one of you may enroll for Self Plus One or each of you may enroll for Self Only in the same or different plans. Generally, you will pay lower premiums for two Self Only enrollments.
No. The only person required to meet the 5-year rule is the employee. Family members do not have this same requirement.
Yes. This is typically done during an FEHB Open Season or by experiencing a Qualifying Life Event.
The government is impartial as to which plan structure you are under. For couple who are married and who have no eligible children, the premiums are typically cheaper to be under two self-only plans.
No. As far as the government is concerned, you have satisfied the 5-year rule because you have been continuously covered under FEHB for the required period of time.
You are eligible to continue health benefits coverage, upon retirement, if you meet all of the following requirements:
If you are a separating employee covered under FERS and you qualify for an immediate annuity under the Minimum Retirement Age (MRA) + 10 provision, you can continue your enrollment when your annuity starts, as long as you meet the requirements for continuing coverage.
If you postpone receipt of your annuity (to avoid the penalty), your enrollment will terminate when you separate from your employment. You will be eligible for temporary continuation of coverage (TCC) or to convert to an individual contract. You may choose to resume FEHB coverage on the date you select for your annuity to begin.
Typically, children can remain under your FEHB coverage until the reach the age of 26.
Each year, Open Season runs from the Monday of the second full workweek in November through the Monday of the second full workweek in December. This applies to both employees and retirees.
You may change carriers, plans and who is covered during an FEHB Open Season.
A qualifying life event (QLE) is a term defined by OPM to describe events deemed acceptable by the IRS that may allow premium conversion participants to change their participation election for premium conversion outside of an Open Season.
Generally, if you choose to make a change to your enrollment, you must make the change within 60 days of the event.
No. This is a special Qualifying Life Event because your family member (in this case, your child), loses eligibility to keep coverage beyond the age of 26.
Medicare Part A covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, and home health care.
No. You are not required to enroll in Medicare Part A, but you should since it is free.
Medicare Part A is "free" at age 65 because throughout your entire working lifetime, you have contributed 1.45% of your pay toward this benefit. This is true for CSRS, FERS and private sector employees.
Medicare Part B covers health care providers' services, outpatient care, durable medical equipment, home health care, and some preventive services.
Some of the items and services that Medicare doesn't cover include:
No. You are not required to enroll in Medicare Part B, but you may decide that it is beneficial for you to do so.
The premium for Medicare Part B is currently $134/mo per person (in 2018). It is possible you would pay more depending on your income.
Most people will pay the standard premium amount. If your modified adjusted gross income is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. This is the most recent tax return information provided to Social Security by the IRS.
To see if you may pay more than the standard amount, check out the Income Related Monthly Adjustment Amounts.
If you are already receiving Social Security benefits, your Medicare premium will be deducted from your monthly payments.
If you are NOT already receiving Social Security benefits, your premium will either be deducted from what OPM pays you in your retirement check or you will receive a bill from Medicare.
No. The FEDVIP program does not require you (or your family members) to be enrolled for 5 years before you retire. It does not carry the same 5-year rule that other programs like FEHB and and FEGLI do in order to be eligible to keep it in retirement.
You are even permitted to enroll in FEDVIP in retirement.
Changes to your FEDVIP carriers or plans can be made during the normal FEHB Open Season each year.
Yes. You are permitted to enroll in FEDVIP (even for the first time) in retirement.
You can use your FSA funds to pay for a variety of expenses for you, your spouse, and your dependents. The IRS determines which expenses can be reimbursed by an FSA. To find out which expenses are covered by FSAFEDS, select the account type you have from the list below:
These lists are extensive and represent the most common types of expenses, but they are not all-inclusive. Even though an item may be found in a list, it does not guarantee reimbursement. Any expenses that are listed as potentially eligible may require additional documentation, such as a Letter of Medical Necessity (PDF), a prescription or an Explanation of Benefits, to be approved. Over-the-counter (OTC) products that require a prescription must include an adequate receipt and a copy of the label or packaging. Please see the Over-the-Counter (OTC) Quick Reference Guide (PDF) for more details.
No. Under the IRS Code, annuitants (other than re-employed annuitants whose employment status is full-time) cannot participate in an FSA. An FSA is a way to set aside part of your salary — before taxes — for payment of eligible out-of-pocket expenses . An annuity is not considered salary.
In order for your spouse to be eligible to continue coverage under FEHB after you die, they must be considered a "survivor annuitant". This means that they are receiving a portion of your pension upon your death.
For CSRS retirees, the minimum amount of your pension that may be protected is 55% of $22. You will make this election when you apply to retire.
For FERS retirees, the minimum amount of your pension that may be protected is 25% of the pension. You will make this election when you apply to retire.