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Frequently Asked Questions Insurance

FEHB for Federal Civilian Employees who Perform Active Military Duty

  • If your FEHB is retroactively reinstated for 6 additional months, FEHB will become the primary payer and TRICARE the secondary payer during the additional 6 month coverage period. Thus, any payments made by TRICARE during that 6-month period could be reconciled with the FEHB carrier and any benefit adjustments could cause a difference in the amounts that you owe. Factors such as covered vs. non-covered services, network vs. out-of-network providers, deductibles, copayments, coinsurance, Health Maintenance Organization (HMO) geographic considerations, and catastrophic coverage applications may alter your total out-of-pocket expenses. Some additional issues for you to consider are:
    • If your FEHB plan covers services that TRICARE does not, having FEHB coverage could work to your advantage.
    • If TRICARE covers services that FEHB does not, TRICARE as the secondary payer should not adversely work against you since TRICARE would pay its normal benefits in the absence of benefits from the FEHB carrier.
    • If your FEHB plan becomes primary and you used TRICARE providers that were out of your FEHB plan's network, you need to determine if you would be better off with just the TRICARE coverage paying benefits alone or would you be better off having FEHB pay as primary and TRICARE as secondary for the out-of-network services.
    • You need to determine if shifting deductibles, copayments, and coinsurance from TRICARE to FEHB as the primary carrier enhances or decreases your overall benefits.
    • You need to determine how the geographic restriction of having an HMO Plan as primary payer affects the benefits received for you and your family members and how it affects payment from TRICARE as the secondary payer.
    • You need to determine if requesting retroactive FEHB for 6 additional months would enable you to meet your catastrophic protection benefits, thus, potentially enhancing your overall payment receipts.
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  • No. The termination is not considered a break in the continuous enrollment necessary for continuing FEHB coverage during retirement. If you decide not to continue your coverage, your enrollment is terminated, not canceled. To avoid a gap in your coverage after you return to work, you must reinstate your enrollment on or before the last day of your TRICARE coverage. See our questions and answers on Return from Military Service.
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  • Your FEHB enrollment will continue unless you elect to have it terminate. You should also consider:
    • Any family members covered under your enrollment
    • Payment of your premiums
    Note: If your enrollment continues and you participate in premium conversion, you may not cancel your enrollment at any time. If you think you might want to stop your FEHB at some time during your military service, you should consider waiving premium conversion at this time.
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  • Yes, FEHB law (5 U.S.C. 8906(e)(3)) gives agencies the authority to pay your premiums if you meet certain conditions. You must:
    1. be enrolled in an FEHB plan;
    2. be a member of a reserve component of the armed forces;
    3. be called or ordered to active duty in support of a contingency operation (as defined in section 101(a)(13) of title 10 U.S.C.);
    4. be placed on leave without pay or separated from service to perform active duty; and
    5. serve on active duty for a period of more than 30 consecutive days.
    Although the law gives your agency the authority to pay your premiums if you meet these conditions, your agency must decide to implement this authority. Ask your Human Resources Office about the policy for your agency.
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  • FEHB law (5 U.S.C. 8905a) permits you to continue your FEHB enrollment for up to 24 months if you were called to active duty on or after September 14, 2001, and meet certain requirements. You must:
    1. be enrolled in an FEHB plan;
    2. be a member of a reserve component of the armed forces;
    3. be called or ordered to active duty in support of a contingency operation (as defined in section 101(a)(13) of title 10 U.S.C.);
    4. be placed on leave without pay or separated from service to perform active duty; and
    5. serve on active duty for a period of more than 30 consecutive days.
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  • It depends.  If your daughter is your only eligible family member and she acquires TRICARE, you may change your FEHB enrollment to self only based on this qualifying life event.  But if you must maintain a self and family enrollment to cover other family members, you may not remove your daughter from your enrollment.  FEHB will coordinate benefits with TRICARE.
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