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Frequently Asked Questions Insurance

Health

  • No, you will pay the same premium as you paid while you were an employee. However, annuitants are paid on a monthly basis so you will pay them at the monthly rate. You may see an increase if you are employed by an agency, such as the Post Office, that contributes additional money towards the total premium. Retirees receive the same government contribution as most Federal employees.
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  • Yes, you may change your FEHB enrollment to any available plan or option at any time beginning 30 days before you become eligible for Medicare. You may use this enrollment change opportunity only once. You may also change your enrollment during the annual Open Season, or because of another event that permits enrollment changes (such as a change in family status).
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  • You need to complete the SF 2809 if you change your enrollment from Self and Family to Self Only or vice versa.

    For example, if you have Self and Family coverage and you plan to keep Self and Family coverage, you do not need to complete any forms. You must let the health plan know the date of the divorce so that your ex-spouse can be removed from your enrollment. If you have Self and Family coverage and you now plan on enrolling in Self Only coverage, you must notify your Human Resources Office. You will have to complete an SF 2809.

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  • Generally, plans under the FEHB Program help pay for the same kind of expenses as Medicare. FEHB plans also provide coverage for emergency care outside of the United States which Medicare doesn't provide. Some FEHB plans also provide coverage for dental and vision care. Medicare covers some orthopedic and prosthetic devices, durable medical equipment, home health care, limited chiropractic services, and some medical supplies, which some FEHB plans may not cover or only partially cover (check your plan brochure for details).
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  • No, you do not have to be enrolled in a family plan for the five years before you retire to meet the five-year requirement. As a retiree, you can enroll in a family plan during the Open Season or when an event occurs that permits a change to the family plan.
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  • Spouse equity is a provision of the law that allows the former spouse of a Federal employee or annuitant to enroll in FEHB if he or she meets certain requirements.
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  • Annuitants sometimes need a new copy of “Your Federal Retirement Benefits” to show their retirement income to their mortgage lender, bank, underwriter, state income tax office, or low-income housing provider.  To request a new copy of “Your Federal Retirement Benefits”, or to receive a verification of your annuity, contact OPM’s Retirement Office at 1-888-767-6738 or retire@opm.gov.  The phone lines are open from 7:30 am to 7:45 pm (Eastern Standard Time). It is a busy phone number so we encourage you to call early in the morning or after 5:00 pm when the phone lines are less busy.
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  • You must apply for Temporary Continuation of Coverage (TCC) with your agency Human Resources Office within 60 days from the date you separate from Federal service. TCC coverage becomes effective the day after the qualifying event. After your 31-day extension of your group coverage ends, you pay the full premium (the enrollee and Government contribution) plus a 2 percent administrative fee. For more information, contact your agency's Human Resources Office and review the TCC pamplet at www.opm.gov/insure/health/eligibility/tcc.
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  • Your spouse is eligible for coverage while you are in the process of getting divorced and even while you are legally separated. Your spouse loses eligibility for coverage as a family member when your divorce is final. Your spouse can apply for coverage in the FEHB Program under the Spouse Equity or Temporary Continuation of Coverage provisions of the FEHB law. Your spouse should contact your HR office to apply.
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  • During the annual FEHB Open Season, you may enroll, cancel an enrollment, change plans or options, and waive or begin participation in premium conversion.

    If you waived participation in premium conversion, you can change from self- and-family enrollment to a Self Only enrollment or cancel your enrollment at any time. You can make other changes during Open Season or due to certain events. Your Human Resources Office can give you more information about these events.

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