Click here to skip navigation
An official website of the United States Government.
Skip Navigation

In This Section

Insurance FAQs Health

  • 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).
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • 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.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • 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).
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • If you choose a Self Plus One enrollment during the 2015 Open Season, your enrollment change will be effective on the 1st of January. For annuitants, Open Season enrollments are always effective on the 1st day of the year following the end of the Open Season. If you choose a Self Plus One enrollment outside of Open Season, your enrollment change will be effective on the first day of the first pay period following the one in which you make a change. For example, if you request an allowable change in the middle of February, your change will be effective on March 1st.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • 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.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • 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.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • 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.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • 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.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • 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.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • 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.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • Once Medicare becomes the primary payer, you may find that a lower cost FEHB plan is adequate for your needs, especially if you are currently enrolled in a plan's high option. Also, some plans waive deductibles, coinsurance, and copayments when Medicare is primary.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • They can apply to suspend their coverage at any time. Annuitants can call OPM's Retirement Information Office at 1-888-767-6738 to obtain a suspension form. Callers within the local Washington, DC calling area must call 202-606-0500. Former spouses can get the form from the employing office or retirement system maintaining their enrollment. Eligible individuals must submit a completed suspension form and provide all necessary documentation to show eligibility for TRICARE or CHAMPVA during the period beginning 31 days before and ending 31 days after the date they designate as using TRICARE or CHAMPVA instead of FEHB coverage.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • You must request a waiver of the five-year requirement from OPM. The steps you must take are given in the FEHB Handbook at Waiver of 5-Year Enrollment Requirement - Waiver of 5-Year Enrollment Requirement. If your agency has buyout authority, you may not need to write to the OPM. If you think you might qualify for a waiver of the 5-year coverage requirement, contact your Human Resources Office for information. If you meet the requirements, your agency will attach a memorandum to your retirement application stating that you meet the requirements for waiver by the OPM.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • If you provide documentation to your retirement system that you are suspending your FEHB coverage to enroll in a Medicare Advantage plan, you may reenroll in FEHB if you later lose or cancel your Medicare Advantage plan coverage. However, you must wait until the next Open Season to reenroll in FEHB, unless you involuntarily lose your coverage under the Medicare Advantage plan (including because the plan is discontinued or because you move outside its service area). In this case, you may reenroll from 31 days before to 60 days after you lose the Medicare Advantage plan coverage, and your reenrollment in FEHB will be effective the day after the Medicare Advantage plan coverage ends (or ended).
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.
  • A. In order for you to continue your health benefits enrollment into retirement, you must: (1) be entitled to retire on an immediate annuity under a retirement system for civilian employees (including the Federal Employees Retirement System (FERS) Minimum Retirement Age (MRA) + 10 retirement; and (2) have been continuously enrolled (or covered as a family member) in any Federal Employees Health Benefits (FEHB) Program plan(s) (not necessarily the same plan) for the five years of service immediately before the date your annuity starts, or for the full period(s) of service since your first opportunity to enroll (if less than 5 years). The 5 year requirement period can include the following: the time you are covered as a family member under another person's FEHB enrollment; or the time you are covered under the Uniformed Services Health Benefits Program (also known as TRICARE) as long as you were covered under an FEHB enrollment at the time of your retirement.
    How well did this answer your question? Submit
    Submitting rating...
    Thank you for your feedback!
    An error occurred while trying to submit your feedback.
    Please try again later.


Total Count: 587, Number of Pages: 40, Page: 2
Control Panel