Federal Employees: Lifetime Health Insurance Benefits Explained

Federal employees in the US may be eligible for health insurance through the Federal Employees Health Benefits (FEHB) program, which is the largest employer-sponsored health insurance program in the world. The program covers more than 8 million federal employees, retirees, former employees, family members, and former spouses. Most permanent federal employees are eligible to elect health insurance, and participation is voluntary. Employees typically share the cost of their health plan premium with the government, and premiums are automatically withheld from salaries on a pre-tax basis. While the FEHB program was the sole program for federal employees until 2025, the Postal Service Health Benefits (PSHB) program was introduced in 2025 for postal service employees and retirees.

Federal Employees Health Benefits (FEHB)

The Federal Employees Health Benefits (FEHB) program is the largest employer-sponsored health insurance program in the world, covering more than eight million federal employees, retirees, former employees, family members, and former spouses. The FEHB offers a wide range of health plan choices, allowing participants to select the option that best suits their needs and preferences.

Eligibility

Most permanent federal employees are eligible to elect health insurance under the FEHB program. Part-time career employees are also eligible, with the government contribution prorated according to the percentage of full-time service they perform. Temporary employees can enrol in the FEHB after completing one year of continuous employment but must pay both the employee and government shares of the premium.

Enrollment Types

The FEHB program offers three enrollment types: Self Only, Self Plus One, and Self and Family. The 'Self Only' option provides benefits solely to the enrollee, while 'Self Plus One' extends coverage to one eligible family member. The 'Self and Family' option covers the enrollee and all eligible family members, including a spouse and children under the age of 26.

Benefits Available

The FEHB includes various plan types, such as fee-for-service with a preferred provider organization, health maintenance organizations, point-of-service, high-deductible health plans, and consumer-driven health plans. The specific coverage and payment methods vary depending on the chosen plan. However, all plans under the FEHB provide benefits for hospital care, surgical care, inpatient and outpatient care, obstetrical care, mental health and substance abuse care, and prescription drug coverage.

Enrollment and Changes

Once enrolled in a health insurance plan under the FEHB, your enrollment automatically continues each year as long as you remain eligible. You are not required to reenroll annually. However, if you wish to modify your health insurance coverage, you may do so during the Benefits Open Season or following a qualifying life event.

Premium Payments

Premiums are typically withheld from the enrollee's salary on a pre-tax basis, reducing taxable income and income taxes. This is known as Federal Employees Health Benefits Premium Conversion (FEHB-PC). It is important to note that participating in FEHB-PC has certain implications, such as reduced earnings reported to the Social Security Administration and the inability to deduct health insurance premiums as an itemized medical deduction on tax returns.

Emergencies

In the event of an emergency, FEHB participants can rest assured that their health benefits will continue without interruption. The FEHB program has multiple health plans to ensure uninterrupted coverage. Participants are advised to continue seeking medical care as needed, either from their regular providers or, if necessary, from emergency rooms or other healthcare providers.

Eligibility for FEHB

The Federal Employees Health Benefits (FEHB) program is the largest employer-sponsored health insurance program in the world, covering more than 8 million Federal employees, retirees, former employees, family members, and former spouses. Most permanent Federal employees are eligible to elect health insurance under the FEHB. Participation in FEHB is voluntary, and employees must make an election to be covered.

Eligibility for new employees

As a new employee, you have 60 days from your date of appointment to make an election for the health benefits program. Your completed Health Benefits Election Form, SF-2809, must be submitted to your servicing Human Resources Office in a timely manner. If you fail to make an election within the required timeframe, you are considered to have declined coverage, and you will not have another opportunity to enroll until the annual open season (conducted in late Fall) or unless you experience a qualifying life event.

Eligibility for part-time and temporary employees

If you are a part-time career employee, the government contribution toward your health benefits is prorated in proportion to the percentage of full-time service you are regularly scheduled to perform. If you are on a temporary, not-to-exceed appointment, you are eligible to enroll in FEHB after you have completed one year of continuous employment. If you elect to enroll, you must pay both the employee and the government shares of the premium.

Eligibility for temporary firefighters and fire protection personnel

Temporary firefighters and fire protection personnel working on wildland fires across the country are eligible for FEHB coverage. If you are part of the wildland firefighting force, you will have the option to enroll in FEHB coverage for yourself and your family, with the option to convert your coverage to an individual contract or enroll in Temporary Continuation of Coverage when your employment ends.

Eligibility for civilian employees on active military duty

If you are a Federal employee enrolled in the FEHB Program and you enter one of the uniformed services for 30 days or less, your FEHB enrollment will continue without change. If you are placed on leave without pay for active military duty for more than 30 days, you may continue your coverage for up to 24 months or elect to have it terminated.

Eligibility for employees serving in support of a contingency operation

If you are called or ordered to active duty on or after September 14, 2001, and meet certain other requirements, your agency has the authority to pay the entire cost of your premium (including the employee share) for 24 months.

Eligibility for annuitants and survivor annuitants

Federal annuitants and their surviving spouses retain their eligibility for FEHB health coverage at the same cost as current employees. To carry your FEHB coverage into retirement, you must meet certain requirements, including being entitled to retire on an immediate annuity under a retirement system for civilian employees and having been continuously enrolled (or covered as a family member) in any FEHB plan(s) for the 5 years of service immediately before the date your annuity starts.

Eligibility for family members

Family members eligible for coverage under yourself and family enrollment include your spouse (including a valid common-law marriage, in certain circumstances) and children younger than age 26. Children include a biological child, an adopted child, a stepchild, a foster child, and, in some cases, a child over the age of 26 who is incapable of self-support due to a disability.

It is important to note that eligibility for FEHB may vary based on specific circumstances and employment status, and employees should refer to the official government sources and their agencies for the most accurate and up-to-date information.

Cost of FEHB

The Federal Employees Health Benefits (FEHB) program is the largest employer-sponsored health insurance program in the world, covering more than 8 million federal employees, retirees, former employees, family members, and former spouses. The cost of FEHB is shared by the enrollee and the government as the employer/former employer. The enrollee share is about 30% of the total cost. Active employees generally pay premiums through biweekly payroll withholding, and retirees through withholdings from their monthly annuity payments.

The government's share of premiums paid is set by law. For most employees and annuitants, the government contribution is 72% of the amounts determined by the Office of Personnel Management (OPM) to be the program-wide weighted average of premiums in effect each year for Self Only, Self Plus One, and Self and Family enrollments. OPM must determine the FEHB program-wide weighted average of premiums no later than October 1st of each year. The government contribution for eligible employees is paid out of agency appropriations or other funds available for payment of salaries. OPM receives an annual appropriation to cover government contributions for eligible annuitants.

The FEHB-eligible career USPS employees fall under the same rate category called "Premium Rate". The 2024 biweekly maximum government contribution for most employees and annuitants is $271.43 for Self Only, $586.50 for Self Plus One, and $646.18 for Self and Family. The monthly maximum government contribution is $588.10 for Self Only, $1,270.75 for Self Plus One, and $1,400.06 for Self and Family. The biweekly program-wide weighted average premiums for Self Only, Self Plus One, and Self and Family enrollments with a government contribution are $376.99, $814.59, and $897.47, respectively. The monthly program-wide weighted average premiums for these enrollment types are $816.81, $1,764.95, and $1,944.52, respectively.

The 2025 FEHB premiums will increase by 13.5% on average, following increases of 7.7% in 2024 and 8.7% in 2023. The 2025 biweekly maximum government contribution for most employees and annuitants is $298.08 for Self Only, $650.00 for Self Plus One, and $714.23 for Self and Family. The monthly maximum government contribution is $645.84 for Self Only, $1,408.33 for Self Plus One, and $1,547.50 for Self and Family. The biweekly program-wide weighted average 2025 FEHB premiums for Self Only, Self Plus One, and Self and Family enrollments are $414.00, $902.78, and $991.99, respectively. The monthly program-wide weighted average premiums for these enrollment types are $897.00, $1,956.02, and $2,149.31, respectively.

Coverage of FEHB

The Federal Employees Health Benefits (FEHB) program is the largest employer-sponsored health insurance program in the world, covering more than 8 million federal employees, retirees, former employees, family members, and former spouses.

FEHB includes different types of plans: fee-for-service with a preferred provider organization; health maintenance organizations; point-of-service; high-deductible health plans; and consumer-driven health plans. How you obtain coverage or services and pay for them differs depending on the plan. However, benefits available under all plans include hospital care, surgical care, inpatient and outpatient care, obstetrical care, mental health and substance abuse care, and prescription drug coverage. There are no waiting periods or pre-existing condition limitations under FEHB, even if you change plans.

Most permanent federal employees are eligible to elect health insurance. Participation in FEHB is voluntary, and you must make an election to be covered. If you are a part-time career employee, the government contribution toward your health benefits is prorated in proportion to the percentage of full-time service you are regularly scheduled to perform. If you are on a temporary not-to-exceed appointment, you are eligible to enroll in FEHB after you have completed one year of continuous employment. If you elect to enroll, you must pay both the employee and the government shares of the premium.

Once you enroll in a health insurance plan, your enrollment automatically continues each year, as long as you remain eligible for the program. You do not have to re-enroll each year. However, if you would like to make a change to your health insurance, you may do so during the Benefits Open Season or in conjunction with a qualifying life event.

If you enroll in health insurance, premiums are automatically withheld from your salary on a pre-tax basis, which reduces your taxable income and income taxes. This is called Federal Employees Health Benefits Premium Conversion (FEHB-PC). If you participate in FEHB-PC, you do not have the flexibility to cancel your health insurance coverage or change to a self-only enrollment from a family enrollment at any time. You will be able to make these changes only during the Benefits Open Season or in conjunction with a qualifying life event.

Your earnings reported to the Social Security Administration will be less since you will pay health insurance premiums with pre-tax money. This may result in a somewhat lower Social Security benefit when you retire. You are not able to deduct health insurance premiums as an itemized medical deduction on your income tax return.

If you want health insurance premiums withheld on an after-tax basis, at the time you enroll in health insurance, you must sign a PC-waiver form electing not to participate in FEHB-PC. After the initial opportunity to waive FEHB-PC as a new employee, you will be able to change whether you participate in FEHB-PC only during the Benefits Open Season or in conjunction with a qualifying life event.

As a new employee, you have 60 days from your date of appointment to make an election for the health benefits program. Your completed Health Benefits Election Form, SF-2809, must be submitted to your servicing Human Resources Office in a timely manner. If you fail to make an election within the required timeframe, you are considered to have declined coverage. You will not have another opportunity to enroll until the annual open season (conducted in late Fall) or unless you experience a qualifying life event that would allow you to enroll. Please note that the SF-2809 should be completed and submitted even if you are declining coverage.

Enrolment in FEHB

Enrolment in the Federal Employee Health Benefits (FEHB) program is open to most permanent federal employees. Participation is voluntary, and you must elect to be covered. If you are a part-time career employee, the government contribution to your health benefits is prorated in proportion to the percentage of full-time service you are regularly scheduled to perform. If you are on a temporary not-to-exceed appointment, you are eligible to enrol in FEHB after completing one year of continuous employment. If you elect to enrol, you must pay both the employee and the government shares of the premium.

As a new employee, you have 60 days from your start date (also known as your entry on duty date) to enrol in a health plan. You can enrol using the Health Benefits Election Form (SF 2809) or through an agency self-service system such as Employee Express, MyPay, Employee Personal Page, or Employee Benefits Information System (EBIS). Please contact the Human Resources Office (HRO) of your agency for details.

Once you enrol in a health insurance plan, your enrolment automatically continues each year, as long as you remain eligible for the program. You do not have to re-enrol each year. However, if you would like to make a change to your health insurance, you may do so during the Benefits Open Season or in conjunction with a qualifying life event.

Qualifying life events include getting married, having a baby, getting divorced, or a change in employee status.

During the Benefits Open Season, you can enrol, change health plans or options, cancel your FEHB enrolment, and change participation in premium conversion (waive or begin participation).

Frequently asked questions