Paul Sanchez
Federal employees in the US are entitled to health insurance through the Federal Employee Health Benefits (FEHB) program. This includes medical, vision, and dental insurance. However, the question of whether these benefits extend into retirement is a complex one. While federal employees are entitled to keep their FEHB coverage after retirement, certain conditions must be met. These include being enrolled in the FEHB program for a minimum of five years before retirement and meeting specific age requirements. Employees must also be retiring on an immediate annuity, starting within 31 days of separation from federal employment.
| Characteristics | Values |
|---|---|
| Health Insurance | Federal employees are entitled to healthcare through the Federal Employee Health Benefits (FEHB) program. |
| To qualify for coverage, employees must meet minimum service requirements, including being covered for at least the preceding five years. | |
| FEHB covers medical expenses, including prescription medications and dental and vision care. | |
| Employees can also sign up for a Flexible Spending Account (FSA) to pay for out-of-pocket expenses with tax-free dollars. | |
| Upon retirement, federal employees can continue their FEHB coverage, but they must pay the full premium for the plan, including a 2% administrative charge. | |
| Retirees can choose to strike a balance between FEHB and Medicare coverage, enrolling in Medicare as their primary insurance and moving to a lower-tier FEHB plan as secondary insurance. | |
| Life Insurance | Federal employees are provided with life insurance. |
| Upon leaving federal service, employees are entitled to a free 31-day extension of coverage and can convert to an individual life insurance policy. | |
| FEGLI coverage can be continued into retirement if certain conditions are met. | |
| Employees can choose the amount of Basic insurance they want to keep after retirement. |
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What You'll Learn
Federal Employees Health Benefits (FEHB) program
The Federal Employees Health Benefits (FEHB) program is a comprehensive health benefits program offered to federal civilian employees, retirees, and their families. With 276 plan options in 2021, it is the most diverse employer-sponsored health benefits program in the country. The actual number of plans available to each employee depends on their geographic location.
The FEHB program offers a wide range of plan options, including Fee-For-Service, Health Maintenance Organization, High Deductible, and Consumer-Driven Health Plans. Federal employees can choose the plan that best meets their needs and the needs of their families. The program also offers three enrollment types: Self Only, Self Plus One, and Self and Family.
The FEHB program provides flexibility in certain situations to ensure that members receive their benefits. For example, during emergencies, fee-for-service carriers may relax their pre-certification requirements, such as notifying the plan within two business days of an emergency admission. Similarly, carriers are encouraged to provide immediate payment for work-related injuries, with subsequent reimbursement from the Office of Workers' Compensation Programs (OWCP).
As a federal employee, you are entitled to healthcare through the FEHB program. This coverage can be continued into retirement if certain conditions are met. To maintain FEHB coverage after retirement, employees must be enrolled in the FEHB program and have been enrolled for the full five years preceding retirement.
When planning for retirement, federal employees must consider their healthcare options. They can choose to balance their FEHB coverage with Medicare Parts A and B or enroll in a Medicare Advantage plan. It is important to understand the coverage provided by FEHB and how it compares to other healthcare programs to make informed decisions about their healthcare in retirement.
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Eligibility criteria for FEHB
Federal employees are entitled to healthcare through the Federal Employee Health Benefits (FEHB) program. This coverage can be continued after retirement, but certain eligibility criteria must be met. Firstly, the employee must be enrolled in the FEHB program at the time of retirement and must have been enrolled for the full five years preceding retirement. If an employee cancels their FEHB enrollment, they will not be able to continue it into retirement.
There are various eligibility criteria for FEHB coverage, and an employee's agency applies these rules and determines their eligibility. As a general rule, employees are eligible for FEHB coverage if they meet the definition of an employee by serving in an Executive agency, the United States Postal Service, or the Smithsonian Institution. Temporary employees who work a minimum of 130 hours per month for at least 90 days are also eligible for FEHB coverage. This includes employees on a seasonal schedule working less than six months per year, as well as intermittent employees. Part-time career employees are not excluded from FEHB coverage.
Certain positions are excluded from FEHB coverage. Employees who are paid on a piecework basis or whose permanent duty station is located outside the United States (including US territories and possessions) are not eligible. Employees of the Tennessee Valley Authority and certain corporations supervised by the Farm Credit Administration are also excluded. If an employee is paid in whole or in part from non-Federal funds, they may not be eligible for FEHB coverage unless certain requirements are met.
In addition to the above criteria, there are special provisions for specific groups of employees. For example, temporary firefighters and fire protection personnel working on wildland fires are eligible for FEHB coverage. Members of Congress and designated congressional staff are subject to specific requirements under the Affordable Care Act and must purchase health benefits plans through the Small Business Health Options Program (SHOP).
It is important to note that eligibility for FEHB coverage extends beyond the employee to include their family members. Spouses are eligible for coverage, provided they can furnish proof of their marital status. Children are also eligible for FEHB coverage until they turn 26, after which they can either enroll in Temporary Continuation of Coverage (TCC) or purchase health insurance through the Health Insurance Marketplace. Former spouses may also be eligible for FEHB coverage under Spouse Equity provisions or TCC.
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Medicare and FEHB coverage
As a federal employee, you are entitled to healthcare through the Federal Employee Health Benefits (FEHB) program. This coverage can be kept after retirement, but certain conditions must be met. Firstly, the employee must be currently enrolled in the FEHB program, and secondly, they must have been enrolled for the full five years preceding retirement.
It is important to note that enrolling in Medicare is a personal decision, and FEHB coverage will continue regardless. However, if retirees choose to enrol in Medicare, they must notify their FEHB plan to ensure proper coordination of benefits. Medicare Advantage plans, also known as Part C, are private plans that combine the benefits of Medicare Parts A and B and may include additional coverage for prescription drugs. FEHB plans may offer benefits that work with Medicare, waiving certain costs like deductibles, coinsurance, and copayments.
Retirees with FEHB coverage who are also enrolled in Medicare Part A or Part B, or both, are automatically enrolled in Medicare drug benefits if their FEHB plan offers them. This provides standard Part D drug coverage, such as a monthly cap on insulin products and yearly limits on out-of-pocket drug costs. Retirees can opt out of this coverage before it begins or disenroll at any time.
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Temporary Continuation of Coverage (TCC)
Federal employees are entitled to healthcare through the Federal Employee Health Benefits (FEHB) program. This benefit can be continued after retirement if certain conditions are met. One such feature is the Temporary Continuation of Coverage (TCC) which allows certain people to temporarily continue their FEHB coverage after regular coverage ends.
TCC enrollees must pay the full premium for the plan, including both the employee and government shares of the premium, plus a 2% administrative charge. To be eligible for TCC, employees must have been separated from Federal service. However, those who are involuntarily separated from service due to gross misconduct are not entitled to TCC.
TCC is also available to family members who become ineligible for FEHB, such as children who reach the age of 26 or older than 26 having recovered from a disability. In such cases, the child is eligible for TCC for up to 36 months. Similarly, former spouses can request a TCC of up to 36 months after divorce.
It is important to note that TCC is not a permanent solution and only provides temporary coverage. For federal employees, TCC is available for up to 18 months after leaving their federal post. This allows them to maintain their health benefits while transitioning to other forms of coverage, such as Medicare or private insurance plans.
Upon re-employment with the federal government in an FEHB-eligible position, the TCC will be terminated, and the individual will be enrolled in an FEHB plan.
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Cost of federal employee health insurance
Federal employees are entitled to health insurance, life insurance, supplemental dental and vision coverage, and a flexible spending account program to help pay for out-of-pocket expenses with tax-free dollars. These benefits can be continued into retirement if certain conditions are met. For example, to carry health insurance into retirement, federal employees must be enrolled in the Federal Employee Health Benefits (FEHB) program and have been enrolled for the full five years preceding their retirement.
The cost of federal employee health insurance is shared by the enrollee and the government. The enrollee typically pays around 30% of the total cost, while the government pays the remaining 70%. In 2025, the biweekly maximum government contribution for most employees and annuitants was $298.08 for Self Only, $650.00 for Self Plus One, and $714.23 for Self and Family. The monthly maximum government contribution for these enrollment types was $645.84, $1,408.33, and $1,547.50, respectively. It is important to note that the enrollee share of premiums for the Self Plus One enrollment type may be higher than for the Self and Family enrollment type.
Active employees generally pay their share of premiums through biweekly payroll withholding, while retirees pay through withholdings from their monthly annuity payments. Federal employees can choose from a wide range of plans, including prepaid plans and FFS (fee-for-service) plans. Prepaid plans offer specified providers at designated locations, while FFS plans allow enrollees to choose their own providers without a referral.
Upon leaving federal service, employees who are not immediately eligible for retirement are entitled to a free 31-day extension of coverage. They may also have the opportunity to convert to an individual life insurance policy, which may result in a higher or lower premium depending on their health status and the insurance company selected.
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Frequently asked questions
Yes, federal government employees can keep their Federal Employee Health Benefits (FEHB) coverage after retirement. However, they must be enrolled in the FEHB program and have been enrolled for the full five years preceding their retirement.
To qualify for coverage, you must meet minimum service requirements, including being covered as a federal employee for at least five years. Your spouse will receive coverage without the five-year rule.
Your premiums will not increase after retirement. However, the frequency of your payments will change. Since you will be receiving a monthly annuity payment, you will pay your premiums monthly.
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