Health insurance is a crucial component of any financial plan. With the cost of healthcare continuing to rise, having adequate coverage is more important than ever. For federal employees and retirees, the Federal Employees Health Benefits (FEHB) Program provides comprehensive medical insurance options. However, navigating the complexities of FEHB plans can be daunting. This article will provide an in-depth look at everything you need to know about federal life health insurance right now.
Overview of the Federal Employees Health Benefits Program
The FEHB Program provides health insurance coverage for federal employees, retirees, and their families. There are several key things to understand about FEHB plans:
FEHB Plan Options
There are a wide variety of FEHB plans to choose from, including fee-for-service (FFS) plans, health maintenance organizations (HMOs), high deductible health plans (HDHPs), and consumer-driven health plans (CDHPs). Each plan has different costs, benefits, and provider networks.
Active federal employees have 60 days from their hire date to enroll in an FEHB plan. There is an annual open season each fall for making changes. Retirees can only change plans or enroll during the open season.
Premiums and Cost-Sharing
Premiums are shared between the federal government and enrollees. Plans also have deductibles, copays, and coinsurance that enrollees must pay.
FEHB coverage is portable when you retire or change federal agencies. You won't lose coverage by moving or changing jobs.
Comparing FEHB Plan Options
Choosing a FEHB plan that meets your needs and budget can be challenging. Here's an overview of the main types of plans:
Fee-for-Service (FFS) Plans
These are the most flexible in terms of choice of providers. Some of the most popular national FFS plans include:
- Blue Cross and Blue Shield (BCBS) Basic and Standard
- Government Employees Health Association (GEHA) High and HDHP
- Mail Handlers Benefit Plan (MHBP) Standard and Value
Health Maintenance Organizations (HMOs)
HMOs have more restrictive provider networks but lower costs. Some nationwide HMO options are:
- Kaiser Permanente HMO
- Aetna HMO
High Deductible Health Plans (HDHPs)
HDHPs have lower premiums but a high deductible you must meet before coverage kicks in. Some examples are:
- BCBS Basic with HDHP
- GEHA HDHP
Consumer-Driven Health Plans (CDHPs)
CDHPs combine an HDHP with a tax-advantaged account like an HSA or HRA. Popular plans include:
- GEHA HDHP with HSA
- MHBP Value with HRA
When comparing plans, look at premiums, deductibles, provider networks, prescription drug coverage, and additional benefits.
Federal Employee Dental and Vision Insurance
In addition to medical insurance, FEHB plans can be paired with:
Federal Dental Insurance
All FEHB medical plans include free preventive dental care. But you can also enroll in the Federal Employees Dental and Vision Insurance Program (FEDVIP) for comprehensive dental coverage.
There are several national and regional FEDVIP dental plans to choose from. Compare monthly premiums and coverage details.
Federal Vision Insurance
Just like dental, all FEHB plans include a yearly eye exam. But FEDVIP also offers vision plans with coverage for glasses and contacts.
VSP Vision Care is the main national vision carrier. Review plan options and premiums.
Bundling medical, dental, and vision benefits maximizes your FEHB benefits.
Life Insurance Options for Federal Employees
In addition to health, dental, and vision benefits, federal employees also have access to robust life insurance options.
Federal Employees' Group Life Insurance (FEGLI)
FEGLI provides term life insurance and is available to all federal workers. Coverage maximums go up to 5x your annual pay. Rates are very competitive.
Federal Employees' Optional Life Insurance (FEOLI)
For additional coverage, FEOLI allows federal employees under age 60 to elect up to $10,000 of optional term life insurance.
Family Life Insurance Options
Spouses and eligible children can also be covered under FEGLI. There are also optional family life insurance plans.
Be sure to calculate your family's life insurance needs and take advantage of this Federal Life Health Insurance.
Comparing FEHB Plans for Single vs Family Coverage
For many federal employees, choosing between self and family coverage is a big decision. Here are some key considerations:
Premium Differences: Family premiums are typically 2-3x more expensive than self-only.
Plan Allowances: Some plans provide higher coverage amounts for families.
Dependent Children Ages: Most FEHB plans cover children up to age 26. Some go up to age 28 if a student.
Coordination of Benefits: If your spouse has other coverage, you can coordinate FEHB benefits.
Crunching the numbers for plan costs and benefits can help determine if self or family coverage is the better option. Don't leave your family uninsured if they don't qualify for other affordable plans.
Retiree FEHB Eligibility and Enrollment Rules
Maintaining FEHB into retirement is crucial. Here are the key eligibility guidelines:
To carry FEHB into retirement, you must have:
- 5 years of coverage directly before retiring, OR
- If less than 5 years, you must have covered the years of Federal Life Health Insurance service that you're using for retirement eligibility.
Retiring employees need to enroll in FEHB specifically for retirement. This is separate from just continuing your active coverage.
- Retirees can also change plans during Open Season.
- Suspending FEHB enrollment will make you ineligible.
Coverage for Family Members
- Spouses and children covered under your FEHB active plan can also stay covered when you retire.
- Divorced spouses require specific eligibility documentation to remain on your FEHB plan.
Understanding these rules will help ensure a smooth FEHB transition into retirement.
Coordinating FEHB with Medicare at 65
Once you turn 65 and become eligible for Medicare, coordinating coverage with your FEHB plan is crucial:
Medicare Part A
Most federal retirees get Part A premium-free based on paying Medicare taxes while working. This covers hospital services.
Medicare Part B
You must proactively enroll in Part B which covers doctor visits and outpatient care. Pay the premium to avoid coverage gaps.
MAPD plans are Medicare private health options that can coordinate with FEHB secondary coverage.
Prescription Drug Coverage
Enroll in Medicare Part D or confirm your FEHB plan has sufficient drug coverage.
Taking the time to integrate Medicare with your FEHB retirement plan will maximize benefits and cost savings.
Making FEHB Plan Changes During Open Season
The annual FEHB Open Season runs from the Monday of the second full week in November through the Monday of the second full week in December. It provides an opportunity for active and retired federal enrollees to:
- Change FEHB health, dental, and vision plans
- Enroll or cancel enrollment
- Change from self to family or back
Other key open season tips:
- Research plan options in advance
- Compare current and new plan benefits side-by-side
- Ensure dependents meet eligibility before switching to family
- Changes made during open season are effective the following January 1st
Use open season each year as a chance to evaluate your FEHB coverage and make adjustments. Don’t miss the deadline and be stuck with your current plan by default.
Rules for FEHB When Separating from Federal Service
Losing FEHB coverage when leaving federal employment can lead to expensive COBRA or marketplace plan premiums. Here are options to maintain FEHB:
You can continue FEHB for life if you meet minimum retirement eligibility requirements. See prior section for details.
Resigning with Minimum Years of Service
Workers who resign or are terminated (except for gross misconduct) can keep FEHB for up to 18 months if they have at least 5 years of Federal Health Life Insurance service.
Converting to Temporary Continuation of Coverage (TCC)
Federal employees who don’t qualify for regular FEHB conversion can get TCC for up to 18 months via COBRA.
- TCC allows you to keep same plan and coverage
- You pay the full premium plus a 2% administrative fee
Losing FEHB can be costly. Research these available options to retain coverage and affordability.
Coverage Options Similar to FEHB for Family Members
Spouses and children who lose eligibility for FEHB coverage still need insurance. Some options similar to FEHB include:
Spouse Coverage via Own Employer
If your spouse works, determine if their employer provides affordable insurance that covers you too. Compare to FEHB costs.
Children Covered Under Spouse’s Plan
Many family plans allow children up to age 26. Compare benefits and coordination rules.
ACA Marketplace Plans
ACA plans offer comprehensive coverage similar to FEHB. Tax credits may help reduce premiums.
Continuing prior employer coverage via COBRA provides an 18-36 month coverage extension. Look at premiums.
Losing FEHB eligibility doesn’t mean you’re out of options. Shop around for the best alternative medical insurance for your situation.
Continuing Health Insurance After Federal Retirement
Transitioning from federal employee to retiree involves navigating new health insurance options. Here are some top choices post-FEHB:
Most federal retirees transition to Medicare Parts A/B and a supplement plan at age 65. Costs vary greatly so compare carefully.
Spouse's Employer Plan
If your spouse works, you may be able to get on their employee group medical insurance once you’re Medicare eligible.
Individual Private Plans
Non-group health plans can be purchased but ensure you enroll during an open enrollment period.
Health Sharing Ministries
Faith-based health sharing groups like Medi-Share provide an alternative way to share medical costs.
University Health Plans
If you or a dependent works or attends certain universities, you may be able to utilize their health system and insurance.
With proper planning, you can find economical health insurance alternatives when retiring from the federal government.
Key Things to Know About Federal Life Health Insurance
Trying to summarize the key points about federal health benefits? Here are the top things to know:
FEHB plans provide solid medical, dental, and vision coverage for federal families. Compare options carefully.
Life insurance is also available through FEGLI and FEOLI at attractive group rates.
Retiring from federal service allows you to continue FEHB coverage for life in most cases. Understand eligibility rules.
Coordinating FEHB with Medicare at age 65 is crucial to maximize benefits and savings.
Losing FEHB eligibility doesn’t mean you are out of insurance options. Research plans for spouses and dependents too.
Open Season each fall provides the opportunity to evaluate plans and make changes. Take advantage of this each year.
Focus on understanding these key aspects of Federal Life Health Insurance programs as you make coverage elections.
Frequently Asked Questions (FAQ) About Federal Life Health Insurance
Still have questions about federal life and health insurance programs? Here are helpful answers to some frequently asked questions:
What is the annual FEHB Open Season period?
FEHB Open Season runs each year from the Monday of the second full week in November through the Monday of the second full week in December.
When can I change my FEHB retirement coverage?
Retirees can decrease, increase, or change FEHB plans during Open Season or if they have a qualifying life event like marriage, divorce, or relocating outside their plan's service area.
How long can I extend FEHB with COBRA after resigning?
You can continue FEHB via COBRA for up to 18 months by paying premiums plus a 2% administrative fee.
Does my child lose FEHB coverage at age 26?
Dependent FEHB eligibility typically ends at 26. Some plans allow coverage until age 28 if the child is a full-time student.
What is Federal Employees Dental and Vision Insurance (FEDVIP)?
FEDVIP provides comprehensive dental and vision insurance to supplement your FEHB medical benefits.
Can I enroll in a Medicare Advantage Plan with my FEHB coverage?
Yes, you can get a Medicare Advantage Plan to coordinate with your FEHB at age 65 for maximum coverage.
What is a qualifying life event for changing FEHB enrollment?
Marriage, divorce, birth of a child, adoption, death of a spouse, and job changes allow mid-year FEHB changes.
What is the maximum life insurance available under FEGLI?
The maximum FEGLI life insurance amount is 5x your annual basic federal pay plus additional options.
Carefully reviewing these common FEHB and FEGLI questions can help clarify how Federal Life Health Insurance programs work.
Navigating federal health, life, dental and vision insurance can be complex. But taking the time to understand your options will ensure you get the maximum benefits. Comparing plans annually and coordinating coverage for life changes and retirement is crucial. Federal insurance programs provide great value for federal employees, retirees and their families. So take full advantage of these offerings to protect your finances and health.