Expert's View

The end of the year is rushing toward us and many of you are thinking about retiring at the end of December (FERS) or no later than the third day of January (CSRS). If so, I hope you’ve stopped long enough to consider whether you’ll be able to take your Federal Employees Health Benefits coverage into retirement. Here are the rules that control whether you will or won’t.

You can continue that coverage if you have been enrolled continuously in the FEHB for the five years immediately preceding retirement or from your first opportunity to enroll in it. This doesn’t mean that you have to be enrolled in a specific plan for that period of time. In fact, you could have changed plans every year and still meet the five year (or first opportunity) requirement. Note: You can count any time under Tricare toward meeting the five-year requirement as long as you are covered under the FEHB when you retire.

There is an exception to the five-year requirement that you need to be aware of. OPM has granted pre-approved waivers to any of you who receive a buyout and retire during your agency’s statutory buyout period, take early optional retirement as a result of your agency’s early-out authority, or take discontinued service retirement due to a RIF, directed reassignment, reclassification of your position to a lower grade, or abolishment of position.

If your retirement opportunity fits one of those situations, your agency will need to attach a memorandum to your retirement papers stating that your retirement meets the criteria for a pre-approved waiver of the FEHB five-year requirement.

Note: These waivers only apply in certain situations. If you decide to retire without meeting either the requirements in law or the waiver criteria, you’ll probably be out of luck. Although OPM has been given the authority to grant individual waivers, it rarely does so. That’s because the law has set a very high threshold. Your failure to satisfy the five-year requirement must be due to circumstances so exceptional that it would be against equity and good conscience to deny you coverage.