Expert's View

fehb spouse coverage

Reg Jones

We’re now about halfway into the annual federal benefits Open Season—it ends December 13—and even if you like your current coverage, you still can use the time remaining to your advantage.

If you are already enrolled in an FEHB plan, whether you are currently employed or retired, you can continue that coverage or select another plan. You can also increase or decrease your coverage options. If you aren’t enrolled in an FEHB plan, you can do that if you are currently employed; retirees generally cannot newly enroll if they were not previously enrolled.

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Whether you are a new enrollee or someone who is changing plans, there aren’t any waiting periods for coverage nor are there any pre-existing condition limitations. If you are an employee, your coverage begins of the first day of the first pay period beginning after January 1—in almost all cases, that is January 2. If you are a retiree, your coverage begins on January 1.

To help you make an Open Season decision, use OPM’s enrollment tools, which you’ll find at the following sites.

For health plan information: https://www.opm.gov/healthcare-insurance/healthcare/plan-information/plans.

For comparison tools: https://www.opm.gov/healthcare-insurance/healthcare/plan-information/compare-plans.

For health care quality and customer and experience scores: https://www.opm.gov/healthcare-insurance/healthcare/plan-information/compare-plans/quality.

If you are happy with your current FEHB plan, you don’t need to do anything. Your coverage will continue without interruption. However, even in that case it is worth your while to visit those sites. You should at least be aware of your plan’s coverage terms and premiums for the upcoming year and could well find a plan that is a better fit for you, possibly unexpectedly. Coverage does vary among plans within the general outlines of the program, to say nothing of the variations in premium costs and out of pocket costs such as deductibles and copays.

If you want to change your health benefits plan (or option), or are eligible to enroll in one for the first time, use the Health Benefits Election form (SF 2809), which is available from personnel offices or can be downloaded by going to https://www.opm.gov/forms/pdf_fill/sf2809.pdf.

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Important note for those planning to retire soon: Carrying your health benefits coverage into retirement isn’t automatic. By law you have to be enrolled in the FEHB program for the 5 consecutive years before you retire or from your first opportunity to enroll. Waivers of this requirement are possible but very rare. While enrollment in either Tricare or CHAMPVA can count toward the 5-year requirement, it can only do so if you are actually enrolled in the FEHB program on the day you retire.

Also remember that the Open Season is the period for making similar elections in the FEDVIP vision-dental insurance program (with the exception that retirees may newly enroll without limit in that program). And for current employees, it’s also the time to elect health care and/or dependent care flexible spending accounts for next year. While current FEDVIP (like FEHB) coverage continues unless changed, a new election must be made each year in the FSA program.

FEHB: Healthcare for Federal for Retirees

Open Season Offers Choices under FEHB, FEDVIP, FSAs

2022 FEHB Premiums to Rise 3.8 Percent

Special Considerations for FEHB after Retirement

Indicator Set for 2023 Raise

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