Valuable as FEHB and PSHB are, you must take the initiative to get informed and choose wisely to get the most from these programs. Image: Minerva Studio/Shutterstock.com
Getting the Most from Your Federal Health Insurance
Updated for the 2026 Plan Year
Health insurance coverage for federal employees and retirees offers valuable advantages: a wide range of choices, no waiting periods to enroll, and eligibility for continued coverage in retirement — with retirees paying the same premiums as active employees. However, that coverage comes at a cost, as average premiums continue to rise each year.
More of FEDweek’s Open Season 2026 coverage here.
The average enrollee premium in the FEHB rose 12.3% for 2026 over 2025, following average increases of 13.5%, 8.7%, and 7.7% over the prior three years. Average increases for PSHB plans were 11.3% for 2026. The difference largely reflects Medicare cost-sharing for postal retirees and demographic factors affecting claims rates.
Premium rate tables are available at:
FEHB Premiums and
PSHB Premiums.
In the Federal Dental and Vision Insurance Program (FEDVIP), dental plan premiums rose by 3.4% and vision plan premiums by 0.5%.
More details: FEDVIP Program.
According to OPM, “The 2026 premiums remain in line with projected increases across other large employers.” Cost drivers include medical inflation, prescription drugs (especially specialty drugs), and behavioral health care expansion.
Understanding the FEHB and PSHB
Both the FEHB and PSHB offer exceptional flexibility compared with most employer-sponsored health insurance. For 2026, the FEHB includes 47 carriers with 132 plan options; the PSHB includes 17 carriers with 75 options.
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Coverage includes nationwide and regional HMO plans, as well as consumer-driven and high-deductible options. About 8.2 million people are covered, split evenly between enrollees and family members.
Premiums for retirees are the same as for employees, though retirees pay monthly instead of biweekly, and cannot use pre-tax payroll deductions. The government covers about 70% of total premium costs.
Eligibility extends to most federal employees and retirees with at least five years of continuous coverage before retirement. Eligible family members include spouses and children under 26 (or disabled before that age). Foster children may be eligible if certain conditions are met.
Enrollment types include self only, self plus one, and self and family. Self plus one generally costs less than family coverage, though some exceptions exist.
Learn more:
FEHB Overview |
PSHB Overview
Postal Service Health Benefits Program: Special Considerations
The PSHB largely mirrors the FEHB but has key differences:
- Fewer carriers, though plans often parallel major FEHB options.
- Most USPS retirees (2025 and later) must enroll in Medicare Part B to retain PSHB eligibility.
- Prescription coverage integrates with Medicare Part D.
- Postal compensationers are exempt from the Part B requirement until retirement.
Additional PSHB resources:
OPM PSHB Page |
PSHB Guide
Changes in Coverage for 2026
Each spring, OPM issues a “call letter” to carriers defining required coverage terms. For 2026, major system-wide updates include:
- Ending coverage for medical or surgical gender-transition procedures.
- Mandatory no-cost coverage for FDA-approved HIV PrEP drugs and monitoring.
- Broader provider networks and out-of-network access for excessive wait times.
- Continued free coverage for at least one opioid rescue medication.
- Expanded coverage for anti-obesity medications (including GLP-1s) and behavioral programs.
- New IVF and fertility storage standards where state laws mandate coverage.
Details:
OPM Health Benefits Site
Making Health Coverage Decisions
Open Season runs November 10 – December 8, 2025 for the 2026 plan year. It applies to FEHB, PSHB, and FEDVIP, plus the FSAFEDS program for active employees.
During Open Season you can:
- Enroll if not currently covered.
- Change plans or coverage levels (self, self plus one, or family).
- Review benefit changes and premium adjustments.
Outside Open Season, changes are allowed only for qualifying life events (marriage, birth, adoption, divorce, employment changes, or loss of coverage).
Plan brochures and comparisons:
FEHB Brochures |
PSHB Brochures
Key Considerations When Choosing a Plan
- Plan Type: FFS, PPO, HMO, consumer-driven, or high-deductible — each has different flexibility and costs.
- Expected Care: Anticipate upcoming surgeries, chronic care, or family health needs.
- Prescription Costs: Compare formularies and copays for expected medications.
- Out-of-Pocket Costs: Factor in deductibles and coinsurance; use FSAFEDS if eligible.
- Flexibility: Plans can be changed annually — tailor coverage as your life circumstances change.
For dual-federal couples, maintaining separate self-only plans may occasionally make sense — though joint coverage often offers better protection when family circumstances change.