The Federal Employees Health Benefits (FEHB) Program is the health insurance program for federal employees and retirees: you pick a private plan, the government pays a share of the premium set by law, and you can keep the coverage for life in retirement if you meet the five-year rule.
Health insurance is the benefit most federal employees underestimate until the year they retire. Then it becomes the line item that matters most. Private-sector retirees often lose their employer plan the day they leave. Federal retirees who follow one rule keep theirs for life, at the same premium employees pay.
That rule, and the choices around it, are what this guide covers. You will learn how the program is built, what plan types exist, how the government share of your premium is set, what each enrollment type means, and what you need to do now to carry coverage into retirement.
Think of FEHB as a key you have to keep in your pocket for five straight years before you retire. If you have it, the door to lifetime coverage opens. If you set it down at the wrong time, there is no way to pick it back up.
01What is FEHB?
FEHB is the Federal Employees Health Benefits Program, the employer-sponsored health insurance program for federal civilian employees, annuitants, and their eligible family members. OPM does not run a single government plan. It contracts with private insurance carriers, and you choose among their plans.
The program is large. OPM describes FEHB, which now includes the Postal Service Health Benefits Program, as the largest employer-sponsored health benefits program in the United States, covering about 7.9 million people (OPM, retrieved 2026-10-11).
Your plan year runs on the calendar. You choose or change plans during the annual Open Season in November and December, or when you have a qualifying life event such as marriage, a birth, or losing other coverage. If you do nothing, your current enrollment carries into the next year.
02What types of FEHB plans can you choose from?
FEHB offers four main plan types, and the type tells you more about how a plan behaves than the carrier name does. Some plans are available nationwide. Others, mostly HMOs, are limited to a state or region.
- Fee-for-service (FFS)Nationwide plans that pay for care from any provider, usually with lower costs when you use the plan's preferred provider network. Many carry High and Standard options.
- Health maintenance organization (HMO)Regional plans that use a defined network of doctors and hospitals. Premiums and cost sharing can be lower, but care outside the network is generally not covered except in emergencies.
- Consumer-driven health plan (CDHP)Plans that pair a higher deductible with a personal care account funded by the plan, which you spend first on covered care.
- High-deductible health plan (HDHP)Plans with a deductible high enough to qualify for a health savings account (HSA). The plan deposits a premium pass-through into the HSA or a similar account.
Within those types, carriers offer different options, such as High, Standard, or Basic. The option changes the premium, the deductible, and the copays. The plan brochure is the legal description of what is covered, and OPM's Plan Comparison Tool lets you line plans up side by side.
The carrier name is the label. The plan type and the brochure are the contract.
03How much does the government pay toward your premium?
For most employees and annuitants, the government pays the lesser of two amounts: 72 percent of the program-wide weighted average premium for your enrollment type, or 75 percent of the total premium for the plan you choose. You pay whatever is left (OPM, retrieved 2026-10-11).
That formula, which OPM calls the Fair Share formula, has two practical effects. First, on lower-cost plans the 75 percent cap often applies, so you pay at least 25 percent of that plan's total premium. Second, on higher-cost plans the government contribution stops at the 72 percent figure, so every extra dollar of premium comes out of your share. That is why the enrollee share of an expensive plan can be several times the share of a modest one.
Premiums change every January. For the 2027 plan year, OPM reported these program-wide averages (OPM, retrieved 2026-10-11):
| FEHB measure, plan year 2027 | Average change | Prior year |
|---|---|---|
| Overall premium | 9.3% | 10.2% in 2026 |
| Enrollee share | 10.9% | 12.3% in 2026 |
| Government contribution | 8.6% | 9.2% in 2026 |
Averages hide a wide spread. Your plan may rise much more or much less than the average, and nine FEHB plan options will not be offered in 2027. Our FEHB premiums data page lists current totals by plan, and the open season guide explains how to compare them.
Worked example: the 75 percent cap
Take one plan from OPM's 2026 rate file: the APWU Health Plan CDHP had a total biweekly Self Only premium of $402.47 (OPM, retrieved 2026-07-05). If the 75 percent cap applies to that plan, the government pays no more than about $301.85 every two weeks, and your share is at least about $100.62. If the 72 percent weighted average figure is lower than $301.85, the government pays that figure instead and your share is higher.
Your record, not our example
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04What is the difference between Self Only, Self Plus One and Self and Family?
Self Only covers you. Self Plus One covers you and one eligible family member you name. Self and Family covers you and all eligible family members, including children up to age 26 (OPM, retrieved 2026-07-05).
- Count who needs coverage. A spouse alone fits Self Plus One. A spouse and one child, or two children, need Self and Family.
- Compare both family premiums. Self Plus One is not always cheaper than Self and Family in every plan.
- Expect documentation. Starting with Open Season for plan year 2027, anyone adding a new family member during Open Season must submit documents that verify the family member's eligibility (OPM, retrieved 2026-10-11).
- Think ahead to retirement. If you want a spouse to keep FEHB after your death, your enrollment type at retirement and your survivor annuity election both matter.
05How do you keep FEHB into retirement?
You can carry FEHB into retirement if you retire on an immediate annuity and you were continuously enrolled in FEHB for the five years of service immediately before retirement, or for all of your service since your first opportunity to enroll if that period is shorter (OPM, retrieved 2026-07-05). Enrollment in any plan counts, and so does coverage as a family member under someone else's FEHB enrollment.
This is the key in your pocket. Miss it and your FEHB ends when you separate, with no buy-back. The rule is strict enough that OPM's early retirement guidance notes the requirement applies "unless waived," and waivers are limited to specific situations such as certain agency early-out programs (OPM, retrieved 2026-10-11).
- Immediate annuity required. Retiring under MRA+10 and postponing your annuity suspends FEHB until the annuity starts. Taking a deferred annuity after leaving early generally does not let you return to FEHB.
- Five years means five years. Dropping coverage for even part of the window, for example to use a spouse's private plan, can break eligibility. Suspending FEHB to use TRICARE or Medicare Advantage is treated differently; check the specific rule before you act.
- Survivors depend on your election. A surviving spouse can keep FEHB only if they receive a survivor annuity and were covered under your enrollment. Declining the survivor benefit can end their health coverage at your death.
- Plan changes stay open. Retirees keep the right to switch plans every Open Season, just like employees.
The survivor point deserves a second look. Our survivor benefits guide explains the FERS election in full. The short version: the survivor annuity is the ticket that lets a spouse keep FEHB, so even a small partial election can matter.
06What happens to FEHB when you leave federal service early?
If you separate before you qualify for an immediate annuity, your FEHB coverage ends after a 31-day extension of coverage at no cost. You can then elect Temporary Continuation of Coverage (TCC) for up to 18 months, but you pay the full premium plus a 2 percent administrative charge, with no government share (OPM, retrieved 2026-10-11).
TCC is a bridge, not a destination. It can carry you to a new employer's plan or to Medicare. It cannot be converted into retiree FEHB later.
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07How does FEHB differ for postal employees?
Since January 2025, most Postal Service employees and postal annuitants get coverage through the Postal Service Health Benefits (PSHB) Program. OPM runs PSHB as part of FEHB, but it has its own plans, its own premiums, and its own government contribution calculation (OPM, retrieved 2026-10-11).
For the 2027 plan year, PSHB offers 65 plan options from 17 carriers, with an average enrollee share increase of 8.2 percent (OPM, retrieved 2026-10-11). The biggest difference for retirees is Medicare: certain Medicare-eligible postal annuitants must enroll in Medicare Part B to keep PSHB, a requirement that does not exist in regular FEHB. Our FEHB and Medicare guide covers the exceptions.
08What should you weigh when you choose a plan?
The best plan is the one whose total cost and network fit how you actually use care. Premium alone tells you only part of the story.
- 01
List your doctors and prescriptions
Check each one against the plan's network and formulary before anything else.
- 02
Estimate a full year
Add 26 biweekly premium payments (or 12 monthly ones in retirement) to your expected deductible, copays, and coinsurance.
- 03
Read the catastrophic limit
The out-of-pocket maximum is your worst-case year. Compare it across plans.
- 04
Check how the plan works with Medicare
If you are near 65, see whether the plan waives cost sharing when Medicare pays first or offers a Medicare Advantage option.
- 05
Look at extras
Dental, vision, wellness incentives, and account deposits (in CDHPs and HDHPs) differ by plan. FEDVIP adds separate dental and vision coverage.
09Moving forward with your FEHB decisions
FEHB is one piece of a retirement plan, but it touches nearly every other piece: your retirement date, your survivor election, your Medicare choice at 65, and your budget for life. The two decisions that cannot be undone are the five-year rule and the survivor election, so confirm both well before your last day.
From here, the open season guide walks through comparing plans each fall, and the FEHB and Medicare guide covers the decision at 65. Our FEHB vs Medicare tool lets you test the numbers on assumptions you choose.
FFEBA is an education organization. If you want someone to look at your own numbers, we can match you with a Federal Retirement Consultant (FRC), a professional trained on federal benefits. The FRC designation is listed with FINRA. The first review is free, nothing is booked until you choose a time, and you are never obligated to work with anyone we introduce. Get matched with an FRC.
Reviewed by the FFEBA education team. Last reviewed October 2026.
Sources
- U.S. Office of Personnel Management, Federal Benefits Open Season Highlights, 2027 Plan Year, retrieved 2026-10-11
- U.S. Office of Personnel Management, 2026 FEHB fee-for-service premium rates (FFEBA data file), retrieved 2026-07-05
- U.S. Office of Personnel Management, FEHB premiums, retrieved 2026-07-05
- U.S. Office of Personnel Management, Healthcare (FEHB in retirement), retrieved 2026-07-05
- U.S. Office of Personnel Management, FEHB enrollment types, retrieved 2026-07-05
- U.S. Office of Personnel Management, Voluntary Early Retirement Authority (FEHB five-year requirement), retrieved 2026-10-11
- U.S. Office of Personnel Management, Temporary Continuation of Coverage, retrieved 2026-10-11
- U.S. Office of Personnel Management, Postal Service Health Benefits (PSHB) Program, retrieved 2026-10-11
Every government figure on this page carries its source and retrieval date. Worked examples are educational estimates on the assumptions shown, not a projection of any person's benefit. FFEBA is an education organization, not a financial advisor.
