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June 28th is National Insurance Awareness Day, offering a timely reminder for federal employees to reassess their current healthcare needs and determine whether their FEHB plan remains the best fit.
It’s important to review your coverage outside of Open Season, know what to expect for 2026, and be aware of trusted resources that can help guide your decisions.
Why federal employees need to regularly evaluate their insurance — not just during Open Season
Life changes — Have recent events prompted you to examine your current health plan? Major milestones like getting married or welcoming a child are considered qualifying life events, which allow you to make changes to your plan outside of Open Season. Other changes, like planning to start a family next year or receiving a new medical diagnosis, do not, but they’re important to consider now as you prepare for Open Season this fall. Anticipating your future healthcare needs can help ensure you choose the most appropriate plan when the opportunity arises.
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Retirement prep — The Federal Employees Health Benefit plan that suited you best during your working years may not be the right option in retirement. If you’re planning to retire soon, now is the time to evaluate which FEHB plan aligns best with your healthcare needs and budget. A key part of this decision involves whether you’ll enroll in Medicare Part B, which currently has a monthly premium of $185. To make an informed decision, take time to compare how different FEHB plans coordinate with Medicare.
Budget check — With the calendar year halfway through, now is a good time to review your healthcare spending. How much have you paid out-of-pocket so far, and what services have you used? While some health events are unexpected — and are a key reason why we carry insurance — some, like routine doctor visits and prescription medications, are more predictable. If you’re enrolled in an FEHB plan with a high premium and broad coverage but haven’t used many services, you might be overinsured. It may be worth assessing whether a lower-premium plan — with potentially higher out-of-pocket costs when care is needed — could better align with your actual healthcare usage. You’ll have the opportunity to make changes during Open Season this fall.
Wellness benefits — Does your FEHB plan offer discounted gym memberships or rewards for completing a health assessment or annual physical? Many include wellness perks as part of their overall benefits package. They’re detailed in Section 5(h) of the official FEHB plan brochure, in the “Non-FEHB Benefits Available to Plan Members” section of the brochure, and on the carrier website.
For example, GEHA High and Standard Option members can earn up to $250 annually per subscriber and covered spouse by completing a health assessment, getting an annual physical, receiving a flu shot, etc. Rewards are issued on a reloadable debit card and can be used for qualified medical expenses.
Be sure to review the wellness benefits your plan provides — you might discover you’re eligible for rewards just by maintaining your regular health routines.
Provider changes — Doctors and other healthcare providers can join or leave a plan’s network at any time, and this does not qualify as a life event that allows you to switch coverage outside of Open Season. To avoid surprises, you should regularly check which FEHB plans your preferred providers accept. You can do this by calling your doctor’s office directly or by visiting FEHB carrier websites to verify whether your providers are still in-network.
Navigating the 2026 FEHB Open Season in an uncertain political climate
Government premium contribution update — Earlier this year, concerns arose among federal employees and annuitants about a potential shift in how the government contributes to FEHB premiums. In late 2024, the Congressional Budget Office released a report exploring budget reduction strategies, including the idea of replacing the government’s current contribution — up to 75% of the FEHB premium — with a fixed-value voucher. The so-called “One Big, Beautiful Bill” ultimately did not include the voucher option, and the existing government premium contribution formula remains in place.
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Family member verification — A key provision included in both the Senate and House versions of the “One Big, Beautiful Bill” is a new requirement for auditing family member eligibility in the FEHB program. Under this provision, federal agencies will be required to verify the eligibility of any family members before they can be added to an FEHB plan — whether during Open Season or following a qualifying life event. The Government Accountability Office estimates that approximately $1 billion per year is being spent by the FEHB program on ineligible family members.
Gender affirming care — There are significant changes to gender affirming care benefits for plan year 2026. First, in response to two executive orders issued by President Trump in early 2025, FEHB plans will no longer provide pediatric transgender surgeries and hormone treatments for gender transition for individuals under the age of 19. Carriers may continue offering gender affirming care to individuals aged 19 and older, but they are not required to do so.
Preventive care — While there are no immediate impacts, this will be one to watch in the future. The Centers for Disease Control and Prevention has recently updated the adult immunization schedule and has removed the recommendation status for the COVID-19 vaccination for pregnant women. In response, a letter from the American College of Obstetricians and Gynecologists has been signed by dozens of medical and public health organizations urging insurers to continue covering the COVID-19 vaccination at zero cost for pregnant patients.
How to find resources and guidance for making informed insurance decisions
The Office of Personnel Management website serves as a comprehensive resource for all things related to the FEHB program. It features a plan-comparison tool that allows users to evaluate their options based on premiums and benefits, and it provides access to every FEHB plan brochure in one convenient location. Users can also find the official FEHB handbook, which details OPM policies on eligibility, enrollment and other key topics.
The official FEHB plan brochure is an essential resource for understanding how your health plan works. Each brochure follows a standardized format, making it easy to locate specific benefit information across all FEHB plans. You can find detailed explanations of what your plan covers and doesn’t cover, which services require prior authorization, how particular benefits are administered, and much more.
The National Active and Retired Federal Employees Association is “…dedicated to the general welfare of all federal workers and retirees.” Through its Federal Benefits Institute, NARFE offers members a range of educational resources — including webinars, benefits briefs and expert guidance — to help federal employees and retirees better understand and navigate their benefits, including the FEHB program.
Since 1979, Consumers’ Checkbook has published Checkbook’s Guide to Health Plans for Federal Employees, a trusted resource for help choosing an FEHB plan. The Guide ranks all FEHB plans based on estimated total yearly cost — a combination of premium and likely out-of-pocket expenses tailored to the user’s personal situation. Many federal agencies offer their employees free access to this valuable tool. In addition, Checkbook provides ongoing FEHB-related guidance through its recurring “Feds With Benefits” column on Federal News Network and on the Checkbook Health YouTube channel.
Happy National Insurance Awareness Day to those that celebrate!
I encourage you to send in any FEHB questions, and I look forward to answering them with actionable advice to help you better understand how the FEHB program works.
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Kevin Moss is a senior editor with the Guide to Health Plans for Federal Employees provided by Consumers’ Checkbook. Watch more of his free advice and check here if the Guide is available for free from your agency. You can also purchase the Guide and save 20% with promo code FEDNEWS.
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