FEHB Plan Check: Did You Choose the Right Health Plan for 2026?
39 FEHB plans charge more for Self Plus One than Family. See the QLE list, cost framework, and HDHP decision matrix.
FEHB Plan Check: Did You Choose the Right Health Plan for 2026?
Last Updated: February 14, 2026 Reading Time: 10 min
Open Season ended in December. Your new coverage started January 1. Six weeks in, you are actually using it. How does it feel?
If you are dealing with sticker shock on copays, a dropped specialist, or a prescription that doubled in price, you are not alone. Fewer than 5% of federal employees change FEHB plans each year, but the gap between the cheapest and most expensive plan for the same family can be $10,710 per year.
Here's how to evaluate whether your plan is right, whether you can change it now, and what to track for November.
Key Takeaways
- Fewer than 5% of feds change FEHB plans each year, despite potential savings of $10,000+
- 39 FEHB plan options in 2026 charge more for Self Plus One than Self and Family
- You can change plans mid-year only through a Qualifying Life Event (marriage, new baby, loss of other coverage, etc.)
- HSA-eligible HDHPs offer triple-tax advantages but work best for healthy employees with funded accounts
- Start tracking your total health spending now to make a better choice in November
5 signs your plan may be wrong
These are the red flags that suggest your plan is costing more than it should:
- Your copays went up from last year and you're not sure why
- Your doctor or specialist left the network, and you're now paying out-of-network rates
- A prescription moved tiers or was dropped from the formulary (GLP-1 drugs like Ozempic and Wegovy got hit hard in 2026)
- You picked Self Plus One, but your plan is one of the 39 where Self and Family is cheaper
- You auto-renewed without checking 2026 changes to premiums, networks, or benefits
If any of these sound familiar, keep reading.
The total cost framework
Most people pick a plan based on the biweekly premium. That's the wrong number. The number that matters is total annual cost:
Total Cost = Premiums + Deductible + Copays + Coinsurance (up to Out-of-Pocket Maximum)
A plan with low premiums but a $3,000 deductible can easily cost more than a higher-premium plan with a $500 deductible if you use health care regularly.
Example:
| Plan A (Low Premium) | Plan B (Higher Premium) | |
|---|---|---|
| Biweekly premium | $80 | $130 |
| Annual premiums | $2,080 | $3,380 |
| Deductible | $3,000 | $500 |
| If you have a $5,000 medical event | $5,080 total | $3,880 total |
Plan B saves you $1,200 despite costing $50 more per pay period in premiums.
Use our FEHB Calculator to compare premium costs across plans and enrollment types. For total cost estimates including expected health care usage, the free Checkbook Guide is the best tool available to federal employees.
Can You Change Mid-Year? The QLE Reference
You are locked into your FEHB plan until the next Open Season in November unless you experience a Qualifying Life Event. Here are the most common QLEs that allow mid-year changes.
Family Status Changes (60-Day Window)
| Event | What You Can Do |
|---|---|
| Marriage | Add spouse, change plan or enrollment type |
| Divorce or legal separation | Reduce enrollment type, change plan |
| Birth or adoption of a child | Add dependent, change to Family |
| Death of spouse or dependent | Reduce enrollment type, change plan |
| Court-ordered coverage | Enroll or change as ordered |
Loss of Other Coverage (60-Day Window)
| Event | What You Can Do |
|---|---|
| Spouse loses employer coverage | Enroll, add dependent, change plan |
| Loss of TRICARE or CHAMPVA | Enroll or change plan |
| Loss of Medicaid or CHIP | Enroll or change plan |
| Spouse's FEHB enrollment canceled | Enroll or change plan |
Employment and Status Changes
| Event | What You Can Do |
|---|---|
| Return from LWOP over 365 days | Enroll or change plan |
| Temporary to permanent appointment | Enroll or change plan |
| Full-time to part-time (or reverse) | Change plan or enrollment type |
Geographic and Plan Changes
| Event | What You Can Do |
|---|---|
| Move outside HMO service area | Change to fee-for-service plan |
| Transfer domestic to overseas (or reverse) | Enroll or change plan |
| Your plan discontinues | Change to any available plan |
Coverage Gains
| Event | What You Can Do |
|---|---|
| Gain Medicare eligibility | Change plan or enrollment type |
| Spouse gains employer coverage | Reduce or cancel enrollment |
Key rules for all QLEs:
- Your change must be "consistent with" the qualifying event
- Submit through Employee Express or your HR office
- Bring documentation (marriage certificate, birth certificate, employer letter)
- Changes take effect the first pay period after your office processes the request
If no QLE applies: You wait for Open Season in November 2026. But start tracking your costs now so you have real data for your decision.
The Self Plus One vs Self and Family Anomaly
Here's a pricing quirk most federal employees don't know about. In 39 FEHB plan options for 2026, Self and Family enrollment is actually cheaper than Self Plus One for the enrollee's share.
Why it happens: The government contribution is capped at the lesser of 75% of the plan premium or 72% of the program-wide weighted average. This formula sometimes produces a higher enrollee share for Self Plus One than Self and Family, especially in plans with older married-couple risk pools.
What to do: If you are enrolled in Self Plus One, compare both rates for your specific plan. If Self and Family is cheaper, you can switch during Open Season (or a QLE). You do not need multiple dependents to choose Self and Family, one covered family member qualifies.
Dual Federal Employee Couples
If both you and your spouse are federal employees, compare these three options:
| Option | When It's Cheapest |
|---|---|
| One Self Plus One | Usually simplest but not always cheapest |
| Two Self Only plans | Often cheapest if both plans have low Self Only rates |
| One Self and Family (anomaly plan) | When Self and Family is cheaper than Self Plus One |
Run the numbers. Two Self Only plans sometimes save $1,000 or more per year versus one Self Plus One.
HDHP vs standard plan
High Deductible Health Plans paired with HSAs are one of the best deals in FEHB, but most people avoid them because the word "deductible" is scary. Here's when they actually make sense.
2026 HDHP Numbers
| Individual | Family | |
|---|---|---|
| Minimum deductible | $1,700 | $3,400 |
| Max out-of-pocket | $8,500 | $17,000 |
| HSA contribution limit | $4,400 | $8,750 |
| HSA catch-up (55+) | +$1,000 | +$1,000 |
Who Should Use an HDHP?
| Your Situation | HDHP Fit | Why |
|---|---|---|
| Healthy, few doctor visits | Excellent | Low premiums plus HSA growth. Preventive care is still 100% covered. |
| Young, long investment horizon | Excellent | HSA can grow to $50,000+ over your career with the triple-tax advantage |
| Moderate health care user | Good | Premium savings often offset deductible, especially with a funded HSA |
| Chronic condition, regular prescriptions | Poor | You pay full cost until the deductible is met |
| Expecting a baby | Poor for that year | Switch to standard for the delivery year, then back to HDHP |
| Medicare-eligible retiree | Not eligible | Cannot contribute to HSA while enrolled in Medicare |
The HSA triple tax advantage
- Contributions are pre-tax (they reduce your taxable income)
- Growth is tax-free (you can invest in stocks, bonds, target-date funds)
- Qualified withdrawals are tax-free (for medical expenses at any age, or any purpose after 65)
The TSP, Roth IRA, and traditional IRA each give you one or two of these. The HSA gives you all three. It's the most tax-efficient account available to federal employees, and most people don't use it.
Strategy: Use the HDHP in healthy years to build your HSA balance. Switch to a standard plan in years with expected high costs (surgery, pregnancy). Switch back after. You can change plan types during any Open Season.
Dental and Vision: The Gap Most Feds Ignore
Most FEHB plans provide little or no dental and vision coverage. If you skipped FEDVIP enrollment, here's what that could cost:
| Procedure | Typical Cost Without Insurance |
|---|---|
| Crown | $1,000-$1,500 |
| Root canal | $700-$1,500 |
| Orthodontics | $3,000-$7,000 |
| Glasses (frames + lenses) | $200-$600 |
| Eye exam | $100-$200 |
FEDVIP (Federal Dental and Vision Insurance Program) offers 12 dental and 5 vision carriers in 2026. Unlike FEHB, there is no government contribution, so you pay the full premium. But for anyone expecting dental work beyond cleanings, the coverage typically pays for itself.
FEDVIP enrollment happens during the same Open Season as FEHB. If you missed it, you are generally locked out until November 2026 unless you have a QLE.
What to track now for Open Season
You have 9 months before the next Open Season. Start a simple spreadsheet (or even a notes app) with these columns:
- Date of visit or prescription
- Provider name
- What you paid (copay, coinsurance, or deductible amount)
- What insurance paid
- Was the provider in-network?
By November, you will have real data instead of guessing. Plug your actual costs into the Checkbook Guide to see how other plans would have performed with your usage pattern.
Compare Your FEHB Options
Use our free FEHB Calculator to compare premium costs across enrollment types and see the Self Plus One vs Self and Family pricing for your plan. For a comprehensive guide to all FEHB plan options, see our FEHB Guide 2026.
Frequently Asked Questions
Can I change my FEHB plan outside of Open Season?
Yes, but only if you experience a Qualifying Life Event (QLE). Common QLEs include marriage, divorce, birth or adoption of a child, loss of other health coverage, and relocation outside an HMO service area. You generally have 60 days from the event to make changes. Without a QLE, you must wait for Open Season in November. Contact your employing office or use Employee Express to submit the change.
What counts as a qualifying life event for FEHB?
OPM defines 18 categories of qualifying life events. The most common are marriage, divorce, or legal separation; birth, adoption, or foster child; death of a spouse or dependent; loss of coverage under another health plan; relocation outside an HMO service area; transfer between domestic and overseas posts; Medicare eligibility; and restoration to duty after military service. Your enrollment change must be consistent with the qualifying event.
Is Self Plus One always cheaper than Self and Family in FEHB?
No. In 2026, 39 FEHB plan options actually charge more for Self Plus One than Self and Family. This pricing anomaly occurs because of how the government contribution formula interacts with each plan's risk pool. Always compare both rates for your specific plan before enrolling. You do not need multiple dependents to choose Self and Family.
Should I choose an HDHP or standard FEHB plan?
It depends on your health care usage. HDHPs have lower premiums but higher deductibles ($1,700 or more for individuals in 2026). They pair with HSAs that offer triple-tax advantages. HDHPs work best for healthy employees who can fund their HSA and absorb the deductible. If you have chronic conditions or expect major medical events, a standard plan usually costs less overall. You can switch between plan types during Open Season.
How do I know if my FEHB plan is costing me too much?
Calculate your total annual cost: premiums paid plus all out-of-pocket expenses including deductibles, copays, and coinsurance. Use the free Checkbook Guide at checkbook.org to compare estimated total costs for all available plans based on your usage profile, or use the FedTools FEHB Calculator to compare premiums across enrollment types. The gap between the cheapest and most expensive plan for the same family can be over $10,000 per year.
Related Resources
- FEHB Calculator: Compare premium costs across plans and enrollment types
- FEHB Guide 2026: Complete guide to FEHB plans, enrollment, and benefits
- FEHB Premiums 2026: Analysis of 2026 premium changes by plan
- FERS Retirement Calculator: Model your retirement income (including health care planning)
- Tax Planning for Federal Retirees: Medicare IRMAA and tax strategies
Sources: OPM Changes Outside Open Season, OPM Enrollment Reference, 5 CFR 890.301, Checkbook Guide to Health Plans