How does the FEHB government contribution work?

Government pays the LESSER of: 72% of the weighted average premium across all plans, OR 75% of your specific plan premium. For 2026, max biweekly contributions are: $324.76 (Self), $711.17 (Self+One), $778.03 (Family). Lower-cost plans get full 75%; high-cost plans may only get 50%.

How much does FEHB cost in retirement?

Retirees pay the same government contribution formula as active employees. The difference: premiums are paid monthly (not biweekly) and are post-tax (deducted from annuity). High-premium plans cost more because the 72% cap kicks in sooner.

What is the FEHB 5-year rule?

To continue FEHB into retirement, you must be enrolled in FEHB (or TRICARE/CHAMPVA) for 5 consecutive years immediately before retirement. Exceptions are rare. Start FEHB at least 5 years before your planned retirement date.

What are the FEHB plan types?

Fee-for-Service (FFS): See any doctor, file claims. PPO: Network discounts, no referrals needed. HMO: Lowest cost, must use network, need PCP referrals. HDHP: High deductible with HSA for tax savings. Choose based on flexibility vs. cost preference.

What are 2026 HSA contribution limits for HDHP plans?

For 2026: Self Only = $4,400, Family = $8,750, plus $1,000 catch-up if 55+. HSAs offer triple tax advantage: pre-tax contributions, tax-free growth, tax-free withdrawals for medical expenses. Unused balances roll over indefinitely.

Can I change FEHB plans in retirement?

Yes. Retirees have full access to Open Season (November) every year and can switch plans freely. Consider nationwide plans if you plan to travel or relocate. You can also change during qualifying life events.

What is the difference between Self and Self Plus One?

Self Only: Covers you only. Self Plus One: Covers you + ONE family member (spouse OR one child). Self and Family: Covers you + ALL eligible family members. Self Plus One is often cheaper than Family when covering just a spouse.

How do FEHB premiums change with Medicare at 65?

FEHB coordinates with Medicare. Most retirees keep FEHB as secondary coverage - Medicare pays first, FEHB covers remaining costs. Consider switching to a lower-premium FEHB plan since Medicare handles most expenses.

Should I change FEHB plans before retirement?

Consider switching if: 1) Your plan has high premiums (72% cap hits harder), 2) You will relocate (check network coverage), 3) You want nationwide coverage for travel, 4) Current plan has limited retiree benefits.

FEHB · Health Benefits

FEHB Premium Calculator

Compare all 132 Federal Employee Health Benefits plan options for 2026 — including regional HMOs by ZIP code. Filter by carrier, plan type, and coverage; every premium recomputes live.

Reviewed by Jonathan D., 20-year federal employee · Formulas verified against OPM.gov · Updated June 2026

The low-premium trap

Of the 132 FEHB plan options for 2026, 66 of 132 unique plan options are priced low enough that the government covers exactly 75% of your total premium — you receive the full subsidy. The other 66 are priced high enough that the 72% weighted-average cap kicks in, costing you a larger dollar share. Picking any of the 66 capped plans without comparing out-of-pocket limits can mean paying more in premiums and more at the doctor.

FedTools 2026 analysis of OPM rate file · 132 options across 96 plan codes · See the full dataset in the calculator above.

FedTools 2026 analysis

Across all 132 plan options in the 2026 OPM rate file, the annual premium spread between the cheapest and most expensive nationwide option exceeds $2,400 for Self Only coverage and more than $6,000 for Self and Family. Enter your ZIP above to see which regional HMOs are available in your area — many offer lower premiums than national FFS plans. The right plan selection can save a federal employee a meaningful fraction of a paycheck every year.

For more context, see our full analysis: Federal Retirement Healthcare Costs: FEHB 2026 and FEHB Value in Retirement 2026.

Your pension pays these premiums

In retirement, your FEHB premium comes straight out of your FERS annuity. Estimate that pension so you know what is left after coverage.

Open FERS Calculator →

How the government contribution works

The government pays the lesser of 72% of the weighted-average premium across all plans, or 75% of your specific plan's premium. Lower-cost plans get a larger effective subsidy.

2026 FEHB maximum government contribution by enrollment type
Enrollment type	Max gov / biweekly	Max gov / monthly
Self Only	$324.76	$703.65
Self Plus One	$711.17	$1,540.87
Self and Family	$778.03	$1,685.73

2026 update: the average enrollee share rose 12.3% — the second consecutive year of double-digit increases. Comparing plans carefully during Open Season is the best way to control your share. Read our complete 2026 FEHB Premiums guide for plan-by-plan breakdowns.

FEHB plan types explained

PPO / Fee-for-Service

Most flexible. See any doctor; file claims for out-of-network reimbursement.

Best for: those wanting low-restriction, nationwide access

HMO (Health Maintenance Org.)

Lower premiums. Use network doctors and get PCP referrals for specialists.

Best for: cost-conscious enrollees in a covered region

HDHP (High Deductible Health Plan)

Lowest premiums, highest deductibles. Paired with an HSA for triple tax advantage.

Best for: healthy enrollees who can save via an HSA

POS (Point of Service)

A hybrid: HMO-style in network, PPO-style out of network, with referrals.

Best for: those wanting both structure and some flexibility

The FEHB 5-year rule for retirement

Critical requirement

To continue FEHB into retirement, you must be continuously enrolled (in FEHB, TRICARE, or CHAMPVA) for the five years immediately before your retirement date.

→Start early: enroll in FEHB at least five years before your planned retirement.

→No gaps allowed: coverage must be continuous — even a 1-day gap can disqualify you.

→TRICARE counts: time covered by TRICARE or CHAMPVA counts toward the five years.

✕Spouse coverage: being covered under a spouse's FEHB does not satisfy the requirement.

2026 HSA contribution limits

High Deductible Health Plans (HDHPs) pair with a Health Savings Account for significant tax advantages.

2026 HSA limits

Self Only$4,400

Family$8,750

Age 55+ catch-up+ $1,000

HSA triple tax advantage

1Contributions reduce taxable income

2Earnings grow tax-free

3Withdrawals for medical expenses are tax-free

Premium conversion: the hidden FICA savings

Active federal employees pay FEHB premiums through premium conversion — a pre-tax payroll arrangement that reduces your taxable income by the full employee premium. The FICA tax savings (Social Security 6.2% + Medicare 1.45% = 7.65%) are on top of the income-tax savings.

2026 FEHB annual FICA savings by enrollment type and salary tier
Enrollment type	Typical employee share / yr	FICA savings (7.65%)	Income-tax savings*
Self Only	$3,000	$230	$660
Self Plus One	$5,500	$421	$1,210
Self and Family	$7,500	$574	$1,650

* Income-tax savings estimated at 22% marginal rate. Actual savings depend on your bracket. FICA savings apply only to active employees paying into Social Security and Medicare — retirees pay premiums post-tax from their annuity.

Retiree note: premium conversion ends at retirement. Your FEHB premium is deducted from your monthly annuity check after tax — so the effective out-of-pocket cost of the same plan rises modestly when you retire, especially if you move to a lower tax bracket.

FEDVIP and part-time proration

Two benefit categories that interact with FEHB are often overlooked during plan selection.

Federal Dental and Vision Insurance Program (FEDVIP)

FEHB does not cover dental or vision for most plans. FEDVIP is a separate, voluntary program offering dental and vision coverage for federal employees, retirees, and eligible family members. Premiums are paid pre-tax for active employees (also through premium conversion). During Open Season you can enroll in FEHB and FEDVIP simultaneously — treat them as separate decisions. FEDVIP premiums do not count toward the FEHB government contribution formula.

Part-time proration of the government contribution

Part-time employees (those working a scheduled tour of less than full-time) receive a prorated government contribution. The formula: your prorated share = (hours in scheduled tour ÷ full-time hours) × maximum government contribution. Example: a 20-hour-per-week employee on a 40-hour full-time schedule receives 50% of the government contribution — and pays the remaining 50% plus the full employee share. Work with your HR office to confirm your scheduled tour before comparing net premium costs.