Make these health coverage decisions before you retire

Before you circle a retirement date, ask a question beyond your pension estimate: Will your health insurance come with you? Federal Employees Health Benefits (FEHB) coverage, with a government contribution toward premiums, is a valuable retirement benefit. Keeping it generally requires an immediate annuity — one that begins accruing no later than one month after final separation from federal service — and continuous FEHB coverage for the five years of service before retirement, or since your first opportunity to enroll if that period is shorter. Check your eligibility before choosing your retirement date.

Military retirees: preserve your options

Military retirees working as civilian federal employees can count TRICARE coverage toward the “five-year test,” but must be enrolled in FEHB — or Postal Service Health Benefits (PSHB), as applicable — on their last day of civilian employment before retirement. Enroll during the preceding Open Season and confirm coverage takes effect before retirement.

Once retired and eligible to continue coverage, you can request suspension using RI 79-9 and continue using TRICARE. Read the form carefully: It also permits cancellation, which is different from suspension. Suspending preserves the option to reenroll during a future Open Season, subject to applicable eligibility requirements.

Medicare: compare costs and enrollment deadlines

Medicare’s 2027 changes include telehealth access from home through Dec. 31, 2027, virtual and self-paced Medicare Diabetes Prevention Program options, and possible electronic prior authorization processing by Medicare Advantage plans beginning Jan. 1. As of Nov. 5, 2026, the 2027 standard Part B premium and income-related monthly adjustment amounts (IRMAA) for Parts B and D have not been officially announced.

The 2026 standard Part B premium is $202.90 per person per month. IRMAA for Parts B and D begins above $109,000 in modified adjusted gross income for individual filers or $218,000 for joint filers, generally using 2024 income. Higher tiers carry larger surcharges. Married people filing separately who lived with their spouse have a separate schedule, also beginning above $109,000.

If retiring at 65 or later, compare how FEHB or PSHB plans coordinate benefits when Medicare pays first. Reductions in deductibles, copayments and coinsurance vary by plan. Postal retirees should check whether Part B is required to retain PSHB; exceptions apply.

To avoid a Part B late-enrollment penalty, employees who qualify through their own or a spouse’s current-employment coverage can enroll while that employment and coverage continue, or during the eight-month Special Enrollment Period after employment or coverage ends, whichever happens first. Retiree coverage does not extend that window. Arrange enrollment through Social Security before retirement to coordinate the start date. If you already have Part A, apply for Part B online or submit CMS-40B and CMS-L564.

Federal couples: coordinate the handoff

When federal spouses retire at different times, moving FEHB coverage to the working spouse can preserve pretax premium payments through premium conversion. BAL 25-102 requires the working spouse to carry Self Plus One or Self and Family coverage and include the retiree. The retiree can then cancel their own enrollment while preserving reenrollment eligibility through continued spousal FEHB coverage. This specific cancellation is different from suspending coverage for TRICARE. The letter’s process excludes people subject to PSHB.

Timing matters. Switching during an earlier Open Season, while both spouses remain employed when the change takes effect, is generally easier. Near retirement, different employee and annuitant effective dates can create a coverage gap. Ask HR to coordinate the handoff rather than assume two Open Season elections will align.

After retirement begins, use RI 79-9 — not SF 2809 — to cancel the retiree’s enrollment, with proof of coverage under the working spouse’s FEHB plan. Cancellation generally takes effect the first day of the month after OPM receives the signed form and documentation.

Open Season near retirement: use the right process

Under BAL 24-103, retiring employees whose FEHB Open Season election takes effect after retirement must complete a paper SF 2809 rather than use the agency’s electronic enrollment system. Discuss the election during retirement counseling. HR certifies it, sends it to the carrier and places a copy and the FEHB Enrollment Change Cover Sheet on top of the retirement package sent to OPM. This helps reduce delays in processing coverage and issuing identification cards.

Confirm the effective date: For retirement before Jan. 1, the post-retirement election takes effect Jan. 1. For retirement from Jan. 1 through the day before the active-employee Open Season effective date, it takes effect on the annuity commencement date. Active-employee elections generally begin with the first full pay period starting on or after Jan. 1. October and November retirees should discuss Open Season elections while retirement processing continues. These procedures exclude PSHB; request the applicable postal instructions.

Protect your spouse — and your lifelong benefit

A survivor annuity election protects more than income. If your spouse will depend on your FEHB enrollment after your death, elect a continuing monthly survivor benefit and cover your spouse under Self Plus One or Self and Family when you die. A survivor annuity without health coverage is not enough; Self Only provides no survivor health coverage. If your spouse has independent FEHB eligibility as an employee or retiree, discuss that with your benefits counselor before deciding.

FEHB or PSHB can remain with you for life if you maintain enrollment, pay your share and meet program requirements. The government continues paying its share of the premium — you do not inherit the entire bill at retirement. Retirees retain annual Open Season opportunities to review and change coverage as premiums, benefits and needs change. Qualifying life events, such as marriage, loss of other coverage or moving outside an HMO’s service area, can also permit changes, subject to applicable deadlines and restrictions. Protecting your eligibility today can safeguard your health and retirement budget for years to come.