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Home | FEHB - Health Benefits | FEHB Program Features

FEHB Program Features

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No Waiting Periods. You can use your benefits as soon as your coverage becomes effective. There are no pre-existing condition limitations even if you change plans.

A Choice of Coverage. Choose between Self Only or Self and Family.

A Choice of Plans and Options. Select from Fee-for-Service (with the option of a Preferred Provider Organization), Health Maintenance Organization, Point-of-Service plans, Consumer-Driven plans, or High Deductible Health Plans.

A Government Contribution. The Government pays 72 percent of the average premium toward the total cost of your premium, up to a maximum of 75 percent of the total premium for any plan.

Annual Enrollment Opportunity. Each year you can change your health plan enrollment. This year the Open Season runs from November 14, 2005, through December 12, 2005. Other events allow for certain types of changes throughout the year. See your Retirement System office for details.

Continued Group Coverage. Eligible participants can continue coverage following retirement, divorce, death, or changes in employment status. See your Retirement System office for more information.

Coverage after FEHB Ends. You or your family members may be eligible for temporary continuation of FEHB coverage or for conversion to non-group (private) coverage when FEHB coverage ends. See your Retirement System office for more information.

Consumer Protections. Go to www.opm.gov/insure/health/consumers to: see your appeal rights to OPM if you and your plan have a dispute over a claim; read the Patients' Bill of Rights and the FEHB Program and; learn about your privacy protections when it comes to your medical information.

If the original Medicare Plan is your primary payer, which is generally the case if you have Medicare and are not working, check the plan brochure to see if the plan waives some of its FEHB cost-sharing (i.e., deductibles, coinsurance or copayments).

If you are interested in an HMO plan, some FEHB HMOs also offer Medicare Advantage plans. Information on coordinating benefits with other coverage, original Medicare Advantage is available in Section 9 of the plan brochures.





·  Changing FEHB Enrollment During Open Season



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