Medicare Open Enrollment 2026: How It Affects Federal Retirees in FEHB

The Medicare Open Enrollment Period (OEP) is a period of time when individuals enrolled in Medicare (called Medicare beneficiaries) can reevaluate their Medicare health coverage and add, drop, or switch it. The OEP is held annually and is discussed in this column. Among the discussion points are what type of changes Medicare beneficiaries can make during the OEP and how federal retirees who are Medicare beneficiaries and enrolled in the Federal Employees Health Benefits (FEHB) program are affected by the OEP.

It is important to first review what Medicare Advantage (formerly called Medicare Choice) is and what it has to offer to Medicare beneficiaries. Medicare Advantage plans are health insurance plans administered by private insurance companies that offer an expanded number of health care benefits. Most plans include prescription drug coverage through Medicare Part D (Prescription Drug coverage), and many Medicare Advantage plans include (in addition to medical insurance) benefits like vision, hearing and dental insurance. In order to be enrolled in a Medicare Advantage plan, an individual has to be enrolled in both Medicare Part A and Medicare Part B, commonly called “Original Medicare.”

Medicare Advantage plans can particularly benefit individuals who have medical, dental and vision insurance needs and who prefer the financial convenience of having their coverage bundled together rather than buying separate health, dental and vision insurance. The disadvantage of being enrolled in Medicare Advantage is that a beneficiary will usually pay more when using preferred doctors, dentists, pharmacies and other health care providers who are not in the plan’s network. Beneficiaries are encouraged to use medical professionals in the plan’s network. But if a Medicare Advantage beneficiary has selected the right plan, it can result in significant savings in overall health care costs.

What is the OEP and why does it occur every year?

The OEP, also known as the Annual Election Period, occurs annually between October 15 and December 7. Any changes a Medicare beneficiary makes during the OEP become effective the following January 1.

The OEP happens every year because Medicare Advantage plans and Medicare Part D prescription drug plans change. The benefits and premiums associated with an enrollee’s plan (Medicare Advantage, Medicare Part D, or both) change in most years. That is why the Centers for Medicare & Medicaid Services (CMS) allows individuals eligible for Medicare to have an election period each year, so they can change plans if they are not satisfied with their current coverage or with changes that will be made to the plan for the next year.

It is important to mention that a Medicare Advantage or Medicare Part D beneficiary does not have to change plans if satisfied with the current plan. Those who like their plan(s) and make no changes during the OEP will remain in the same plan(s) in the new plan year.

Changes allowed during the 2026 OEP

During the 2026 OEP, an individual enrolled in Original Medicare can make the following changes to their health coverage:

• Switch from Original Medicare to a Medicare Advantage plan.
• Switch from a Medicare Advantage plan to Original Medicare.
• Change from one Medicare Advantage plan to a different Medicare Advantage plan.
• If enrolled in Medicare Part A or Part B, join or drop a Medicare Part D prescription drug plan.
• If enrolled in a Medicare Part D prescription drug plan, switch to a different Medicare Part D prescription drug plan.
• Do nothing, and the beneficiary’s current Medicare coverage will automatically renew for plan year 2027.

Medicare beneficiaries enrolled during 2026 in a Medicare Advantage plan or a Medicare Part D prescription drug plan must receive a letter from their plan during September 2026. This is called the Annual Notice of Change. Among the information provided is whether the plan premium and plan benefits will change. The Annual Notice of Change issued in September 2026 should also provide the plan’s side-by-side benefit changes from 2026 to 2027, which facilitates comparing coverage.

Whatever changes are made to Medicare Advantage and Medicare Part D prescription drug plans will become effective January 1, 2027.

How the OEP affects federal retirees enrolled in Original Medicare

Federal retirees who are enrolled in the FEHB program and in Original Medicare are eligible to enroll in a private Medicare Advantage plan and a Medicare Part D prescription drug plan. But there are several important points that federal retirees considering a private Medicare Advantage plan and/or Medicare Part D prescription drug plan should be aware of:

• The FEHB program offers its own Medicare Advantage plans. A federal retiree who is enrolled in Original Medicare and who is considering a Medicare Advantage plan for 2027 can enroll in an FEHB program-sponsored Medicare Advantage plan during the 2026 FEHB open season (November 9 through December 14, 2026). Several nationwide FEHB program insurance companies offer Medicare Advantage plans.
• Federal retirees enrolled in an FEHB program health plan and Original Medicare who are interested in a private Medicare Advantage plan may enroll during the OEP. However, they must suspend their FEHB program coverage. Suspending FEHB program coverage means that the retiree is temporarily disenrolling from the FEHB program and will be eligible to re-enroll during a future open season. Also, by suspending FEHB program coverage, the retiree will have to pay the full cost of any Medicare Advantage and Medicare Part D monthly premium, because the federal government does not contribute to a retiree’s premium when they enroll in a private Medicare Advantage plan. In contrast, for a federal retiree enrolled in an FEHB program-sponsored Medicare Advantage plan, the federal government pays 72 to 75 percent of the plan premium.
• Whether a federal retiree enrolls in an FEHB program-sponsored Medicare Advantage plan or a private Medicare Advantage plan, the retiree needs to be aware that if their preferred doctors, dentists or other health care providers are not in the plan’s network, they will most likely have to pay more out-of-pocket in order to use them.
• Federal retirees considering a Medicare Part D prescription drug plan should note two points. First, Medicare Part D is designed for individuals who have “catastrophic” out-of-pocket prescription expenses; specifically, more than $2,100 a year. Since FEHB program health plans offer what is considered creditable prescription drug coverage, a federal retiree is not required to enroll in Medicare Part D at age 65 when they become eligible for Medicare. This is important because when the retiree gets older and incurs catastrophic prescription drug expenses, the retiree could enroll in a Medicare Part D prescription drug plan (during an OEP) and not be subject to a late enrollment penalty. Second, since 2023, the Office of Personnel Management (OPM) has encouraged FEHB program health insurance companies to provide their own Medicare Part D drug plans, called Prescription Drug Plans (PDPs). A federal retiree enrolled in Medicare Part A or Original Medicare must enroll in Medicare Part D in order to be enrolled in a PDP, but the retiree could save significantly. The amount of savings will depend mostly on whether the PDP includes the prescriptions that the federal retiree (and spouse, if married) are taking. FEHB health insurance companies offering PDPs are required to include PDP information in their brochures, which will be available to federal and Postal Service employees and retirees during the 2026 open season. Retirees who are Medicare beneficiaries with significantly high prescription expenses (more than $2,200 per year) are encouraged to check out the PDP information associated with their FEHB health plan.