Q. I am going to retire soon. What are the requirements to continue health
benefits into retirement?
A. To continue your health benefits enrollment into retirement, you must: (1) have retired on an immediate annuity (that is, an annuity which begins to accrue no later than one month after the date of your final separation); and (2) have been continuously enrolled (or covered as a family member) in any FEHB Program plan (not necessarily the same plan) for the five years of service immediately preceding retirement, or if less than five years, for all service since your first opportunity to enroll.
Q. How would I get a waiver of the 5-year coverage requirement to continue health benefits into retirement?
A. You must request a waiver of the five-year requirement from OPM. The steps you must take are given in the FEHB Handbook at Waiver of 5-Year Enrollment Requirement - Waiver of 5-Year Enrollment Requirement.
If your agency has buyout authority, you may not need to write to the OPM. If you think you might qualify for a waiver of the 5-year coverage requirement, contact your Human Resources Office for information. If you meet the requirements, your agency will attach a memorandum to your retirement application stating that you meet the requirements for waiver by the OPM.
Q. How will OPM verify that I am eligible to carry FEHB into retirement?
A. Your Human Resources Office will compile your health benefits records and
forward them to OPM along with your retirement application and other records.
OPM will review your health benefits records to determine if you are eligible to
continue your FEHB enrollment into retirement. If you are eligible, OPM will
process a transfer-in action and forward you a copy of this action for your
records.
Q. I am currently in a health maintenance organization (HMO). I am retiring and will be moving to another state in the next few months. Will I be covered after I move?
A. You will be covered only for emergency care. Unless your HMO has a "reciprocity" agreement with a plan in your new area that allows you to get routine care, you must travel back to your HMO for care, or change plans. You can change plans anytime after moving; contact your retirement system.
Q. Will my premiums increase once I retire?
A. No, you will pay the same premium as you paid while you were an employee.
However, annuitants are paid on a monthly basis so you will pay them at the
monthly rate. You may see an increase if you are employed by an agency, such
as the Post Office, that contributes additional money towards the total
premium. Retirees receive the same government contribution as most Federal
employees.
Q. I am working a part-time schedule and therefore my Government
contribution is prorated. When I retire, will I continue to get the prorated
Government contribution?
A. When you retire, you are entitled to the full government contribution.
Q. After I retire, can I enroll in a family plan or do I have to be enrolled in a Self and Family plan for the five years before I retire in order to continue it into?
A. No, you do not have to be enrolled in a family plan for the five years before you retire to meet the five-year requirement. As a retiree, you can enroll in a family plan during the Open Season or when an event occurs that permits a change to the family plan.
Q. I recently retired but my spouse is a current Federal employee. I have
carried our FEHB enrollment for the past several years and recently
discovered that I can't take advantage of premium conversion as a retiree.
If I cancel my FEHB enrollment to be covered by my spouse's FEHB
enrollment, will I be able to enroll in a Self Only enrollment in the future?
A. Yes, you will be able to reenroll in the future because you are canceling your
enrollment to be covered by another FEHB enrollment.