Washington's federal employees and retirees
Federal Employees Health Benefits (FEHB) is the health insurance program for federal employees and retirees, run by the U.S. Office of Personnel Management (OPM). In Washington, federal employers include:
- Puget Sound Naval Shipyard (Bremerton), civilian shipyard employees
- Joint Base Lewis-McChord, Department of the Army and other civilian employees
- VA medical centers in the Puget Sound area, Spokane and Walla Walla, Veterans Health Administration employees
- The Department of Energy's Hanford Site (Tri-Cities), federal DOE staff (most Hanford workers are contractor employees, who get coverage through their employers, not FEHB)
- Federal courts in Washington's two federal judicial districts
- Other federal agencies, such as the IRS, Forest Service, Bureau of Land Management, Bureau of Reclamation and NOAA
U.S. Postal Service employees and retirees moved from FEHB to the separate Postal Service Health Benefits (PSHB) program in 2025, which has its own Medicare rule (below).
FEHB and Medicare: more flexibility than TRICARE or PEBB
TRICARE For Life requires Part B, and Washington's PEBB retiree coverage requires Part A and Part B. FEHB does not require you to enroll in Medicare to keep your FEHB coverage as a retiree. That gives federal retirees more flexibility, and more decisions to make.
If you're still working for the federal government at 65, your FEHB coverage is group coverage from current employment, so you can delay Part B without a penalty and use the 8-month Special Enrollment Period when you retire. See Working past 65.
The FEHB and Medicare options
At 65, federal retirees with FEHB usually have three main paths:
Option 1: FEHB only, no Part B
You can keep FEHB and decline Part B. That avoids the Part B premium ($202.90 a month standard in 2026). The trade-off: if you later want Part B, you may owe a late enrollment penalty for as long as you have it, because retiree FEHB isn't coverage from current employment. FEHB alone may also leave you with more cost sharing than FEHB plus Medicare.
Option 2: FEHB plus Part A only
Most federal retirees can get Part A with no premium, because federal employees have paid Medicare taxes since 1983 (earlier service may count differently). Part A adds Medicare's hospital coverage. You skip Part B and its premium.
Option 3: FEHB plus Parts A and B
You enroll in Part A and Part B and keep FEHB. As a retiree, Medicare generally pays first and FEHB pays second. OPM says some FEHB plans may waive certain costs, such as deductibles, coinsurance and copayments, when Medicare pays first. Some FEHB plans also offer Medicare Advantage options for members with Parts A and B; each plan's brochure explains them.
You must tell your FEHB plan when you enroll in Medicare.
Why some federal retirees take Part B
- Their FEHB plan may reduce cost sharing when Medicare pays first (check the brochure)
- Total out-of-pocket costs can be lower for people who use a lot of care, even after the Part B premium
- Original Medicare works with any provider in the country who accepts Medicare
- Coverage works the same if you move out of Washington or travel in the U.S.
- Signing up at 65 avoids a lifetime Part B late enrollment penalty if they want Part B later
Why some federal retirees skip Part B
- FEHB is comprehensive coverage on its own, and for some people the Part B premium may not pay off
- Their plan's cost sharing without Medicare may already be acceptable to them
- Some prefer to keep all their coverage with one plan
The IRMAA factor
If you have a higher income, the income-related monthly adjustment amount (IRMAA) raises your Part B premium. In 2026, a retiree in the third IRMAA bracket pays $527.50 a month for Part B, compared with the standard $202.90. Run the numbers with your FEHB plan and your bracket. See IRMAA in Washington and the IRMAA calculator.
Postal Service retirees: PSHB requires Part B for most
Under OPM's PSHB rule (5 CFR 890.1604), most Postal Service annuitants and their family members who are entitled to Part A must enroll in Part B to stay in PSHB. The main exceptions are people who were already postal annuitants on January 1, 2025, postal employees who were 64 or older on January 1, 2025, people living outside the U.S., and people eligible for Indian Health Service care. If you're a postal employee in Washington nearing retirement, check the PSHB rules on opm.gov before you decide about Part B.
Hanford and EEOICPA
Hanford workers and survivors may qualify for the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), run by the U.S. Department of Labor, for illnesses linked to work at Department of Energy sites, including radiation-related cancers. EEOICPA pays for treatment of conditions it has accepted on a claim: show your EEOICPA medical benefits card to providers for those conditions. Medicare and your other coverage handle the rest of your care. EEOICPA covers many contractor employees, who aren't in FEHB.
OPM resources and Open Season
OPM publishes FEHB plan brochures each year that explain how each plan works with Medicare. Check your plan's brochure before you decide. For plan year 2027, the Federal Benefits Open Season runs November 9 through December 14, 2026, and changes generally take effect January 1.
Where to get help
- Your FEHB or PSHB plan, at the customer service number on your card
- OPM Retirement Services: 1-888-767-6738
- OPM FEHB program: opm.gov/healthcare-insurance
- Social Security (1-800-772-1213), to sign up for Part A or Part B
- 1-800-MEDICARE (1-800-633-4227), for Medicare coverage questions
- A licensed insurance agent with Benefits Life, at (206) SENIORS (206-736-4677), TTY 711, at no cost to you, about Medicare plan options outside FEHB, or you can see plans in your ZIP code
Sources
- OPM — FEHB and Medicare
- OPM — 2026 Federal Benefits Open Season announcement (November 9 to December 14, 2026)
- Federal Register — Postal Service Health Benefits Program final rule, 89 FR (May 6, 2024), 5 CFR 890.1604
- U.S. Department of Labor — EEOICPA medical benefits
- Medicare.gov — Who pays first
- Medicare.gov — Working past 65
Frequently asked questions
Do I have to enroll in Medicare to keep FEHB?
No. FEHB doesn't require you to enroll in Medicare Part B to keep your coverage as a federal retiree. That's different from PEBB retiree coverage and TRICARE For Life, which require Part B, and from the Postal Service Health Benefits program, which requires Part B for most postal retirees.
Should federal retirees enroll in Part B?
It depends on your plan and your income. With Part B, Medicare usually pays first and OPM says some FEHB plans may waive certain costs, such as deductibles and coinsurance, for members with Medicare. Without it, you avoid the Part B premium but may pay a late enrollment penalty if you sign up later. Compare your plan's brochure, the Part B premium and any IRMAA amount.
Can I change my FEHB plan after retirement?
Yes. You can change plans during the annual Federal Benefits Open Season. For plan year 2027, OPM's Open Season runs November 9 through December 14, 2026, and changes generally take effect January 1.
Are there Medicare Advantage options in FEHB?
Some FEHB plans offer Medicare Advantage options for members who have both Part A and Part B. Each plan's brochure explains what it offers and how it works with Medicare. Check during Open Season, because plan options change from year to year.
What about Hanford workers with EEOICPA benefits?
The Energy Employees Occupational Illness Compensation Program, run by the U.S. Department of Labor, pays for treatment of conditions it has accepted on a claim. Show your EEOICPA medical benefits card to providers for those conditions; Medicare and your other coverage handle the rest of your care. Most Hanford workers are contractor employees, who aren't in FEHB.
Medicare in your Washington county
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