2025 FEHB Open Season Starts on November 11th. Are You In the Right Health Plan?

These are some tips to help federal employees choose the best 2025 health plan during the FEHB Open Season.

Federal employees should be aware that the average cost of FEHB premiums is going up by 13.5%. However, not every plan in your area is going up by that amount. The average means that your plan may go up much more or not at all.

The most popular Federal Employee Health Benefit plan is the Blue Cross Blue Shield (BCBS) plan. All three levels will see increases, with the Basic option going up the most by 15.6%, the standard option going up by 14.5%, and the FEP Blue Focus plan going up by 7%. On the other hand, the CareFirst Blue Choice Blue Value plan in the DC area will have no change in the premium. Note that this plan is not the same as the BCBS plan.

While the premiums are going up, some benefits will be added. For example, all plans now provide access to fertility benefits. Coverage may cover artificial insemination, fertility drugs, and IVF (in vitro fertilization). There are also added benefits for maternal health, such as postpartum depression and certified nurse midwives. 

Self Plus One vs Self & Family for Couples

For couples at or near retirement, you may no longer have children under 26 who are being covered under your FEHB Plan. If it’s just the two of you, you should change your plan to a Self Plus One plan, right?  

In most instances, a Self Plus One plan would be a lower-cost option. However, there are times when that is not the case.

There are 46 FEHB plans where self and family would be less expensive than self plus one. For example, the Kaiser High plan in the DC area has a family option that is actually less expensive than the self plus one option, according to Kevin Moss, Senior Editor for Checkbook’s Guide to Health Plans.

Here are other plans where Self + One is more expensive than Self + Family. Please note that your region’s cost may vary. The provider uses the same plan name, but the plan code would differ by geographical area.

  • Aetna HealthFund CDHP and Aetna Value Plan
  • Aetna Open Access High Option
  • Kaiser Permanente in Colorado, Georgia, Mid-Atlantic, Northern California, and Northwest

So, What Should You Do to Prepare for Open Season?

There are several things you want to consider. Here are my top suggestions:

  1. Make sure you review your plan early. Open season starts on November 11 and ends on December 9th.  Do not wait until the last minute to review the changes.  
  2. Too often, federal employees don’t review their FEHB plan because the plan’s name stays the same. Just because the name didn’t change, coverage and benefits may have.  
  3. Compare all the FEHB options available! If you are on medication, you should check to see if changes have been made to its coverage. Moreover, a lower-cost option may cover the medication. Be your own health advocate and do the research.

What About Medicare at 65? 

There are many considerations regarding Medicare decisions, and not one idea would apply to most retirees. However, you must understand that if you are still in federal service at age 65, you do not need to enroll in Medicare.

Medicare has a Special Enrollment Period (SEP) for Medicare Part B that allows current federal employees to delay that decision until they retire from federal service. However, if you retired from federal service before age 65 but decided to pursue a second career or start your own business, your Medicare eligibility window begins at age 65. The Special Enrollment Period only applies to active federal employees and their spouses under FEHB as an active employer health plan. If you are a retiree, FEHB is now a retiree health plan and no longer eligible for special enrollment.  

Lastly, if you are Medicare eligible in 2025, you must understand the pros and cons of adding Medicare Part B.  The clear advantage is that FEHB providers will integrate with Medicare. That means any co-pay, co-insurance, or other out-of-pocket expenses are gone if you are enrolled in FEHB and have Medicare A & B.

I have worked with many retirees with both types of coverage, and they share with me that they had surgeries and paid nothing out of pocket. So, if you are worried about high out-of-pocket expenses, consider adding Medicare Part B to your FEHB Coverage, especially if you qualify for the lowest Medicare Part B premium rates.

The disadvantage is that you will face two monthly premiums, the FEHB premium, and Medicare Part B costs. What makes the matter worse is that your income from two years ago will determine Medicare B premiums. The premium may really jump once RMD (required minimum distribution) starts and pushes your income higher. 

So, if your concern is high monthly expenses, you can keep your FEHB plan only with Medicare Part A. You are not required to enroll in Medicare Part B. Understand that co-insurance and co-pays would still apply when you need care. However, FEHB plans have out-of-pocket maximums that will protect you from catastrophic costs. Once you have exceeded the annual out-of-pocket maximum, the plan picks up all the expenses from that point until the end of the year.   

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. Please consult legal or tax professionals for specific information regarding your individual situation. The opinions expressed and material provided are for general information and should not be considered a solicitation for the purchase or sale of any security. Securities and advisory services offered through Osaic Wealth, Inc., member FINRASIPCOsaic Wealth is separately owned and other entities and/or marketing names, products or services referenced here are independent of Osaic Wealth. Representatives may not be registered to provide securities and advisory services in all states. Branch address: 10701 Parkridge Blvd, Ste 130, Reston, VA 20191. Branch phone: 571-543-2783.

About the Author

David Fei is the co-founder of PlanWell Financial Planning. He specializes in guiding federal employees toward a confident retirement nationwide. PlanWell’s mission is to empower Feds when making retirement decisions, ensuring their benefit choices align with their retirement aspirations. Sign up for our no-cost Federal Retirement Webinar or contact him for a confidential review.