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FEHB Eligibility

U.S. Office of Personnel Management

Employees

As a Federal employee, you are eligible to elect FEHB coverage, unless your position is excluded by law or regulation. Your agency applies these rules and determines your eligibility. However, there are numerous special provisions for people in part-time or intermittent employment, temporary appointments, and specifically named positions.


Dependents


Family members eligible for coverage under yourself and family enrollment are your spouse (including a valid common law marriage) and unmarried dependent children under age 22, including legally adopted children and recognized natural (born out of wedlock) children who meet certain dependency requirements. Your stepchildren and foster children are included if they live with you in a regular parent-child relationship. An unmarried dependent child age 22 or over who is incapable of self-support because of a mental or physical disability that existed before age 22 is also an eligible family member. Your employing office will look at the child’s relationship to you as the enrollee to determine whether the child is a covered family member.


Retirees and Survivor Annuitants


Federal retirees and their surviving spouses retain their eligibility for FEHB health coverage at the same cost as current employees. In order to carry you FEHB coverage into retirement, you must have been continuously enrolled (or covered as a family member) in any FEHB plan(s) for the 5 years of service immediately before the date of your annuity starts, or for the full period(s) of service since your first opportunity to enroll (if less than 5 years).


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TCC is a feature of the Federal Employees Health Benefits (FEHB) Program that allows certain people to temporarily continue their FEHB coverage after regular coverage ends. Important: You must exhaust TCC eligibility as one condition for guaranteed access to individual health coverage under the Health Insurance Portability and Accountability Act of 1996.

TCC enrollees must pay the full premium for the plan they select (that is, both the employee and Government shares of the premium) plus a 2 percent administrative charge.


Coverage of Former Spouses


Under the Civil Service Retirement Spouse Equity Act of 1984 (Public Law 98-615), as amended, certain former spouses of Federal employees, former employees, and annuitants may qualify to enroll in a health benefits plan under the FEHB Program.

You are eligible to enroll under spouse equity provisions if:

  1. you are divorced from a Federal employee or annuitant during his/her employment or receipt of annuity;
  2. you were covered as a family member under an FEHB enrollment at least one day during the 18 months before your marriage ended (Note: This requirement is also met when both you and the Federal employee or annuitant have FEHB enrollments);
  3. you are entitled to a portion of the Federal employee’s annuity or to a former spouse survivor annuity; and
  4. you have not remarried before age 55.

Former spouse enrollees must pay the full premium for the plan they select (that is, both the employee and Government shares of the premium).


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  • Photo_user_blank_big

    jeryruse

    almost 4 years ago

    10 comments

    There are some other FEHB benefits but are mild. You pay 10% more ice per year in Part B, if you choose to pick up later. Once I checked the coverage in VA, but considered it was not as good as my FEHB at the time, but it was 10 years ago. Know today, but it is hard to beat FEHB.

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