Medicare 2026

Federal Retirees With FEHB: How to Think Through the Medicare Part B Decision

If you're a federal retiree with Federal Employees Health Benefits (FEHB) coverage and you're approaching Medicare eligibility, you have a choice many other retirees don't: you can keep FEHB without signing up for Medicare Part B. That flexibility is real, but the decision has long-term consequences. Here's a plain-English look at what to weigh.

FEHB and Medicare: how they fit together

FEHB is different from the new Postal Service Health Benefits Program in one important way: FEHB has no Part B enrollment requirement. A federal retiree can keep FEHB without ever enrolling in Part B.

If you do take Medicare as a federal annuitant, Medicare becomes your primary payer and FEHB pays second. (For current federal employees, FEHB still pays first.) Enrolling in Medicare doesn't change your FEHB premium up or down. According to OPM, when Medicare pays first, your FEHB plan may waive its copays, coinsurance, and deductibles for services Part B covers, and some FEHB plans offer partial or full reimbursement of the Part B premium. Specifics vary by plan — review your plan brochure during Open Season.

The case for enrolling in Part B

• Lower out-of-pocket costs at the point of care. Many FEHB plans reduce or waive your cost-sharing when Medicare is primary.
• Broader provider access. Part B gives you access to any doctor who accepts Medicare, which is a large national network.
• Avoiding the late-enrollment penalty. For 2026, the standard Part B premium is $202.90 a month. If you skip Part B and sign up later outside a Special Enrollment Period, you generally must wait for the General Enrollment Period (January 1 – March 31), may face a gap before coverage begins, and will pay a Part B premium that is 10% higher for each full 12 months you could have had Part B — for as long as you have Part B. CMS announces the 2027 Part B standard premium and deductible, and the IRMAA income-related surcharges, in the fall.
• Access to an FEHB-sponsored Medicare Advantage option. A Medicare Advantage plan accessed through FEHB requires both Part A and Part B. OPM notes that many of these plans that include drug coverage reimburse some or all of the Part B premium.

The case for skipping Part B

• Avoiding a second monthly premium. Part B is not free; some retirees decide FEHB alone meets their needs.
• Satisfaction with current coverage. If your doctors are in-network and your out-of-pocket costs feel manageable, you may not want to add a layer.
• Awareness of the trade-offs. If you skip now and change your mind later, the penalty and waiting period apply. Retiree coverage ending does not qualify you for Medicare's Special Enrollment Period for employer coverage.

Timing: don't miss your window

Medicare's Part B Special Enrollment Period for people with employer coverage lasts while you're covered through current employment and for 8 months after that employment or coverage ends, whichever comes first. If you're retiring, OPM says your retirement system completes form CMS-L564 so you can use the SEP.

Once that window closes, the General Enrollment Period (January 1 – March 31) becomes your fallback, with the penalty and possible coverage gap described above.

Suspending vs. cancelling FEHB

This distinction matters:

• Suspend FEHB to enroll in a Medicare Advantage plan (not through FEHB), Medicaid, TRICARE, TRICARE For Life, or CHAMPVA. You can generally re-enroll in FEHB during a later Open Season, or immediately after an involuntary loss of the other coverage.
• Cancel FEHB and you can never re-enroll.

The 2026 Federal Benefits Open Season runs November 9 through December 14, 2026.

Medicare Advantage vs. Original Medicare + FEHB/Medigap

Neither path is "better" — they're different trade-offs. Original Medicare paired with FEHB (or in some situations a Medigap plan) tends to offer wide provider choice and predictable secondary coverage. A Medicare Advantage plan — including one accessed through FEHB — may bundle drug coverage, add extra benefits, and sometimes reimburse part of the Part B premium, but typically uses networks and prior authorization. Compare plan documents carefully.

A note on drug coverage

Many FEHB plans include creditable prescription drug coverage, so you may not need a separate Part D plan. If you do enroll in Part D, the 2027 out-of-pocket cap is $2,400 (it's $2,100 in 2026), the maximum allowable Part D deductible in 2027 is $700, and the national base beneficiary premium used for the late-enrollment penalty is $41.33. Actual plan premiums vary.

Medicare's Annual Enrollment Period for 2027 coverage runs October 15 – December 7, 2026.

If you have Medicaid or Extra Help

Since 2025, people with Medicaid or Extra Help have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can join an integrated D-SNP in any month.

Paying the Part B premium

If you have an OPM annuity but are not entitled to Social Security or Railroad Retirement Board benefits, you must ask Social Security to deduct your Part B premium from your annuity. Otherwise, Medicare bills you — typically every three months.

Where to go next

For official enrollment rules, forms, and plan comparisons, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24/7.