Suspending FEHB coverage

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Q. Federal employees who are veterans with service-connected disabilities and who use the Veterans Health Administration (VHA) for their healthcare are not afforded the opportunity to suspend their Federal Employees Health Benefits (FEHB) upon retirement. This forces those veterans to choose between FEHB, Medicare Part B/C, when they need neither. Is this an Office of Personnel Management policy that can be changed, or does the solution require an act of Congress?

A. By regulation, OPM does allow annuitants to suspend their FEHB enrollment in order to enroll in a Medicare Advantage plan, TRICARE or CHAMPVA, or Medicaid or similar state-sponsored program of medical assistance. (Information on suspending FEHB coverage at  https://www.opm.gov/healthcare-insurance/Guide-Me/Retirees-Survivors/#url=Health.) It doesn’t allow employees to do that, nor does it allow employees or retirees to suspend their FEHB coverage when they are receiving VHA benefits. To change this would require an act of Congress.

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About Author

Reg Jones was head of retirement and insurance policy at the Office of Personnel Management. Email your retirement-related questions to fedexperts@federaltimes.com.

32 Comments

  1. Karen Mamalakis on

    Great question and I was just waiting until my daughter turned 26 and then I planned to drop my FEHB coverage. So there goes that money saver. My question is what we veterans are too sick to afford our FEHB coverage because mine is very expensive. That’s over $300 a month that I could put in to natural remedies and vitamins which is the only thing helping me at the time.

    • Here is the answer taken from OPM’s website:

      How can annuitants or former spouses suspend FEHB coverage to use TRICARE or CHAMPVA?

      They can apply to suspend their coverage at any time. Annuitants can call OPM’s Retirement Information Office at 1-888-767-6738 to obtain a suspension form. Callers within the local Washington, DC calling area must call 202-606-0500. Former spouses can get the form from the employing office or retirement system maintaining their enrollment. Eligible individuals must submit a completed suspension form and provide all necessary documentation to show eligibility for TRICARE or CHAMPVA during the period beginning 31 days before and ending 31 days after the date they designate as using TRICARE or CHAMPVA instead of FEHB coverage.

      • If we would suspend our FEHB, could we reinstate it at a later date? I cannot afford it; but, if VHA would get bad or the VA would STOP serving us, then I would need FEHB again. Thank you!

        • If you suspended your FEHB coverage and later lost your Tricare or CHAMPVA coverage, you could reactivate your FEHB coverage.

  2. I am a 100% Permanent and Total Service connected Veteran. I am also a retired annuitant paying for FEHB coverage that I don’t need because I receive ALL of my care at my VAMC. I’m only 54 so not enrolling in Medicare for quite some time. I find it very concerning that I have to chose between continuing to pay for coverage I don’t use or cancelling it and never being allowed to re-enroll if I chose to at a later date. Am I reading that wrong or is there a possibility that I can suspend? My wife, a current Gov’t employee who is enrolled in CHAMPVA because of my 100% status is choosing to continue FEHB as a personal choice but has more flexibility in this than I do. Seems silly that I cannot suspend coverage.

    • No, there isn’t any possibility that you could suspend your FEHB coverage. As a lower cost alternatively to a self only enrollment, you could ask your wife to add you to her enrollment during the current open season, which would then be self plus one.

      • We studied that scenario and due to the plan costs for United Healthcare (our chosen FEHB plan) we decided to each do Self Only plans for each of us. We did the math for a few scenarios and honestly it’s the cheaper way to go. Although I’m almost convinced I won’t use the plan outside of the VA I’m not convinced I won’t EVER need it so stopping coverage with no ability to reenroll means I eat the 150.00 a month premium for that piece of mind. I know I could always hop on my wife’s coverage if I cancel and decide to return but that’s only if my wife stays alive and well, none of us are guaranteed to be here tomorrow so best plan for worst case scenario when dealing with health and life.

      • BRIAN STONEBACK on

        Also, just to clarify, an annuitant can suspend coverage while on a spouses FEHB policy and then reenroll at a later date. They just can’t suspend without being on another FEHB, Medicare, Tri-care or ChampVA. However looking at the cost of self /plus one versus self only for her and self only for me; it’s 15$ cheaper even though as an annuitant I can’t take advantage of bi-weekly payments price.

      • I have a question about suspending my bc/bs fehb. I presently have medicare part b and tricare for life. I would like to suspend my fehb due to my high medicare premiums. I’m paying a 100% penalty for medicare premiums due to some erroneous information I was given by medicare when I started receiving SSDI at age 50. I was informed that I could delay enrolling in part b because I had a fehb. What a farce! Can I suspend my bc/bs benefit?

          • Gary Cunningham on

            Reg, yes!!!!! That’s what I did. So many Federal retirees told me they kept their FEHB and Medicare because they were worried about losing their FEHB coverage. I looked into it, and FEHB was WAY more than what I could get through a Medicare Advantage plan. And it’s true that if you cancel your FEHB, you can’t get back in, but you can “suspend” it. I called OPM and did just that. They will send you a message every year asking if you want to renew, if you don’t you do nothing.
            I have pretty much the same coverage under an Advantage plan for just the cost of Medicare (~$135 a month) that I had under my FEHB plan at almost $400/month!!!! I just don’t get the retirees who keep both, doesn’t make sense!!!

  3. Hello Mr. Jones,
    I need some help. I am retired FERS and have my wife and I enrolled in FEHB (self+1). I’m 61 years of age, but my wife turns 65 this month (November 2018). She is already enrolled in Medicare Advantage plan. I am also a service connected disabled veteran, but do not receive any treatments with VHA. My question is can I suspend my wife FEHB since she is already enrolled in a Medicare Advantage plan? Thank you for your help.

  4. I am not sure why he’s asking about suspending his wife’s FEHB, but if he is already retired and has FEHB, he could just choose Self Only at the next Open Season. If she decides to drop her Advantage plan, he would need to wait until another Open Season in order to elect Self Plus One coverage to cover her again under FEHB.

  5. Gary Cunningham on

    Hi Reg!

    This is a great forum, thank you for hosting it! I have a couple questions regarding suspending my FEHB plan. I am retired, currently have an FEHB plan. I am turning 65 in March, and am considering joining a Medicare Advantage Plan. I would suspend my FEHB plan at that time, in case I decide to go back to it.
    1) If I decide to re-enroll in my FEHB, I know you have to wait until the next open season, which would be the fall period. But the Advantage Plans have an additional open season in the spring, could I do it then as well? And would it have to be that first open season, or could you still go back say, the next open season the following year? I guess I’m asking if there is just that one shot for going back to FEHB.

    and 2) Say I decided to re-enroll in my FEHB plan, and at a later open season decided to get back into another Medicare Advantage Plan…..could I go ahead and suspend my FEHB coverage again? In other words, can you go through that scenario more than once?

    Thanks so much!!

    • Unless your Medicare Advantage plan goes out of business, you can only re-enroll in the FEHB program during the annual Open Season. There is nothing that would prevent you from suspending your FEHB coverage at a later date to enroll in that Medicare Advantage plan or any other.

  6. I suspended my fehb in June 2019 because medicare advantage was effective July 1, 2019. However, it is not yet in the system and opm is still taking money from my retirement for bcbs, which I don’t use anymore. So far, they owe me for 3 months of withdrawals, and I’m sure they will take it out for October, too.

    Every time I speak with someone there, they tell me something different. One person says it takes 3 weeks, another says 60 days. Either way, the time should be up since I requested it the first week of June. Will they reimburse the money they have already taken (so far $477, and if they take October it will be $636)? I can’t afford to pay for two insurance coverages forever! So incompetent!

  7. My name is Sheila Stukes i want to suspend my Febh in January 2020. It starts in January I don’t want to pay for both. It is to high I am on a fix income. Can you send the form to my address at 140 Elgar place apt 5g bronx ny 10475. I can’t afford to pay for 2 insurance policy. $215 a month.

    • To suspend your FEHB coverage, you’ll have to call the Office of Personnel Management’s Retirement Information Office at 1-888-767-6738.

  8. Mr. Jones ,Last year for 2019 My Insurance was changed from medicare plus too medicare Advantage by Kaiser I would like to suspend FEHB if I do, can i change back FEHB if Kaiser or medicare advantage benefits are not suitable for me. i pay part B premium And FEHB premium .

  9. Mr. Jones, thank you for providing info to us folks. My question is this: I currently have Self+1 BC/BS coverage but want to suspend it to try Tricare for life. However I also have a service connected 10% disability for hearing loss, and have been going periodically to the VA for dermatology care. If I read you correctly, I cannot suspend my FEHB plan. What if I voluntarily gave up my 10% VA payment and didn’t go for any more derm care? After all the 10% disability comes out of my military pension dollar for dollar. Thus, the only benefit I get out of that is it is not taxable. Oh, and I also have some VA-issued hearing aids and get free batteries for them. Am I out of luck for suspending my FEHB plan (which also covers my wife)?

    • While you can suspend your FEHB coverage in favor of Tricare for Life, you’d deprive your wife of her health care coverage unless she is a current or retired Federal employee who could then enroll in her own name. Dropping your VA payment wouldn’t change anything other than that you’d lose those benefits.

      • How would I be depriving my wife? She would be covered under the Tricare for Life, and she would be reinstated in FEHB with me if we wanted to ditch the Tricare and reactivate the FEHB. Also I haven’t been able to find anything in black and white about being ineligible to suspend FEHB if I am receiving VA benefits. I am looking at OPM Form 2809, and it mentions nothing about that restriction. What am I not understanding here?

  10. Hello Reg, I must retire immediately for disability. I can’t afford to pay for FEHB, while waiting for approval of the disability retirement. What are my options? The only reason that I kept working for the federal government is to carry my FEHB into retirement. Is there a way to have my FEHB reinstated, when the disability retirement is approved?

    • I’m not aware of any way that you could have your FEHB coverage reinstated if your application for disability retirement is approved.

  11. Mr. Jones, please refer to my comment, above, of March 3. I mentioned that I haven’t been able to find anything in black and white to the effect of what you are saying. I was finally able to talk to a person at OPM and ask her about this. She said she had never heard anything like this in her 4 years of working there. I read her word for word your post of Oct. 17, 2017. Now, I realize she only has 4 years there and you were the head honcho of retirement and insurance at OPM but I need to know, is what she said correct and have I been misinterpreting what you have said. I am ready, in the near future to suspend my (and my wife’s) FEHB coverage in favor of Medicare parts A & B, and Tricare for life. Please state where your info is coming from.

    • Here is a confirming quote from OPM’s website:

      Can I suspend my coverage?
      Yes, under limited circumstances. As an annuitant you can suspend your Federal Employees Health Benefits (FEHB) enrollment to enroll in a Medicare Advantage plan, TRICARE, CHAMPVA, Medicaid or a similar State-sponsored program of medical assistance for the needy, or use Peace Corps health insurance coverage.

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