Program in Retirement
The Federal Employees Health Benefit Program consists of three basic elements: who can enroll, how much it costs, and the contracts with carriers. Let’s
focus on how and when things change when you retire.
Eligibility to carry coverage into retirement
As a rule, you must be enrolled in the FEHB Program either for the full five
years immediately before you retire or from your first opportunity to enroll. The
latter exception applies to someone who transferred from a position that didn’t
provide FEHB coverage to one that does and then retires before completing five
However, there are three other exceptions to the five-year rule. First, if you
are covered by Tricare or The Civilian Health and Medical Program of the Department of Veteran Affairs (CHAMPVAQ) that time will count toward the five-year
requirement if you are enrolled in an FEHB Plan when you retire.
Second, if you receive a buyout (or take early optional or discontinued
service retirement) OPM will grant you a pre-approved waiver of the five-year
Third, OPM can grant a waiver of the five-year requirement when it would
be against equity and good conscience not to do so.
FEHB and Medicare Part A
While you were employed, deductions were taken from your salary to pay for
Medicare Part A (Hospital) coverage. If you are retired and eligible for Medicare,
your FEHB benefits won’t be reduced and neither will premiums you pay for that
benefit. They will remain the same as they were before you retired.
When you are eligible for Medicare, it will become the primary payer of
your medical bill and your FEHB Plan will become the secondary payer, but only
where both provide the same benefit. On the other hand, if Medicare provides a
benefit that your plan doesn’t, it will be sole payer, and if your plan provides a
benefit that Medicare doesn’t, it will be the sole payer.
Medicare Parts B, C and D
You have already paid for Medicare Part A through deductions while you
were working. If you want to be covered by Medicare Part B (Medical), you will
have to pay for that out of your own pocket. The same is true of Medicare Part
D (Prescription Drugs).
Medicare Part C (Medicare Advantage Manage Care) is an option offered
to retirees who are enrolled in both Medicare A and B, and is available through
private insurers at one’s own expense. Retirees wishing to enroll in Medicare Part
C are permitted to suspend their FEHB enrollment. They may either re-enroll in
FEHB during Open Season or do so immediately if their Part C provider stops
offering coverage. Whether any of these options will be worth considering depends on your situation.
Few federal retirees who have FEHB elect Medicare Part D, which also
comes at an additional cost. The cost of prescription drug coverage is generally
superior to a Part D plan. There are limited situations, though when electing Part
D might make sense for example, if you would qualify for a premium beak based
on your income. Again, this is something you’d have to consider based on your
I would like to offer my congratulations to all letter carriers who will
be retiring this year; and as Director of Retirees, I would like to assure you
that I am here to help you any way that I can. Branch 36 would like for you
to maintain your NALC membership by completing the required 1189 form.
If you have not received or need a 1189 form, call the Branch and we will
mail it to you. Be sure to include the Civil Service Active (CSA) number on
the form. Once you receive your CSA number from the Office of Personnel
Management (OPM), you will be able to access your account through Service
Online. This OPM website allows you to perform a few functions, such as:
reviewing payments, updating bank account info, modifying tax withholding
and viewing tax documents.
Each year, you will receive Form 1099-R from OPM, which is a tax form
used to detail distributions from pensions. OPM will mail out the 1099-R to all
annuitants by January 31st for the preceding year. You may not receive it until
mid-February according to OPM. The 1099-R is ready and available for online
viewing on the third week of January.
I would like to welcome all those who joined the NALC Health Benefit Plan
for 2023. That is the smartest move you could ever make with regards to having
the best health plan for you and your family. We extend an enormous thank you
to all retired and active members who have chosen to continue with the NALC