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Healthcare

The New Self Plus One Enrollment Type

Self Plus OneThe Bipartisan Budget Act of 2013 established a Self Plus One enrollment type in the Federal Employees Health Benefits (FEHB) Program. Coverage under a Self Plus One enrollment is now available during the annual Federal Benefits Open Season. Read More

The Federal Employees Health Benefits (FEHB) Program

The FEHB Program can help you and your family meet your health care needs. Federal employees, retirees and their survivors enjoy the widest selection of health plans in the country. You can choose from among Consumer-Driven and High Deductible plans that offer catastrophic risk protection with higher deductibles, health savings/reimbursable accounts and lower premiums, or Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Health Maintenance Organizations (HMO) if you live (or sometimes if you work) within the area serviced by the plan.

Use this site to compare the costs, benefits, and features of different plans. We chose the different benefit categories based on enrollee requests, differences among plans, and simplicity. However, we urge you to consider the total benefit package, in addition to service and cost, and provider availability when choosing a health plan.

The FEHB plan brochures show you what services and supplies are covered and the level of coverage. Review the brochures carefully. The brochures are formatted to ensure they are all organized alike. You can get brochures from the health plans or your human resource office. When it comes to your health care, the best surprise is no surprise.

Pharmacy Incentive Programs and FEHB

OPM does not prohibit FEHB members from participating in pharmacy-sponsored incentive or pharmaceutical company co-pay reimbursement programs, and we are unaware of any Federal laws restricting participation. Enrollees in other Federal Programs such as Medicare and Medicaid are statutorily prohibited from participating in pharmacy incentive programs under section 1320a-7b of title 42, United States Code (“the Anti-Kickback Act). However, the FEHB Program is exempt from the application of this provision.

OPM does not have authority over promotional incentive programs retail pharmacies choose to offer customers, and OPM cannot direct retail pharmacies to provide the incentives to FEHB Program members. We are working with FEHB Program plans to remove any restrictions.

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