Guides · Updated August 28, 2026
Medicare Part B and FEHB in Retirement: Costs and Deadlines
See whether Medicare Part B is worth adding to FEHB in retirement: your enrollment window and what your plan gives back.
The real question is narrower: does the Part B premium buy back more for your household than it costs, once you count your plan's cost sharing, any premium reimbursement, and how much care you actually use.
This guide applies to Medicare-eligible FEHB enrollees and annuitants at or near 65, whether you're already retired, still working past 65, or covered through a working spouse. This is general information, not financial or legal advice. Confirm your own dates and plan terms with Medicare, Social Security, and your FEHB carrier before you act.
Which enrollment window applies to you
Already retired on FEHB. The Initial Enrollment Period is the applicable window, because retiree FEHB is not coverage based on current employment and does not protect a Part B delay.
Still working past 65 with FEHB through your own job. If FEHB coverage is based on your current employment, you can delay Part B while that coverage continues.
Covered through a spouse who is still actively working. If your coverage is based on your spouse's current employment, you can delay Part B while that coverage continues.
Past your window, no longer covered by current employment. If the Initial Enrollment Period has passed and neither you nor a working spouse has current-employment coverage, a delay is not protected; the General Enrollment Period runs January 1 through March 31. Part B coverage generally begins on the first day of the month after you enroll, so confirm your exact start date with Social Security.
The cost examples later in this guide assume the already-retired scenario.
Key takeaways
What to check before you decide on Part B
- Part B costs $2,434.80 a year per person in 2026, and income surcharges can push that higher.
- FEHB keeps paying full benefits even if you decline Part B, so nothing forces the decision.
- Check your plan brochure for cost-sharing waivers and Part B reimbursements.
- Give-back terms differ by carrier, so what one FEHB plan pays back another plan may not.
- A late Part B enrollment can add 10% for each full 12-month delay, usually for life.
Your deadline depends on which of these four situations fits you
Already retired with no other coverage. Select Health describes a seven-month Initial Enrollment Period: the three months before the month you turn 65, your birthday month, and the three months after it. The Congressional Research Service says people who do not enroll during that period must wait for the next General Enrollment Period. Confirm separately whether your coverage creates a Special Enrollment Period before you delay Part B.
Still working past 65 on your own FEHB. For people 65 or older who are employed, Select Health says its FEHB benefits remain primary. The Congressional Research Service says working people with group coverage through current employment may be exempt from the late-enrollment penalty under certain conditions. It describes an eight-month Special Enrollment Period after employment or the group coverage ends.
Covered through a spouse who is still working. The Congressional Research Service includes spouses with group coverage through a spouse's current employment among people who may be exempt from the late-enrollment penalty under certain conditions. It describes the same eight-month Special Enrollment Period after the employment or group coverage ends.
Past your window with no qualifying coverage. The Congressional Research Service says people who do not sign up during the Initial Enrollment Period and do not meet an exception must wait for the next General Enrollment Period. The period runs January 1 through March 31. Its report says a 10% surcharge can be added to the Part B premium for every full 12-month period of delay, and the increase generally lasts for as long as you have Part B. Waiting shifts enrollment to that later period instead of letting you add Part B when you first become eligible.
What Part B costs before your FEHB plan is added
The Centers for Medicare & Medicaid Services set the standard Part B premium at $202.90 a month for 2026, up from $185.00 in 2025, which works out to $2,434.80 a year per person. If you and a covered spouse both enroll, that cost applies separately to each of you, so a two-Medicare household is looking at roughly $4,870 a year before anything else.
Higher earners pay more. Social Security's 2026 tables add a surcharge starting above $109,000 in income for an individual filer or $218,000 for joint filers, and the surcharge climbs in steps up to a total premium of $689.90 a month at the top bracket. Your premium is generally set from a tax return filed roughly two years earlier, so if your income dropped when you retired, Social Security lets you request a new decision with Form SSA-44 rather than wait for the surcharge to catch up on its own.
Those figures are only the Part B piece of the household budget. A full annual total needs the annuitant premium for the exact plan year and enrollment tier, Part B for every beneficiary, any surcharge and reimbursement, expected medical and prescription cost sharing, and the plan's medical out-of-pocket maximum. Do not treat a reimbursement or cost-sharing waiver alone as proof that another option costs less.
What your FEHB plan gives back once you add Part B
What you get back for paying the Part B premium depends entirely on the plan and option you're in right now, so start there before pricing anything else.
Select Health's 2026 FEHB Standard Option waives 100% of Part A and Part B member cost sharing for an annuitant when the waiver applies. That includes the plan's medical deductible and most coinsurance and copays. Prescription-drug cost sharing still applies.
At the 2026 standard premium, one person starts with roughly $2,435 in annual Part B cost before counting the value of Select Health's medical cost-sharing waiver.
Kaiser Permanente's 2025 Senior Advantage 2 program is for its Northern California Region. It reimburses enrolled members and their covered dependents up to $250 a month toward the Medicare Part B premium, including any late-enrollment penalty or income-related surcharge.
If your Part B decision is part of a bigger move out of federal service, FedUp.work's broader transition resources can help you plan the rest of that timeline too.
Confirm these details in your own plan brochure
Three things move the math and none of them are safe to assume. First, record your option, plan year, enrollment tier, annuitant premium, medical out-of-pocket maximum, and any Part B reimbursement. Add Part B separately for every household member who enrolls, including any surcharge.
Next, check whether your plan waives medical deductibles and coinsurance when Medicare is primary. Confirm whether that waiver covers you, your spouse, or both.
Finally, check prescription drug coverage and service-specific limits separately. Select Health's 2026 Standard Option says drug cost sharing still applies even when its Medicare waiver covers medical cost sharing. Look for limits such as a cap on certain therapy visits, because those terms can affect the total even when medical cost sharing is reduced.
Provider access with Medicare versus an FEHB network
Provider access is a separate part of the decision. Before enrolling in a carrier's Medicare arrangement, check whether your doctors, hospitals, and pharmacies participate and whether its rules fit your travel or two-home needs.
Kaiser Permanente's cited Senior Advantage 2 program is a Northern California Region program. Its terms should not be treated as a nationwide provider-access rule.
This guide offers general information, not legal or financial advice, so confirm the details that affect your own decision with your plan brochure or OPM before you enroll or decline.
Steps to work through your Part B and FEHB decision
- Find your timing branch and mark the deadline
Already retired on FEHB: identify the Medicare enrollment timing that applies to you. Still working past 65 with FEHB through your own job: identify the Medicare enrollment timing that applies to you. Covered through a spouse who is still working: identify the Medicare enrollment timing that applies to you. Past a prior enrollment window: identify the Medicare enrollment timing that applies to you. Write down the exact date your window closes.
- Confirm FEHB actually carries into retirement
Check that you retired, or will retire, on an immediate annuity and were enrolled in FEHB for the five years right before retirement, or since your first chance to enroll. This rule keeps your FEHB coverage in force, separate from your Medicare enrollment window.
- Open your plan's Medicare section and record what it gives back
Go to your current FEHB carrier's Medicare brochure or coordination page. Note exactly what it waives when Medicare is primary (deductibles, copays, coinsurance), whether it reimburses part of the Part B premium or contributes to an HRA, and which household members qualify.
- Add up your household's full annual Part B cost
Multiply the standard monthly Part B premium by 12 for each person who would enroll, then add any income-related surcharge based on your modified adjusted gross income from two years prior. If your income dropped after retirement, you can ask Social Security to use a more current figure through a reconsideration request.
- Price your current FEHB option against the alternatives
Compare your plan's annuitant premium by option and enrollment tier against other FEHB choices for your household size using compare FEHB plan costs side by side. Do this before you assume a cheaper option is worth switching to.
- Verify when a plan change would actually take effect
A plan or option change generally takes effect only at a specific enrollment opportunity. Confirm with OPM or your carrier which opportunity applies to you, then re-run your first-year savings for the period the new option would actually be in force.
- Weigh what tips the decision toward enrolling or declining
Enrolling tends to pay off when your plan waives meaningful cost-sharing or reimburses part of the premium and you use enough care to value broader access to providers who accept Medicare. Declining is a defensible choice when you're still covered under a qualifying current-employment plan and want to avoid the premium while that protection lasts.
- File your decision through SSA or Medicare by your deadline
Enroll, delay, or request a surcharge reconsideration at ssa.gov/medicare or by phone before the date you recorded in step one. Keep a copy of your confirmation and any surcharge determination for your records.
Common questions about Part B and FEHB after you retire
Do I have to enroll in Medicare Part B if I already have FEHB?
No. Retirees with FEHB can decline Part B. Before deciding, check which coverage your providers accept, which services you use regularly, and the flexibility you need.
Does FEHB coverage carry into retirement automatically?
No. You must retire on an immediate annuity and have been continuously enrolled in FEHB for the five years before retirement, or since first eligible. That FEHB eligibility test is separate from Medicare's enrollment-period rules.
Is it worth keeping FEHB and paying for Part B too?
It depends. Medicare Interactive advises comparing the costs and benefits of each coverage option. Check your plan brochure for any Part B reimbursement or cost-sharing waiver before counting it in your decision.
Sources and further reading
- 2026 Medicare Parts A & B Premiums and Deductibles | CMS (cms.hhs.gov)
- Avoid late enrollment penalties (medicare.gov)
- Medicare General Information, Eligibility, and Entitlement (cms.gov)
- FEHB Medicare Brochure 2026 (selecthealth.org)
- FEHB-GHO Coordination of Benefits with Medicare (wa.kaiserpermanente.org)
- Federal Employees Health Benefits (FEHB) Plan (choose.kaiserpermanente.org)
- Coordination of Benefits in Health Care (fedweek.com)
- stwserve.com
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