Key Takeaways:
- An annual review and update of your FEHB (Federal Employees Health Benefits) health plan ensures that your coverage meets your evolving healthcare needs and financial situation.
- Following a comprehensive checklist helps you systematically assess your current plan, explore new options, and make informed decisions during the Open Season.
Annual Checklist for Reviewing and Updating Your FEHB Health Plan
Reviewing and updating your Federal Employees Health Benefits (FEHB) plan annually is a crucial task to ensure that your healthcare coverage continues to meet your needs and fits within your budget. Open Season, the period when federal employees and retirees can make changes to their FEHB coverage, provides the perfect opportunity to evaluate your plan and make necessary adjustments. This guide offers a comprehensive checklist to help you systematically review and update your FEHB health plan each year.
- Also Read: New Rules for Federal Employees in 2025: What You Need to Know to Stay Ahead
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- Also Read: Military Buyback for Federal Employees: Is It Really Worth It? Here’s What You Need to Weigh Up
Key Steps for Conducting an Annual Review of Your FEHB Plan
Assess Your Current Coverage
- Review Plan Details: Start by thoroughly reviewing the details of your current FEHB plan. Understand what is covered, the cost of premiums, copayments, deductibles, and out-of-pocket maximums. This provides a baseline to compare against other plans.
- Analyze Usage: Look at how you and your family have used your health benefits over the past year. Identify the types of services you frequently use, such as primary care visits, specialist appointments, prescription medications, and any hospitalizations.
- Evaluate Satisfaction: Reflect on your satisfaction with your current plan. Consider factors like ease of accessing care, customer service quality, and the convenience of the provider network.
Identify Changes in Healthcare Needs
- Life Changes: Consider any significant life changes that might impact your healthcare needs, such as marriage, the birth of a child, or retirement. These events can necessitate changes in coverage.
- Health Status: Assess any changes in your health status or that of your dependents. New diagnoses, ongoing treatments, or expected surgeries can affect the type of coverage you need.
- Future Plans: Think about your plans for the upcoming year. Are there any anticipated healthcare expenses, such as elective surgeries, dental work, or vision care, that your current plan may not cover adequately?
Compare FEHB Plan Options
- Use the OPM Comparison Tool: Utilize the Office of Personnel Management (OPM) Plan Comparison Tool to compare different FEHB plans. This tool allows you to input your preferences and view side-by-side comparisons of costs and benefits.
- Review Plan Brochures: Download and read the detailed brochures of the plans you are considering. These documents provide comprehensive information about coverage, exclusions, and limitations.
- Consider Premiums and Costs: Compare the premiums, deductibles, copayments, and out-of-pocket maximums of different plans. Ensure that you understand the total cost implications of each plan.
Explore Additional Benefits
- Preventive Care: Ensure that the plans you are considering offer robust preventive care benefits, such as annual check-ups, screenings, and immunizations.
- Prescription Drug Coverage: Review the prescription drug coverage of each plan. Check if your current medications are covered and understand the copayment or coinsurance costs.
- Specialty Services: If you or your family members need specialty services, such as mental health care, maternity care, or chronic disease management, verify that these services are adequately covered.
How to Update Your FEHB Coverage Based on Changing Health Needs
Make Informed Decisions
- Prioritize Needs: Prioritize the health services that are most important to you and your family. This helps you focus on plans that best meet these needs.
- Seek Advice: Consult with your agency’s human resources department or a health benefits counselor if you need assistance understanding your options or making a decision.
Update Your Plan During Open Season
- Open Season Dates: Be aware of the Open Season dates. For 2024, Open Season runs from November 11 to December 9.
- Log into the Enrollment System: Access the FEHB enrollment system through your agency’s HR portal or the OPM’s online platform.
- Submit Changes: Follow the instructions to submit your enrollment changes. Ensure that all information is accurate before finalizing your selections.
- Confirmation: After submitting your changes, you should receive a confirmation notice. Keep this notice for your records to verify your new coverage.
Communicate Changes to Providers
- Inform Healthcare Providers: Notify your healthcare providers of any changes to your insurance plan to ensure they bill the correct insurer and avoid any disruptions in care.
- Update Information: Provide your new insurance information at your first appointment after the change takes effect.
Verify New Coverage
- Effective Date: Remember that changes made during Open Season take effect on January 1 of the following year.
- Review New ID Cards: Once your new coverage begins, review any new insurance ID cards you receive to ensure they match your selected plan.
Important Deadlines and Actions for Annual FEHB Plan Updates
Key Deadlines
- Open Season Start and End Dates: Mark the Open Season dates on your calendar to ensure you don’t miss the opportunity to make changes.
- Plan Selection Deadline: Make sure to finalize your plan selection before the end of Open Season.
Actions to Take
- Prepare Early: Begin reviewing your current coverage and exploring new options well before Open Season starts. This gives you ample time to make an informed decision.
- Set Reminders: Set reminders for key dates and deadlines related to Open Season.
- Review Confirmation: After making your changes, review the confirmation notice carefully to ensure that all details are correct.
Conclusion
Conducting an annual review and update of your FEHB health plan is essential to ensure that your coverage continues to meet your needs and fits within your budget. By following a comprehensive checklist, you can systematically assess your current plan, explore new options, and make informed decisions during Open Season. Staying proactive and informed will help you maximize your FEHB benefits and maintain optimal healthcare coverage for you and your family.




