Not affiliated with The United States Office of Personnel Management or any government agency

Not affiliated with The United States Office of Personnel Management or any government agency

The FEHB-Medicare Combo Is Powerful—But Only If You Time Enrollment Correctly

Key Takeaways

  • Proper timing of Medicare Part B enrollment is crucial if you want to avoid lifelong penalties and get the most value from your FEHB plan.

  • The FEHB-Medicare combination can reduce out-of-pocket healthcare costs significantly—but only if coordinated within the right enrollment windows.

Why Enrollment Timing Matters More Than You Think

When it comes to retirement planning, many government employees assume that staying enrolled in the Federal Employees Health Benefits (FEHB) Program is enough. And for many years, it might be. But the moment you become eligible for Medicare—usually at age 65—your decisions can make or break the financial efficiency of your healthcare coverage.

The FEHB-Medicare combination is considered one of the strongest retiree health coverage options available. However, to make this pairing work in your favor, you must understand when and how to enroll in Medicare correctly.

Your Medicare Initial Enrollment Period (IEP)

Most government retirees become eligible for Medicare at age 65. The Initial Enrollment Period (IEP) is your first chance to sign up for Medicare and lasts for seven months:

  • Three months before your 65th birthday

  • The month of your birthday

  • Three months after your birthday month

If you don’t enroll during this period and don’t have other qualifying coverage, you risk late enrollment penalties and a delayed start date for your benefits.

What Happens If You Miss Your IEP

Missing your IEP means waiting for the General Enrollment Period (GEP), which runs from January 1 to March 31 every year. If you enroll during the GEP, your Medicare coverage won’t start until July 1, and you’ll likely face permanent late enrollment penalties.

The penalty for Part B is especially costly. It adds 10% for each full 12-month period you delayed enrollment after your IEP—unless you had qualifying coverage. The penalty stays with you for life.

Qualifying Coverage That Lets You Delay

As a federal retiree, your FEHB coverage does not count as active employment coverage once you retire. That means you cannot delay Medicare Part B enrollment past age 65 without incurring penalties unless you are still employed in a position offering FEHB.

If you’re still working at 65 and covered by FEHB through current employment (either yours or your spouse’s), then you can delay Medicare Part B without penalty. But once you retire, the clock starts ticking.

Coordinating FEHB With Medicare at the Right Time

When timed correctly, enrolling in Medicare Part B while keeping your FEHB plan gives you layered protection:

  • Medicare pays first (primary), and FEHB pays second (secondary).

  • Your out-of-pocket costs may decrease significantly.

  • Some FEHB plans waive deductibles or offer reduced copayments when Medicare is primary.

This setup can shield you from high medical costs and provide broader access to healthcare providers.

What to Do If You’re Nearing Age 65

If you’re approaching 65 and planning to retire:

  • Mark your Initial Enrollment Period. Know the start and end dates.

  • Decide whether you’re keeping FEHB. Most retirees do, and for good reason.

  • Apply for Medicare Part A. It’s usually premium-free and offers hospitalization coverage.

  • Evaluate your need for Part B. If you’re retiring at 65, enroll during your IEP to avoid penalties.

Why Some Retirees Delay Part B—And Why That Can Backfire

Some retirees choose to delay Medicare Part B to avoid the monthly premium. While the standard premium in 2025 is $185 per month, skipping Part B can leave you underinsured and facing higher long-term costs.

FEHB plans are not required to cover everything Medicare would. For example, some services may not be fully covered without Medicare’s coordination, leading to surprise bills.

Additionally, you won’t be able to take advantage of the cost-sharing benefits that many FEHB plans offer to Medicare-enrolled retirees.

Medicare and FEHB: What Each Covers

Understanding what each program offers helps you see why both are important:

  • Medicare Part A: Inpatient hospital stays, skilled nursing care, hospice.

  • Medicare Part B: Outpatient care, doctor visits, durable medical equipment.

  • FEHB: Broader coverage including prescription drugs, dental and vision in some plans, and provider network flexibility.

FEHB alone may seem sufficient, but without Medicare Part B, you’re relying entirely on a plan that assumes Medicare is in place.

Common Scenarios That Lead to Mistimed Enrollment

Several missteps can lead to bad timing, such as:

  • Retiring right before 65 and assuming FEHB acts as qualifying coverage.

  • Forgetting to enroll in Part B during your IEP.

  • Misunderstanding the Special Enrollment Period rules.

  • Listening to outdated advice from colleagues who retired under different rules.

You can avoid these problems with a proactive enrollment strategy.

How Special Enrollment Periods Work

You may qualify for a Special Enrollment Period (SEP) to sign up for Part B without penalty if:

  • You had FEHB coverage due to current employment (not retirement).

  • You apply for Medicare within 8 months of employment ending.

If you miss this 8-month window, the penalty will apply, and your coverage will be delayed until the next GEP.

FEHB + Medicare in 2025: What Changes and What Stays the Same

As of 2025, FEHB plans still offer:

  • No required Medicare enrollment to keep your plan.

  • Continued federal government premium contributions.

  • Prescription drug coverage included in most plans.

But the landscape is shifting:

  • Out-of-pocket costs in many FEHB plans increase without Medicare Part B.

  • More plans are introducing cost-sharing incentives for Medicare-enrolled members.

  • Medicare Part D has a $2,000 cap on out-of-pocket prescription drug expenses, which complements your FEHB coverage.

Should You Ever Drop FEHB After Enrolling in Medicare?

In most cases, no. Dropping FEHB removes one of your most powerful healthcare safety nets. The only time it makes sense is if you:

  • Have qualifying coverage through a spouse’s employment.

  • Move to a retiree health plan that explicitly replaces FEHB.

Even then, be cautious. If you cancel FEHB in retirement, you generally can’t reenroll.

The Best Time to Review Your Coverage

The ideal review window is 3-6 months before you turn 65. At this point, you can:

  • Confirm your retirement timeline.

  • Review FEHB brochures for Medicare coordination.

  • Contact Social Security to initiate Medicare enrollment.

  • Consider speaking with a licensed agent listed on this website to fine-tune your decision.

This proactive review ensures you don’t get locked into high costs or coverage gaps.

Coordinating Benefits Can Help You Save

When timed correctly, your FEHB and Medicare benefits will:

  • Fill each other’s coverage gaps.

  • Reduce or eliminate copayments and coinsurance.

  • Lower your total out-of-pocket medical expenses.

  • Help you avoid unexpected bills from services Medicare covers but FEHB doesn’t fully cover alone.

You Only Get One Shot at This

Unlike employer coverage you can change annually, Medicare Part B enrollment has permanent consequences. If you get the timing wrong, the penalties stick. So does the delay in coverage.

That’s why getting the timing right the first time is critical.

Don’t Let Missed Timelines Undermine Your Retirement Healthcare

The FEHB-Medicare combination gives you a powerful shield in retirement—but only if you enroll in Medicare Part B at the right time. Delaying or skipping that step could leave you exposed to penalties, higher costs, and limited care options.

To make confident choices, review your options early and speak with a licensed professional listed on this website. With proper timing, you can ensure a smoother, more secure retirement.

After entering the financial services industry in 1994, it was a desire to guide people towards their financial independence that drove Aaron to start Steele Capital Management in 2013. Armed with an extensive background in financial planning and commercial banking coupled with a sincere passion for helping people, Aaron has the expertise and affinity for serving the unique needs of those in transition. Clients benefit from his objective financial solutions and education aligned solely with
helping them pursue the most comfortable financial life possible.

Born in Olympia, Washington, Aaron spent much of his childhood in Denver, Colorado. An area outside of Phoenix, Arizona, known as the East Valley, occupies a special place in Aaron’s heart. It is where he graduated from Arizona State University with a Bachelor of Science degree in Business Administration, started a family, and advanced his professional career.

Having now returned to his hometown of Olympia, and with the days of coaching his sons football and baseball teams behind him, he now has time to pursue his civic passions. Aaron is proud to serve on the Board of Regents Leadership for Thurston County as the Secretary and Treasurer for the Morningside area. His past affiliations include the West Olympia Rotary and has served on various committees for organizations throughout his community.

Aaron and his beautiful wife, Holly, a Registered Nurse, consider their greatest accomplishment having raised Thomas and Tate, their two intelligent and motivated sons. Their oldest son Tate is following in his father’s entrepreneurial footsteps and currently attends the Carson College of Business at Washington State University. Their beloved youngest son, Thomas, is a student at Olympia High School.

Focused on helping veterans and their families navigate the maze of long-term care solutions, Aaron specializes in customized strategies to avoid the financial crisis that care related expenses can create. Experience has shown him that many seniors are not prepared for the economic transition that takes place as they reach an advanced age.

With support from the American Academy of Benefit Planners – an organization with expertise and resources on the intricacies of government benefits – he helps clients close the gap between the cost of care and their income while protecting their assets from depletion.

Aaron can help you and your family to create, preserve and protect your legacy.

That’s making a difference.

Disclosure: Investment advisory services are offered through BWM Advisory, LLC (BWM). BWM is registered as an Investment Advisor located in Scottsdale, Arizona, and only conducts business in states where it is properly licensed, notice has been filed, or is excluded from notice filing requirements. This information is not a complete analysis of the topic(s) discussed, is general in nature, and is not personalized investment advice. Nothing in this article is intended to be investment advice. There are risks involved with investing which may include (but are not limited to) market fluctuations and possible loss of principal value. Carefully consider the risks and possible consequences involved prior to making any investment decision. You should consult a professional tax or investment advisor regarding tax and investment implications before taking any investment actions or implementing any investment strategies.

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