Q&A: TriCare and FEHB

Question

I know FEHB has a 5-year requirement. I currently have TriCare, but want to make sure I satisfy FEHB’s 5-year rule, so I was planning to enroll in FEHB. But then I will be paying for 2 insurances.

Do you think it’s worth it?

Answer

Your TriCare will count toward your FEHB’s 5-year requirement, so you don’t need to have both, if you don’t want to.

However, if you want to continue FEHB into retirement, you will need to be covered under FEHB on the date you retire.

So, you just want to make sure you’re enrolled in FEHB on the date you retire. Then you can “suspend” FEHB and rely on Tricare, keeping the FEHB backdoor open, so to speak. This means that in the future, should you ever wish to re-enter FEHB, you can do so during a future open season (in some instances you can re-enter even outside of an open season).

Should you pass away while your FEHB is in “suspension” your spouse can re-join FEHB, so long as they, too were covered under your FEHB when you elected to “suspend.” 

Here are the words of OPM:

“Annuitants and survivors who have suspended their enrolment may be able to reenroll in an FEHB plan during a future Open Season for any reason, other than an involuntary loss of coverage. If an annuitant or survivor is involuntarily disenrolled from the other coverage, he/she can re-enroll in the FEHB Program immediately.”

Read more about suspension here: https://www.opm.gov/healthcare-insurance/healthcare/reference-materials/reference/annuitants-and-compensationers/

You can use this form to “suspend” your EHB: https://www.opm.gov/forms/pdf_fill/ri79-9.pdf

Be sure to “suspend,” not “cancel.” Read the form carefully.

Be sure to discuss all this with your HR, just in case any rules change. You can show them this article with all links.

Note:

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