FEHB & Medicare FEHB in Retirement

Why FEHB costs more after you retire

Same premium. Same government share. The tax break ends.

What changes, and what doesn’t
Same
premium
And the same government share
After-tax
in retirement
Premium conversion is for employees only
~$2,160
a year
On $8,000 of premiums at 22% federal + 5% state

Budget for it: multiply your annual premium share by your federal plus state income tax rate. That is the real increase in what your coverage costs you.

Jump to a section
  1. Why the tax break ends
  2. What it costs you
  3. Ways to keep it longer
  4. Deducting premiums in retirement
  5. Frequently asked questions
72% / 75%
Government share, unchanged in retirement
OPM
§125
The tax provision that limits it to employees
Internal Revenue Code
$3,000
Exclusion for eligible retired public safety officers
IRS
7.5%
Of AGI your medical costs must exceed to deduct
IRS

1. Why the tax break ends

While you work, your share of the FEHB premium is paid through premium conversion, a pre-tax arrangement under section 125 of the Internal Revenue Code. The premium comes out before federal income tax, Social Security and Medicare tax, and in most states state and local income tax. It lowers your taxable pay.

Section 125 benefits are available only to current employees. An annuity is not salary. So annuitants are not eligible for premium conversion, and your participation ends on the last day of your last pay period as an employee.

Nothing about the coverage itself changes — same plan, same network, same deductible. The government contribution is identical for employees and annuitants: the lesser of 72% of the weighted average premium or 75% of your plan's premium. The only thing that moves is how the money you pay is taxed.

2. What it costs you

The rough formula: your annual premium share × your federal plus state income tax rate.

Annual premium share22% federal + 5% state12% federal + 5% state
$3,000 (Self Only)$810$510
$8,000 (Self Plus One)$2,160$1,360
$10,000 (Self and Family)$2,700$1,700

Notice what is not in that math: Social Security and Medicare tax. While you work, premium conversion also saves you payroll tax. In retirement that part of the saving would not apply anyway, because annuities are not subject to Social Security or Medicare tax. The retirement loss is the income-tax piece only.

If you are building a retirement budget from your last paycheck, this is one of the line items that quietly gets worse. The full picture of what changes is in retiring at 57 and the five-year rule.

3. Ways to keep it longer

Don’t cancel to save money

The tax increase is real but modest. Cancelling FEHB to avoid it is not a trade: cancellation in retirement is permanent. See cancelling FEHB in retirement.

4. Deducting premiums in retirement

After-tax premiums can count as a medical expense if you itemize, but only the portion of your total medical costs above 7.5% of your adjusted gross income is deductible. Most retirees don't clear that bar, so for most people the premiums are simply paid with after-tax money.

It becomes worth tracking in a year with large medical bills — a surgery, long-term care costs, or a year of high out-of-pocket spending. In that year, add your FEHB premiums to the total before deciding whether to itemize. The broader tax planning is in state taxes on federal retirement.

5. Frequently asked questions

Why does FEHB cost more after I retire?

The premium itself does not change, but the tax treatment does. While you work, your share is paid through premium conversion, a pre-tax arrangement under section 125 of the Internal Revenue Code. Those tax advantages are available only to current employees, so as an annuitant you pay the same premium from after-tax income.

Does the government pay less toward my FEHB when I retire?

No. The government contribution is the same for annuitants as for employees: the lesser of 72 percent of the weighted average premium or 75 percent of your plan’s premium. Only the tax treatment of your share changes.

How much more does it actually cost?

Roughly your share of the annual premium multiplied by your combined federal and state income tax rate. An annuitant paying $8,000 a year in premiums at a 22 percent federal and 5 percent state rate loses about $2,160 a year in tax savings. Social Security and Medicare tax savings are not part of the retirement loss, because annuities are not subject to those taxes.

Is there any way to keep the tax break?

A few. If your spouse is also a federal employee who will retire later, enrolling under that spouse keeps the premiums pre-tax until they retire. Reemployed annuitants in a position that conveys FEHB eligibility can participate in premium conversion again. Eligible retired public safety officers may exclude up to $3,000 a year of health premiums paid from their retirement plan.

Can I deduct FEHB premiums on my taxes in retirement?

Only if you itemize and your total medical expenses exceed 7.5 percent of your adjusted gross income, in which case after-tax premiums count toward that total. Most retirees do not clear that threshold, so for most people the premiums are simply paid with after-tax money.

Sources
  1. OPM, premium conversion for federal employees
  2. OPM, FEHB cost of insurance and the government contribution
  3. 5 CFR part 892, FEHB premium conversion
  4. IRS Topic 502, medical and dental expenses
  5. IRS Publication 575, including the retired public safety officer exclusion