FEHB and Medicare at 65: Should Federal Retirees Take Part B in 2026?

Enduring Insights · Federal Retirement · 2026

One of the biggest decisions federal retirees face at 65 is whether to enroll in Medicare Part B on top of their Federal Employees Health Benefits (FEHB) coverage. There's no single right answer — but there are a few rules and numbers that should drive your decision.

First: protect your FEHB

Before the Medicare question, make sure you can even keep FEHB in retirement. The general rule is that you must be enrolled in FEHB for the 5 continuous years immediately before you retire (or since your first opportunity to enroll). Miss that window and you can lose FEHB permanently. Confirm this well before your retirement date.

Part A is easy; Part B is the real decision

Most people take Medicare Part A (hospital insurance) at 65 because it's premium-free if you or your spouse paid Medicare taxes for 10+ years. The decision is really about Part B (doctor and outpatient care), which has a monthly premium. For 2026, the standard Part B premium is $202.90 per month, with a $283 annual deductible.

How FEHB and Part B work together

Many federal retirees keep FEHB and add Part B. When you have both, Medicare generally pays first and FEHB pays second — often covering deductibles, copays, and coinsurance that FEHB would otherwise charge. Some FEHB plans even reduce their cost-sharing or reimburse part of your Part B premium when you're enrolled in both. Others — especially those in good health or with higher incomes — keep FEHB alone and skip Part B.

Two watch-outs on Part B. (1) Late-enrollment penalty: if you delay Part B past 65 without qualifying current-employment coverage, you can face a permanent penalty of 10% for every 12 months you delayed — and FEHB as a retiree doesn't always shield you. Confirm with SSA first. (2) IRMAA: Part B premiums rise with income above $109,000 single / $218,000 joint in 2026.

There's no universal answer — run your numbers

Whether Part B makes sense depends on your health, your specific FEHB plan's coordination benefits, and your income. To compare the actual annual cost of FEHB alone vs. FEHB plus Part B, the Federal Retirement Readiness Kit includes a side-by-side calculator built on 2026 figures.

Free download: The Federal Retirement Countdown Checklist walks you through the health-care decisions at 65 alongside every other retirement milestone.

Educational resource only, not financial, tax, or legal advice. Figures verified July 2026 against CMS and OPM. Confirm your situation with SSA, Medicare, and your FEHB plan before deciding.