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FEHB plan and family enrollment comparison

A useful FEHB comparison puts the same plan year, enrollment category and household needs beside each alternative. Comparing one plan's monthly premium with another plan's biweekly deduction, or a current claim with next year's brochure, can produce a misleading result before benefits are even considered.

OPM's comparison tool is a starting point. OPM expressly identifies each plan's FEHB brochure as the official statement of benefits. This worksheet organizes the information to verify in those documents; it does not select a plan or quote an individual's costs.

Identify the year and program first

As reviewed on November 3, 2026, OPM's public comparison page displays 2027 plans. That is useful for an upcoming enrollment decision, but it is a different year from benefits paying a 2026 claim. Keep the intended year visible on every comparison record.

Also confirm whether the person belongs in FEHB or the separate PSHB program. OPM directs eligible Postal Service members to the PSHB system for their plan research and enrollment. A familiar carrier name does not make the two program enrollments interchangeable.

Record the actual plan option, enrollment code, geographic eligibility and effective date from the official source. If someone lives or works outside a service area, or is planning a move, ask the administrator which choices are available for that situation.

Compare the enrollment tiers on their actual terms

Self Only, Self Plus One and Self and Family concern different coverage arrangements. Confirm the eligible family members and the tier that would cover them. Do not infer family-member eligibility solely from a tax dependency rule or from the number of people living in a household.

Use the actual published premium for each eligible tier. Avoid assuming that a tier's name guarantees a particular price relationship in every plan. A fair comparison uses the correct employee, annuitant or other enrollee category and the same payment frequency.

Comparison field What to verify for each option
Program and year FEHB or PSHB, the plan year and effective dates.
Enrollment The exact option, code, eligible tier and covered family members.
Premium The applicable share and whether the figure is monthly, biweekly or another frequency.
Providers Network status, service area and referral or authorization requirements.
Prescriptions The plan's current formulary, pharmacy arrangements and applicable cost rules.
Medical cost sharing Deductibles, copayments, coinsurance and the rules for different services.
Annual limits What the stated maximum includes and excludes, according to the brochure.
Other coverage How Medicare or another applicable program changes coordination.

Build an annual comparison without inventing a forecast

Separate the premiums paid over the relevant period from the costs that depend on care received. Record the assumptions used for any illustrative scenario and identify which figures come from the official brochure. An estimate based on one pattern of care is not a promise about the coming year.

Read the exclusions and conditions alongside a deductible or out-of-pocket maximum. Ask the plan which charges count toward a limit, which expenses remain outside it and whether network use changes the result. A single headline figure cannot describe the entire benefit.

For provider or prescription questions, use the plan's current verified channel. Keep private medical details in the appropriate plan or clinical process rather than a general website inquiry. A dated answer is more useful than an assumption based on a previous year's directory or formulary.

Add Medicare and survivor questions where relevant

Medicare coordination can change the comparison, but FEHB and PSHB have different enrollment requirements. The applicable employee or annuitant status matters too. Use the working-past-65 timeline and PSHB exception checklist for those separate records.

For a household planning for a spouse's future coverage, also review the survivor-coverage checklist. Current family enrollment and a future continuation entitlement answer different questions.

Confirm the change rather than assuming it happened

Before acting, verify the enrollment window, effective date and official submission method. Afterward, retain the confirmation and reconcile the plan, tier, covered members and payroll or annuity deduction. If a result is unconfirmed, investigate the original change through the responsible office.

Keep the brochures, dated answers and comparison assumptions together. They provide a basis for an informed decision and a later claim question without treating a comparison table or private website as the official benefit contract.

Browse federal benefits, retirement and insurance topics or read how we prepare and check our guides.

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