Managing My Own Health

Your health. Your benefits. Your choice.

As a federal employee or annuitant, you have a comprehensive package of health and wellness benefits.

Benefits that Work Together

Your health plan is one piece of a bigger picture. Combine these programs, and they work harder for you.

*Higher-level plan comparison tools are available on both BENEFEDS.gov and OPM.gov, and FEDVIP carrier brochures – the official statement of benefits – are posted on both sites for a detailed review of your plan options.

First Things First: Am I Eligible?

Eligibility depends on your employment status and enrollment window. Use the links below for specifics.

• You’re a federal employee. Most employees are eligible for FEHB (or PSHB for USPS), FEDVIP and FSAFEDS. Enrollment is not automatic. You must enroll, either within 60 days of becoming eligible (new hires), during Open Season, or after a qualifying life event.
• USPS employees / annuitants. USPS employees and annuitants receive health coverage through the PSHB Program. Your FEDVIP eligibility works the same way as it does for other federal employees.
• You’re a federal annuitant (retiree). If you retired on an immediate annuity and were enrolled in FEHB (or PSHB) for the 5 years before retirement (or since your first opportunity to enroll), you can keep coverage into retirement. Annuitants are also eligible for FEDVIP but note that flexible spending accounts are for active employees only.
• Family members. Your spouse and children under age 26 can be covered. Children with a disabling condition that began before age 26 may remain covered.
• Need help? Eligibility can vary. Check OPM’s Healthcare Eligibility page or ask your agency HR/benefits office.

I Want To…

Get where you’re going in one click.

• Preventive services & screenings – MyHealthFinder
• Choose or change my plan – FEHB/PSHB Plan Comparison Tool; FEDVIP Plan Comparison Tool
• Find my plan brochure – FEHB plan brochures; PSHB plan brochures
• Ways to lower my costs – cost saving tips (below)
• Use FSAFEDS or an HSA/HRA – FSA / HSA (PSHB HSA)
• High Deductible Health Plan (HDHP) Fact Sheet – FastFacts HDHP
• Compare vision and dental service costs (FEDVIP) – Plan Selection | BENEFEDS
• Use my Employee Assistance Program (EAP) – EAP resources
• Track my health information – Personal Health Record tools (adult) (child). This is for your records. No information is retained by the government.
• Dispute a claim – How to appeal a plan denial

*Plan services like provider directories, cost estimators, claims status, and ID cards are on your carrier’s member portal.

Smart Ways to Lower Your Costs

Small choices add up. Seven habits that can save you real money.

• Stay in network. In-network providers have agreed to negotiated rates. Out-of-network care almost always costs more.
• Use your preventive care. Most preventive services (checkups, screenings, and routine immunizations) are covered at no cost to you when you use in-network providers.
• Ask for generics. Generic medications meet the same FDA standards as brand names, usually at a fraction of the cost.
• Try telehealth when appropriate. Virtual visits are often faster and less expensive for routine and follow-up care.
• Put tax-advantaged accounts to work. Explore FSAFEDS or a high-deductible health plan with an HSA or HRA to pay for care with pre-tax dollars. FSAFEDS can reimburse your FEHB and FEDVIP copays and deductibles. Just remember, it does not renew automatically each year.
• Compare dental costs before you commit. Use the Compare Dental Service Costs tool at BENEFEDS.gov to see expected out-of-pocket costs for common dental treatments across FEDVIP carriers.
• Coordinate your coverage with Medicare. If you’re retired (or nearing retirement) and eligible for Medicare, enrolling in Medicare Parts A & B alongside your FEHB or PSHB plan can significantly reduce what you pay. Many plans waive their deductibles, copays, and coinsurance when Medicare is your primary payer, and some offer a Part B premium reimbursement. Check your plan brochure’s Medicare section (section 9) to see how your plan coordinates. Note: most PSHB annuitants are required to enroll in Part B to keep their coverage. Learn more at Healthcare & Insurance - OPM.gov.

Healthcare Quality Scores — measures how well health plans perform in preventing and treating conditions through activities such as but not limited to: breast cancer screening, comprehensive diabetes care, and controlling high blood pressure.

Recommended Health Care Screening

Recommended Health Care Screening for Men and Women

Preventive Care & Well-Being

The best care is the care that keeps you well. Your plan covers a wide range of preventive services – most at no cost when you use in-network providers. Here’s what’s available and where to find the details in your plan brochure.

Screenings & Vaccinations (Section 5(a) of your plan brochure)

Adults: Routine use of adult immunizations recommended by the Advisory Committee on Immunization Practices (ACIP) and adopted by the Centers for Disease Control and Prevention (CDC) is covered. A recommendation is considered to be for routine use if it is listed on the CDC's Immunization Schedules. For the current immunization schedule, visit cdc.gov/vaccines/imz-schedules.

You can also find the full list of recommended preventive screenings — the U.S. Preventive Services Task Force (USPSTF) A and B recommendations — at uspreventiveservicestaskforce.org.

Children: Well-child visits, examinations, and other preventive services follow the American Academy of Pediatrics Bright Futures Guidelines (brightfutures.aap.org). Routine use of children's immunizations recommended by ACIP and adopted by the CDC is covered — see the current schedule at cdc.gov/vaccines/imz-schedules.

Good to know: Immunizations, boosters, and medications for travel or work-related exposure are generally not covered as preventive care, and physical exams required for employment, insurance, school, camp, sports, or travel are typically excluded. Check Section 5(a) of your plan brochure for your plan's specific terms.

Mental & Behavioral Health (Section 5(e) of your plan brochure)

Your well-being includes your mental health. Your plan covers mental health and substance use disorder services, and your EAP offers free, confidential support – often the fastest first step.

Nutrition & Physical Activity (Section 5(h) of your plan brochure)

Many plans offer nutrition counseling, wellness incentives, gym discounts, and health coaching. Check your brochure’s wellness section to see what your plan includes.

Maternal & Reproductive Health (Section 5(a) of your plan brochure)

Prenatal care, maternity services, contraception, and related preventive services are covered – see your brochure for specifics.