Why it's a choice, and what it depends on
OPM's guidance for annuitants is straightforward: FEHB coverage continues with or without Medicare, and your FEHB premium doesn't change when you enroll. What changes is who pays first. Medicare pays first for annuitants (unless you're a reemployed annuitant), and your FEHB plan pays second.
| Your situation | What OPM says about Part B |
|---|---|
| Retired, in a fee-for-service FEHB plan | Part B and the plan "may combine to provide almost complete coverage." Some plans waive deductibles and coinsurance when Medicare is primary. |
| Retired, in an FEHB HMO | You "may not need Part B," but it pays for out-of-network care and care while traveling in the U.S. |
| Want Medicare Advantage or TRICARE For Life | Part B is required. |
| Still working with FEHB | You can defer Part B; FEHB is primary. You'll get a Special Enrollment Period later. |
Take Part A either way if it's premium-free; OPM says it can cover hospital costs your plan doesn't.
The cost of saying no
Part B has a monthly premium ($202.90 for most people in 2026, more with IRMAA), and you keep paying your FEHB premium too. That's why some retirees decline it. The risk: if you turn down Part B when you retire and later want it (to join Medicare Advantage, or because your needs change), you generally have to wait for the General Enrollment Period (January 1 to March 31) and pay a late penalty of 10% for each full 12 months you could have had Part B, for as long as you have it.
How to decide
- Read Section 9 of your FEHB plan brochure. It explains how your plan works with Medicare and what it waives when Medicare pays first.
- Compare your yearly costs. FEHB premium plus Part B premium, against your likely out-of-pocket costs with and without Part B.
- Think about travel and providers. With Original Medicare you can see any provider in the U.S. that accepts Medicare.
- Enroll at retirement if you want Part B. Use your Special Enrollment Period, within 8 months after your job-based coverage ends.
In Ohio, Medicare Advantage plans are sold by county; for 2027, CMS data show 119 open to everyone statewide. Our full guide: FEHB and Medicare in Ohio. You can also request a call from a licensed insurance agent.
Related questions
Do postal retirees need Part B for PSHB?
PSHB's different rule.
Does the Social Security Fairness Act change Medicare?
CSRS retirees too.
Do Ohio teachers have to pay for Part A?
Premium-free Part A explained.
Sources
- OPM — Medicare for federal annuitants
- OPM — Active federal employees and Medicare
- OPM — FastFacts: The FEHB Program and Medicare
- OPM — Postal Service Health Benefits Program
- Medicare.gov — Avoid late enrollment penalties
More questions in this guide
- Can STRS Ohio retirees join a different Part D plan?
- Do Ohio teachers have to pay for Medicare Part A?
- Do OPERS retirees have to enroll in Medicare?
- Do postal retirees in Ohio need Medicare Part B for PSHB?
- Do STRS Ohio retirees need Medicare Part B?
- Does OPERS pay for Medicare Part B?
- Does SERS reimburse Medicare Part B?
- Does the Social Security Fairness Act change Medicare for Ohio public retirees?
- How does HPRS retiree health care work with Medicare?
- How does the OPERS Medicare Connector work?
- What happens to OP&F retiree health care when I turn 65?
Part of the guide: Ohio's public retirement systems and Medicare · All questions
Frequently asked questions
Is FEHB drug coverage creditable for Medicare Part D?
Yes. OPM says FEHB provides creditable drug coverage, so you won't pay a Part D late penalty for delaying Part D as long as you keep FEHB.
Can I delay Part B while I'm still a federal employee?
Yes. OPM says active employees can defer Part B because FEHB is primary. When you retire, ask your employing office to complete form CMS-L564 so you can use the Special Enrollment Period without a penalty.
Can I suspend FEHB to join a Medicare Advantage plan?
Yes. OPM says annuitants can suspend FEHB while enrolled in a Medicare Advantage plan and re-enroll later, but canceling FEHB as an annuitant is permanent. You must have Part A and Part B to join Medicare Advantage.
Medicare in your Ohio county
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