Unfortunately, the 12.3% average enrollee increase in FEHB premiums isn\u2019t the only health insurance cost rising next year. Depending on your plan and providers, what you pay when you use medical services may also go up, sometimes significantly.<\/p>\n
Let’s walk you through the key benefit changes, highlight examples of what\u2019s shifting, and point you to the best resource for understanding how your specific FEHB plan is affected next year.<\/p>\n
Sample of FEHB Benefit Changes<\/p>\n
While some FEHB plans remain unchanged from year to year, this is the exception and not the rule. Occasionally, plans add new benefits (see IVF coverage below), but often benefit changes result in higher out-of-pocket costs.<\/p>\n
To give you an idea about what could change from one year to the next, here are some examples:<\/p>\n
Next year, 29 out of 132 FEHB plans will increase their catastrophic limit, or the maximum you\u2019ll pay out-of-pocket for approved healthcare services. GEHA Standard is increasing both the in-network and out-of-network limits for 2026, with the latter climbing 135% from $8,500 for self-only coverage to $20,000, and from $17,000 for self-plus-one\/self-&-family coverage to $40,000.<\/p>\n
Several popular nationwide PPO plans are also changing: BCBS Basic members will see increased costs for durable medical equipment, and inpatient hospital, outpatient hospital, emergency room, lab tests, and ambulance services. GEHA High and Standard members will pay more for physician and emergency room visits, and a higher deductible, catastrophic limit, and coinsurance percentage.<\/p>\n
All FEHB plans must provide coverage for at least one GLP-1 medication prescribed for weight loss. For those who currently use these medications, go to the carrier website to see if there will be any changes in what you pay. For example, Kaiser plans will increase the member cost share to 50% for GLP-1s prescribed for weight loss next year.<\/p>\n
It\u2019s not all higher costs for plan members; a handful of plans are adding new benefits, like doula coverage for Qualchoice and Kaiser Colorado, and hearing aid coverage for Kaiser Colorado and Medical Mutual Basic.<\/p>\n
In-Vitro Fertilization Coverage<\/p>\n
One of the most promising developments in the FEHB program is expanded access to in-vitro fertilization (IVF) benefits. In 2026, OPM has mandated that HMO plans operating in states with IVF coverage laws must offer benefits that meet those state requirements. As a result, FEHB will feature the highest number of plans offering IVF coverage in its history.<\/p>\n
For families looking for IVF benefits, keep in mind the following:<\/p>\n
Out-of-pocket costs can still be substantial, and they vary widely by plan.
\nSome plans cap the amount they\u2019ll pay for IVF services annually.
\nVerify that your providers are in-network to avoid unexpected charges.
\nUnderstand the prior-approval process, which may be required before treatment begins.
\nDon\u2019t overlook other key benefits and premiums, and make sure the plan also works for your broader healthcare needs.
\nEnroll in a Flexible Spending Account (FSA) and consider making the maximum deposit of $3,400 next year. You\u2019ll save roughly 30% on healthcare expenses paid through the FSA.<\/p>\n
Plans offering IVF benefits for the first time in 2026<\/p>\n
California: Anthem Blue Cross of CaliforniaHealthnet of California: Basic, Standard, and HighKaiser Northern California: Standard, High, and Prosper Kaiser Southern California: Standard, High, and ProsperKaiser Fresno California: Standard, High, and Prosper\u00a0<\/p>\n
Utah: Altius: HDHP, High, and Standard\u00a0<\/p>\n
Various locations: Aetna: Basic, Direct CDHP, Healthfund CDHP, Healthfund HDHP, Saver, and ValueUnitedHealthcare: Choice Open Access, Choice Plus Primary, Choice Primary, Choice Plus Advanced, and HDHP<\/p>\n
Plans that will continue offering IVF benefits in 2026:\u00a0<\/p>\n
PPOs: BCBS StandardGEHA HighForeign Service Benefit Plan (restricted enrollment)<\/p>\n
DC area HMOs: Aetna Open Access High Carefirst: Standard, Blue Value PlusBlueChoice Advantage HDHPKaiser: Standard, High, and Prosper<\/p>\n
MDIPA<\/p>\n
California: Sharp Health PlanWestern Health Advantage<\/p>\n
Colorado: Kaiser: Standard, High, and Prosper<\/p>\n
Hawaii: HMSA: Standard and HighKaiser: Standard and High<\/p>\n
New Mexico: Presbyterian Health Plan: Standard, High, and Wellness<\/p>\n
New York: Independent Health: Standard and HDHP<\/p>\n
Pennsylvania: Geisinger: Basic and StandardUPMC: Standard and HDHP<\/p>\n
Utah: SelectHealth: Standard and HDHP<\/p>\n
Texas: Baylor Scott & White Health Plan: Standard, Basic, and Value<\/p>\n
Guam\/Northern Mariana Islands: Calvos Selectcare: Standard and High<\/p>\n
Puerto Rico\/US Virgin Islands: Triple S Salud<\/p>\n
Where to Find Out How Your FEHB Plan is Changing<\/p>\n
The most reliable source for understanding how your FEHB plan is changing in 2026 is the official plan brochure. Section 2 titled \u201cChanges for 2026\u201d outlines all updates to plan benefits. You can find the plan brochure on:<\/p>\n
However, some changes, like provider networks and prescription drug coverage, won\u2019t be listed in the brochure. These can change from year to year, so it\u2019s important to:<\/p>\n
Use the carrier\u2019s provider search tool to confirm your doctors and facilities are still in-network.
\nUse the prescription drug lookup tool to check whether your medications are still covered and what they\u2019ll cost.<\/p>\n
The Final Word<\/p>\n
Even if you\u2019re planning to stick with your current FEHB plan, do your homework to make sure it\u2019s still the right fit for 2026. Most premiums are increasing, and many plans are also raising out-of-pocket costs, changes that could significantly impact your budget.<\/p>\n
Start by reviewing your plan\u2019s official brochure, especially Section 2, to understand how benefits are shifting. Then visit your carrier\u2019s website to confirm your providers are still in-network and prescription drugs remain covered.<\/p>\n
If your family is seeking IVF coverage, you\u2019ll find more options than ever before. Be sure to review Section 5(a) of the plan brochure for details on coverage limits, out-of-pocket costs, and prior-approval requirements.<\/p>\n
Taking these steps now can help you avoid surprises and ensure you\u2019re getting the best value from your FEHB coverage next year.<\/p>\n
Kevin Moss is a senior editor with Consumers\u2019 Checkbook. Checkbook\u2019s 2026 Guide to Health Plans for Federal Employees will be available on the first day of Open Season, Nov.\u00a010. Check here<\/a> to see if your agency provides free access. The Guide is also available for purchase<\/a> and Government Executive readers can save 20% by entering promo code GOVEXEC at checkout.<\/p>\n","protected":false},"excerpt":{"rendered":"Unfortunately, the 12.3% average enrollee increase in FEHB premiums isn\u2019t the only health insurance cost rising next year.…\n","protected":false},"author":2,"featured_media":275001,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[121067,146531,97,5269,252,9149,143030,253,28535,146063],"class_list":["post-275000","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-federal-employees-health-benefits-program","tag-fehbp","tag-health","tag-health-benefits","tag-health-care","tag-health-care-costs","tag-health-care-enrollment","tag-healthcare","tag-ivf","tag-open-season-2026"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/275000","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=275000"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/275000\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/275001"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=275000"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=275000"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=275000"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}