What OPM says about Part B
FEHB continues with or without Medicare, and OPM says your FEHB premium doesn't go down if you enroll. What changes when you retire 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 |
|---|---|
| Retired, in a fee-for-service FEHB plan | Part B and the plan "may combine to provide almost complete coverage." Some plans waive deductibles, copays and coinsurance for Part B services, and some reimburse Part B premiums. |
| Retired, in an FEHB HMO | You may not need Part B, but it pays for care outside the HMO's network and non-emergency care while traveling in the U.S. |
| Want Medicare Advantage or TRICARE | Part B is required. |
| Still working with FEHB | You don't have to enroll in Part B at 65; you'll have a Special Enrollment Period when you retire. |
OPM also says that if you can get Part A without paying a premium, you should take it, even while working.
The cost of saying no
Part B costs $202.90 a month for most people in 2026 (more with IRMAA), on top of your FEHB premium, which is why some annuitants decline it. If you don't enroll when first eligible and later want Part B, you generally wait for the General Enrollment Period (January 1 to March 31) and pay 10% more for each full 12 months you could have had it, for as long as you have Part B. Retiring from federal service? Have your retirement system complete form CMS-L564 so you can use the Special Enrollment Period. Estimate a penalty with the penalty calculator.
What's different in North Carolina
- Medicare Advantage is sold by county. For 2027, CMS data show 106 plans open to everyone statewide, from 11 in Carteret County to 57 in Guilford County.
- No Medigap birthday rule. North Carolina doesn't give a yearly right to switch Medigap policies, so outside your 6-month Medigap open enrollment, companies can ask health questions. If you might ever want Medigap alongside or instead of FEHB, that window is the time to buy.
- FEHB is not the State Health Plan. Federal retirees follow OPM's rules; North Carolina's State Health Plan rules for state retirees don't apply. See State Health Plan retirees and Medicare if a spouse is a state retiree.
To compare Medicare plans from the companies they work with, you can request a call from a licensed insurance agent.
Related questions
Do NC state retirees need Part B?
The State Health Plan's rule.
Do LGERS retirees get State Health Plan coverage?
Local government retirees.
Can my spouse stay on the State Health Plan?
Couples with state coverage.
Sources
- OPM — FastFacts: The FEHB Program and Medicare
- OPM — Medicare for federal annuitants
- OPM — Postal Service Health Benefits Program
- Medicare.gov — Avoid late enrollment penalties
- N.C. General Statutes Chapter 58, Article 54 (Medicare supplement insurance)
More questions in this guide
- Are NC state employees hired after 2021 eligible for retiree health coverage?
- Can I drop the State Health Plan and buy my own Medicare plan in NC?
- Can my spouse stay on the State Health Plan when I go on Medicare?
- Do LGERS retirees get State Health Plan coverage with Medicare?
- Do North Carolina state retirees need Medicare Part B?
- Does the NC State Health Plan pay for Medicare Part B?
- What happens to my State Health Plan coverage when I turn 65?
- What Medicare plans does the NC State Health Plan offer retirees?
Part of the guide: State Health Plan retirees and Medicare in North Carolina · All questions
Frequently asked questions
Is FEHB drug coverage creditable for Medicare Part D?
Yes. OPM says FEHB provides creditable drug coverage, so as long as you keep FEHB you won't owe a Part D late enrollment penalty for delaying Part D.
Do postal retirees in North Carolina need Part B?
Many do. Under the Postal Service Reform Act of 2022, certain Medicare-eligible Postal Service annuitants and their Medicare-eligible family members must enroll in Part B to stay in a Postal Service Health Benefits (PSHB) plan, with some exceptions.
Can I suspend FEHB to join a Medicare Advantage plan?
OPM says to contact your retirement office about suspending FEHB if you want to join a Medicare Advantage plan. You must have Part A and Part B to join one.
Medicare in your North Carolina county
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