2025 FEHB Open Season Checklist
FEHB Open Season has arrived, offering federal employees an opportunity to review and adjust their plan for next year. With premiums increasing in most plans and potential changes to benefits, it’s important to evaluate whether your current plan still fits your needs. To help you navigate the process, I’ve prepared a checklist to guide your decision making and will share tips to help you save on healthcare costs.
Confirm Available Plans
Each year plans in the FEHB program change, and 2025 is no exception. It’s important to review newly available plans and keep an eye on those being discontinued to ensure you can choose a new plan if your current plan is no longer offered.
There are two new FEHB plans, both in California, Sharp Health Plan in the San Diego area and Western Health Advantage in areas around San Francisco. Additionally, Compass Rose has two plans that are available to all FEHB enrollees for the first time. Previously, Compass Rose had enrollment restrictions where you had to work for specific agencies to enroll in the plan. Those restrictions are dropped in 2025.
Check Your Plan Premium
The average enrollee share of premium is increasing 13.5%, one of the largest increases in recent memory. However, this increase isn’t consistent across all plans. Of the 144 FEHB plans that were available this year and next, 28 will see premium decreases, 5 will remain unchanged, and 111 will have a premium increase. To avoid any unwelcome surprises in January, review your premium during Open Season and compare how your current plan stacks up against others. You can find premiums on the carrier website and marketing materials, the OPM plan comparison tool, and on the last page of any FEHB plan brochure.
Check Section 2 of the Official Plan Brochure
The official plan brochure is an invaluable source of information on how your FEHB plan works. The one thing that you should check every Open Season is section 2 “Changes for 2025”. In this section the plan will alert you to important benefit changes which might be a cost share increase for a service, new preauthorization requirements, or new benefits for the upcoming year.
Here are a few examples of 2025 changes:
- All GEHA plans have added doula coverage
- BCBS Basic is increasing the member cost share for several benefits including: emergency care, urgent care, specialist visits, inpatient and outpatient hospital, brand name prescription drugs, and more.
Check Providers and Prescription Drugs
If you have existing providers, you’ll want to check to see how they’ll be covered by your plan. You always pay less in a plan by staying in-network and you can’t assume that the providers will remain unchanged from one year to the next. You can find a provider directory on the plan website where you’ll be able to search for your providers.
Similarly, for any current medications you take, you’ll want to check to see if those medications will be covered by the plan. Many FEHB plan websites will have prescription drug cost tools where you’ll be able to select your drug, dosage, and preferred pharmacy, and the cost of the drug will be shown. Again, you can’t assume that there won’t be any prescription drug changes in your current plan from one plan year to the next.
For example, I’ve heard from some federal employees that have received a notice about a formulary change in the BCBS Basic plan that will significantly increase their out-of-pocket prescription drug costs for Wegovy, a GLP-1 weight loss medication. Due to a tier change, the cost of a 28-day supply at a CVS in the Washington D.C. area will rise from $60 this year to $767.38 next year.
Use Yearly Cost Estimates To Narrow Down Plans
What you’ll pay next year for healthcare costs is more than just the plan premium. While important, and a for-sure expense, selecting an FEHB plan on premium alone ignores what you’ll pay when using a healthcare service. In the most recent Federal Benefits Survey administered by OPM, 81% of federal employees indicated total out-of-pocket costs as the most important factor when selecting a health plan.
Checkbook’s Guide to Health Plans for 46 years has ranked plans on estimated total yearly cost based on user information —age, family size, and expected healthcare usage, to help federal employees and annuitants see which plans offer the best value. The benchmark ranking shows big cost differences among plans.
Take Advantage of Flexible Spending Accounts
With a 13.5% increase in the average enrollee share of FEHB premiums for 2025, federal employees should be looking for ways to save money on healthcare expenses. Only about 20% of federal employees use a flexible spending account. That number should be 100% as all federal employees will have some predictable health care expenses—dental care, vision care, planned medical visits, prescription drug refills, or approved over-the-counter pharmacy items. With funding from payroll contributions before taxes are applied, paying for approved health care expenses with the FSA will save you about 30%. Contribution and rollover limits are rising in 2025. Employees can contribute up to $3,300 but must be somewhat careful in budgeting as only $660 of unused funds can be rolled over into a new plan year. Employees with an HSA aren’t allowed to have a health care FSA but can still set-up a limited expense FSA for dental and vision expenses, which is a good idea to help keep HSA funds invested.
You must renew your enrollment every Open Season to keep your FSA. You can enroll and learn more at FSAFEDS. FSA and FEHB Open Season ends on 12/9.