The open-season period remains critical even for enrollees who are satisfied with FEHB and PSHB coverage. Experts urge reviewing options to understand upcoming changes in premiums and coverage terms.
Key numbers for 2026
FEHB enrollees face an average premium increase of about 12.3 percent compared with 2025, following year-over-year rises of 13.5 percent, 8.7 percent, and 7.7 percent in the previous three years.
PSHB plans show an average premium rise of 11.3 percent over 2025, marking the first year of the program’s existence.
There is variation across plans. Some plans are flat or have only modest increases.
Self-plus-one premiums can be higher than family coverage on several national and regional FEHB and PSHB plans. This disparity is often tied to retiree-couple enrollment patterns and higher anticipated claim costs for self-plus-one coverage. A family enrollment can cover two people, potentially offering a more economical option.
2026 program-wide requirements from OPM
End coverage for gender transition procedures at all ages for medical or surgical modification of sex traits.
Cover FDA-approved HIV PrEP drugs and related monitoring with no cost sharing.
Expand networks and permit out-of-network care when wait times are excessive.
Continue to provide at least one opioid rescue agent at no cost, with expanded education on safe use.
Include FDA-approved obesity treatments, featuring at least one GLP-1 and two oral options, plus accompanying behavioral and nutritional programs.
Beyond these mandates, carriers frequently adjust other coverage details and out-of-pocket costs. Plan brochures will outline these specifics.
For readers exploring options, consider:
Comparing premiums across FEHB and PSHB plans for 2026.
Checking whether your household’s enrollment type (self, self-plus-one, or family) remains the most cost-effective.
Reviewing any changes to covered services, including new preventive benefits and medications.
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