Premium increases and coverage changes loom for FEHB and PSHB enrollees, even for those who are currently satisfied with their plans. Experts urge reviewing options during the benefits open season to understand upcoming premium and coverage-term changes.
The 2026 average enrollee premium for FEHB plans is rising 12.3 percent compared with 2025. This continues a trend of higher increases: 13.5 percent last year, then 8.7 percent, and 7.7 percent in the years before. PSHB plans show an 11.3 percent average rise for 2026 over this year—the first year of the program.
There is variation among plans. Some plans have flat or even decreasing premiums.
Enrollees with only one eligible family member in addition to themselves should note that in several national and some regional FEHB and PSHB plans, self-plus-one premiums can be higher than family coverage. This is largely due to a concentration of retiree couples in self-plus-one, which drives higher anticipated claims. A family enrollment can cover two people.
For 2026, OPM required carriers to:
end coverage for medical or surgical gender-transition procedures for all ages;
cover FDA-approved HIV PrEP drugs and related monitoring with no cost sharing;
broaden networks and permit out-of-network care when wait times are excessive.
Carriers were also required to continue offering at no cost at least one opioid rescue agent, with expanded education on safe use; and to cover FDA-approved medications for obesity care, including at least one GLP-1 option and two oral options, plus behavioral and nutritional programs.
Beyond these program-wide mandates, carriers frequently adjust coverage and out-of-pocket costs in plan brochures.
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