Medicare & FEHB Coverage Comparison Tool
2026 figures — Medicare.gov CMS-11579 & OPM guidance. For federal employees and annuitants approaching Medicare eligibility.
Includes annual premium cost analysis, OOP exposure scenarios, and 20-year cumulative projection.
OPM guidance: Your FEHB coverage continues whether or not you enroll in Medicare. If enrolled, Medicare pays first and FEHB pays as secondary. FEHB premiums do not decrease when you add Medicare. OPM advises enrolling in premium-free Part A at 65 — it reduces out-of-pocket costs for both you and FEHB. opm.gov/medicare →
Your information
FEHB plan
Time horizon
Annual cost comparison — premiums + out-of-pocket exposure
Medicare A&B + FEHB: premiums only — no additional OOP assumed (Medicare primary + FEHB secondary eliminates nearly all cost-sharing). All other plans show realistic OOP scenarios. Healthy = routine care. Moderate = specialist visits, one procedure. Major illness = near OOP max.
20-year cumulative cost projection
Cumulative premiums grow at your selected inflation rate. Toggle to worst-case to add annual OOP max on top of premiums every year for plans that carry OOP exposure.
Sources & assumptions
- Part B 2026: $202.90/mo standard. Deductible $283/yr. Part A deductible $1,736/benefit period. Source: CMS Product No. 11579, December 2025.
- 2026 IRMAA (Part B): Tier 1 $284.10 / Tier 2 $405.80 / Tier 3 $527.50 / Tier 4 $649.20 / Tier 5 $689.90/mo total. Based on 2024 MAGI.
- Part D 2026: $32/mo assumed. National base premium $38.99/mo. IRMAA adds $14.50–$91.00/mo by income tier.
- Medigap Plan G: ~$175/mo estimated. Actual varies by age, state, and tobacco use. OOP max = $283/yr (Part B deductible only) regardless of utilization.
- Medicare A&B + FEHB: Premiums only assumed — with Medicare as primary and FEHB as secondary, cost-sharing exposure is treated as negligible for comparison purposes.
- FEHB premiums shown: Approximate 2025 self-only biweekly × 26 ÷ 12. Verify at opm.gov.
- OPM: Canceling FEHB as an annuitant is generally irreversible. SEP available at retirement for penalty-free Part B enrollment.
- This tool is for educational and illustrative purposes only. Consult a benefits counselor, your agency HR office, or Social Security for personalized guidance.