Federal employees can keep their health insurance under the FEHB program for up to 365 days while in unpaid status, according to the latest OPM guidance. The government continues paying its share of premiums, but employees must choose how to handle their portion to avoid lapses in coverage or additional out-of-pocket costs.
The Office of Personnel Management confirms that under the Federal Employees Health Benefits program, coverage continues for up to one year when an employee is not receiving pay. This applies to those on extended leave or in a deferred resignation program. However, returning to work for less than four months does not restart the 365-day limit. Only a return lasting four months or longer resets the coverage period.
An OPM spokesperson noted that these rules ensure federal employees can maintain access to their providers and avoid gaps in essential health services. After 365 days, coverage ends at the close of the pay period, although enrollees receive a 31-day grace period with no additional cost.
While employees are not on the payroll, the federal government continues paying its share of FEHB plan premiums. Workers are responsible for their portion, which can be paid in three ways: directly while on leave, through catch-up payments after returning to work, or via prepayment before going on leave. The method chosen affects the amount of out-of-pocket costs employees will incur later.
During events like a government shutdown, employees are unable to make direct payments. Instead, unpaid premiums automatically accumulate and are deducted from future paychecks. OPM guidance explains that this structure prevents lapses in coverage and helps ensure medical and prescription drug coverage continues without interruption.
Employees are encouraged to verify their agency’s procedures and confirm how their payments will be processed. Each agency’s human resources department must send written notification explaining payment responsibilities, available options, and deadlines.
The FEHB program provides flexibility for employees in specific situations. Military personnel may continue their health benefits for up to 24 months, though after the first year, they must pay both their share and the government’s portion, plus a 2 percent administrative fee. Coverage for workers on state or international assignments may extend beyond the standard 365 days if both parties continue contributing to premiums.
Separate programs, such as the Federal Employees Dental and Vision Insurance Program (FEDVIP), require direct payment to carriers to maintain dental or vision plans. Enrollees who fail to pay risk termination of coverage, which can only be reinstated during the next open season or after a qualifying life event.
The OPM also reminds employees that coverage under the FEHB plan continues to count toward eligibility for retirement benefits; however, any unpaid time does not contribute to the required five years of continuous enrollment.
The vision insurance program and FEDVIP plan operate separately from standard FEHB health plans. Federal employees and retirees can maintain vision and dental benefits as long as payments remain current. Carriers provide information about provider networks, covered services, and costs, and employees should contact them directly for billing arrangements.
OPM’s online resources include details on how to manage FEHB, FEDVIP, and vision plans during unpaid status or other periods that affect enrollment. Employees can review current rates, available plans, and qualifying life events on the Office of Personnel Management’s website.
Once coverage ends, employees have 60 days to re-enroll in FEHB upon returning to pay status. If they miss that window, they must wait until the next open season to join a plan again. OPM emphasizes that agency HR offices must notify employees in writing of these deadlines.
Those nearing retirement or eligible for Medicare should review how FEHB coverage interacts with federal and state healthcare programs. Coordination between FEHB and Medicare can help reduce medical and prescription drug costs, particularly for retirees managing multiple health plans.
An OPM official added, “We want to make sure federal employees are aware of their rights and options before going into unpaid status. Contact your HR office early, review your plan’s carrier information, and verify payment details to ensure uninterrupted health benefits.”
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