Federal Employee Health Benefits FEHB Cost Calculator

What This Calculator Does and Why It Matters

The Federal Employee Health Benefits program offers federal employees and retirees one of the largest selections of health insurance plans in the country. Choosing the right plan means understanding exactly what you will pay — not just the premium on paper, but your actual share after the government contribution, spread across your pay schedule.

This free FEHB cost calculator helps you estimate your annual premium share, per-paycheck deduction, and total estimated out-of-pocket costs including deductibles and copays. It is quick, free, and requires no registration. If you are also comparing retirement income options, the FEHB cost calculator works well alongside the FERS disability retirement calculator for complete federal benefits planning.

How to Use This Calculator

Step-by-Step Instructions

1. Enter the Total Annual Premium — find this on the OPM plan brochure or FEHB plan comparison tool for your chosen plan and enrollment type.
2. Enter the Government Contribution Percentage — the default is 72%, which is a common benchmark, but check your specific plan since it can be up to 75%.
3. Select your Enrollment Type — Self Only, Self Plus One, or Self and Family.
4. Select your Pay Period frequency — most federal employees are paid biweekly (26 pay periods).
5. Optionally enter your estimated annual deductible and copay/coinsurance amounts for a total out-of-pocket estimate.
6. Click Calculate to see your premium share, per-paycheck cost, and total estimated annual cost.
7. Click Reset to start over with a different plan comparison.

The Formula Explained

The FEHB cost-sharing formula is set by the Office of Personnel Management (OPM), which establishes how much the government contributes toward each plan’s premium each year.

Breaking Down the Formula

The government contributes the lesser of: 72% of the weighted average premium of all FEHB plans, or 75% of the specific plan’s premium. For simplicity, many employees use 72% as a working estimate since most plan costs land near the weighted average.

Employee Annual Premium Share = Total Annual Premium × (1 − Government Contribution %)

Per-Paycheck Cost = Employee Annual Premium Share ÷ Number of Pay Periods

Total Estimated Annual Cost = Employee Premium Share + Estimated Deductible + Estimated Copays

Example Calculation with Real Numbers

Suppose your chosen plan has a total annual premium of $8,400 for Self and Family. The government contributes 72%. Your share = $8,400 × 0.28 = $2,352 per year. Divided across 26 biweekly pay periods, that is $90.46 per paycheck. Add a $350 deductible and $600 in estimated copays, and your total estimated annual FEHB cost is $3,302.

When Would You Use This

This calculator is most useful during the FEHB Open Season, which runs each fall. That is the annual window when federal employees can switch plans, change enrollment types, or adjust coverage. Running these numbers across two or three plan options helps you pick the lowest true cost — not just the lowest-looking premium.

Real Life Use Cases

Federal employees use this tool when comparing a high-premium low-deductible plan against a lower-premium high-deductible plan. Retirees use it to compare pre-65 FEHB coverage against what they will need once Medicare kicks in. New hires use it during their 60-day initial enrollment window to get oriented before making their first plan selection.

Specific Example Scenario

A federal employee is deciding between two FEHB plans. Plan A has an annual premium of $7,200, a $200 deductible, and estimated $400 in copays. Plan B has an annual premium of $5,600 but a $1,500 deductible and estimated $900 in copays. Using this calculator, Plan A total out-of-pocket = $2,616 and Plan B total = $2,268 — making Plan B cheaper despite the higher deductible. For related federal benefits math, see the FERS survivor benefit election calculator.

Tips for Getting Accurate Results

Get the Total Premium from the OPM Plan Comparison Tool

Do not guess the premium. Use the official OPM FEHB Plan Comparison tool at opm.gov to find the exact total annual premium for your plan type and enrollment category. The numbers vary significantly between Self Only, Self Plus One, and Self and Family tiers.

Factor In the Maximum Out-of-Pocket Limit

All FEHB plans have a maximum out-of-pocket (MOOP) limit. If you expect high medical usage, compare plans by their MOOP rather than just the deductible. Once you hit the MOOP, the plan pays 100% for the rest of the year — this can make a high-premium plan more cost-effective in a heavy-use year.

Compare at Least Three Plans Side by Side

Run this calculator for your top three plan candidates before Open Season closes. Many employees default to the same plan year after year without checking if a better-value option is now available. FEHB plans change their premiums and cost-sharing structures every year. You can also pair your FEHB planning with the HSA vs PPO health plan comparison calculator if one of your options includes an HSA-eligible high-deductible plan.

Frequently Asked Questions

How much does the government pay toward FEHB premiums?

The government pays the lesser of 72% of the weighted average premium across all FEHB plans, or 75% of the specific plan’s premium. The exact dollar amount varies by plan and enrollment type each year. OPM publishes the official contribution amounts each Open Season.

Can I use this calculator for FEHB retiree coverage?

Yes. Federal retirees who carried FEHB into retirement continue to receive the government contribution and pay the same premium share as active employees. The calculator works the same way — just use your retirement pay schedule for the pay period selection.

What is the difference between Self Only, Self Plus One, and Self and Family?

Self Only covers just the enrollee. Self Plus One covers the enrollee plus one eligible family member. Self and Family covers the enrollee and all eligible family members. Each tier has a different total premium and therefore a different government contribution amount.

Does FEHB cover dental and vision?

Standard FEHB plans generally do not include comprehensive dental or vision coverage. Federal employees can enroll separately in the Federal Employees Dental and Vision Insurance Program (FEDVIP) through OPM, which is a separate premium and enrollment process.

When can I change my FEHB plan?

The main window to change plans is during Open Season, which typically runs from mid-November through mid-December each year. Outside of Open Season, you can only change plans if you experience a Qualifying Life Event such as marriage, divorce, birth, or a change in employment status.

Can FEHB and Medicare work together?

Yes. Many federal retirees coordinate FEHB with Medicare. When Medicare is the primary payer and FEHB is secondary, out-of-pocket costs often drop significantly. Some retirees drop down to a lower-cost FEHB plan once Medicare Part B is in place because the coverage combination is more than sufficient.

Is FEHB available to part-time federal employees?

Yes, but the government contribution is prorated based on the number of hours worked. Part-time employees pay a larger share of the premium than full-time employees. The calculator can still be used — just enter the reduced government contribution percentage that applies to your situation.

How do I find the exact total annual premium for my FEHB plan?

Go to the OPM FEHB Plan Comparison tool at opm.gov and search by plan name, enrollment type, and your location or agency code. The tool displays the total annual premium and the government and employee share for each plan side by side.

Conclusion

The Federal Employee Health Benefits FEHB Cost Calculator takes the guesswork out of Open Season planning. By knowing your exact premium share, per-paycheck cost, and estimated total annual expense, you can make a confident, informed plan selection instead of defaulting to last year’s choice.

Pair it with the TSP early withdrawal tax calculator and the Social Security bridge strategy calculator for a complete picture of your federal retirement finances. Use this free tool every Open Season — it only takes a minute and could save you hundreds of dollars a year.