How to compare two FEHB plans in 20 minutes
Four numbers decide it: your premium share, the deductible, the catastrophic limit, and what your own care costs under each plan. Everything else in a 90-page brochure is detail you can skip.
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Before the clock starts
Narrow the field to two plans, or three at most. Comparing twelve is why people give up and keep whatever they had. Pick the plan you are in now, plus one or two that are cheaper or that colleagues rate, then work only on those.
Shortlist on premium firstUp to three plans, your share and the government's, side by side.Have last year's medical spending to hand: what you actually paid, not what you think you paid. Explanation-of-benefits statements or the carrier's year-end summary will do.
1. Read what changed (3 min)
Every plan brochure opens with a section listing that year's changes: new deductibles, changed copays, dropped drugs, new prior-approval rules. It is two or three pages, and it is the highest-value reading in the whole document.
This is where a plan that was right for you last year quietly stops being right. Premium held flat, but the specialist copay doubled and your drug moved a tier.
2. Pull the four numbers (5 min)
For each plan, write down four figures and nothing else.
| Number | Where it lives |
|---|---|
| Your premium share | Last page of the brochure, or OPM's rate tables |
| Deductible | Section 4, by enrollment type |
| Catastrophic limit | Section 4, the worst case for the year |
| Your usual care | Section 5: primary visits, specialists, urgent care |
Use the in-network column. Out-of-network figures are a different plan for practical purposes.
3. Check your people (5 min)
- Search each doctor on the carrier's own provider tool, not a third-party directory, and make sure you are searching the network that matches the plan option you are considering.
- Check the hospital you would actually use, not just the one nearest your house.
- If a relationship matters, phone the practice and ask which FEHB plans they are taking next year. Directories go stale; front desks know.
- For regional HMOs, confirm the service area covers where you live or work. Eligibility depends on it.
4. Check your prescriptions (4 min)
Open each plan's formulary and find every drug you take regularly. Note its tier and whether it needs prior approval or a specialty pharmacy.
This is the single largest source of surprise cost in FEHB. Two plans with nearly identical premiums can differ by hundreds of dollars a month on one prescription, and formularies change every year even when the premium does not.
5. Run two totals (3 min)
For each plan, add it up twice.
The two numbers that matter
- A normal year
- premium × 26, plus what you spent last year under this plan's rules
- A bad year
- premium × 26, plus the catastrophic limit
A plan that wins the normal year and survives the bad one is your plan. If one wins each, ask how much risk you can absorb, and remember the low-premium plan usually loses the bad year by more than it won the normal one.
What people get wrong
- Comparing premiums only. It is the one number both plans advertise, and the least predictive of what a year costs.
- Assuming last year's plan is unchanged. Benefits move every year. Read the changes section.
- Checking the doctor but not the drugs. The formulary usually costs more than the network does.
- Doing nothing. Enrollment rolls over automatically at the new premium, whatever happened to the benefits.
Open season for the 2027 plan year runs November 9 to December 14, 2026. Twenty minutes in that window is worth more than any other twenty minutes you will spend on benefits this year.
Common questions
Where do I find an FEHB plan's premium?
On the last page of the official plan brochure, which lists the enrollee share for all three enrollment types, and in OPM's premium tables. Use the row that matches you: non-postal or postal, employee or annuitant.
What is the catastrophic limit?
The most you can pay out of pocket in a year for covered in-network care, not counting premiums. It is the number that decides what a bad year costs you, and it is in Section 4 of every brochure.
Do I have to re-enroll in FEHB each year?
No. Your enrollment carries into the next year automatically at the new premium. FSAFEDS is the exception and must be re-elected every open season.
How do I check whether my doctor is in network?
Check on the carrier's own provider search, not a third-party directory, and confirm the network name that matches your plan option. If the relationship matters, phone the practice and ask which FEHB plans they are taking next year.
Where do I find my prescriptions?
In the plan's formulary, which lists each drug and its tier. Two plans with nearly identical premiums can differ by hundreds of dollars a month on the same prescription.
Is a cheaper premium usually the cheaper plan?
Not reliably. Add the yearly premium to what you actually expect to spend, then check the catastrophic limit for a bad year. The cheapest premium and the cheapest year are often two different plans.
Sources
Open season dates follow the rule in OPM's regulations: the Monday of the second full work week in November to the Monday of the second full work week in December. Checked on September 24, 2026.