What to know when your child ages out of federal health coverage

I received a question this week about what happens when a child “ages out” of a Federal Employees Health Benefits (FEHB) or Postal Service Health Benefits (PSHB) plan at age 26.

Children can remain on a parent’s Self and Family or Self Plus One enrollment until they turn 26, regardless of college attendance. Foster children living in a regular parent-child relationship and children with a preexisting mental or physical disability that prevents self-support are also eligible.

According to the Office of Personnel Management (OPM), it is the enrollee’s responsibility to notify their agency or retirement system when a family member is no longer eligible. Plans may send a “Happy Birthday” letter notifying the child of 31 days of free coverage after losing family-member eligibility.

During this 31-day period, the child may convert to a guaranteed-issue policy. Carriers must either offer a conversion policy or assist enrollment in a guaranteed-issue plan on or off the HealthCare Marketplace. Key points about conversion:

• The effective date is retroactive to the end of the 31-day extension.

• Coverage purchased outside the FEHB plan may start later than 31 days after termination.

• If the 31-day period is insufficient, carriers may extend coverage up to 60 days.

• Conversion contracts often provide fewer benefits at higher cost.

• The government does not contribute to conversion premiums.

Temporary Continuation of Coverage (TCC)

To enroll in TCC, contact your human resources office and notify them your child is turning 26. You have 60 days from the 26th birthday to apply. Your child has 60 days from the later of the birthday or TCC notice to request enrollment.

Eligibility requires that the child:

• Was covered as a child under Self Plus One or Self and Family enrollment;

• No longer meets the definition of an eligible child; and

• Would not otherwise be eligible for FEHB coverage beyond the 31-day extension.

TCC requires payment of the full premium plus a 2% administrative charge. Coverage begins the day after the 31-day extension ends and may continue for up to 36 months from the qualifying event. Premiums are prorated if enrollment does not align with pay periods.

Q&A: Federal retiree questions

Q: Our son turned 26. We are considering Temporary Continuation of Coverage options, including Blue Cross/Blue Shield, plan code 131, with a 2025 TCC premium of $523.11. Does this seem reasonable?

A: Yes. BC/BS Focus, plan code 131, is a strong choice. The 2026 TCC premium increases to $590.64. For PSHB, the plan code is 35A with a monthly premium of $664.37. Other comparable plans include:

• Compass Rose, Standard Option, Self Only FEHB plan code 424, $544.89/month (not offered in PSHB)

• MHBP Value Plan, Self Only FEHB plan code 414, $599.33/month (PSHB plan code 73A, $555.71)

• NALC Consumer Driven Health Plan, PSHB plan code 77D, $522.69/month (FEHB no longer offers)

Q: Do we have to stay with Blue Cross while our son is on TCC?

A: No. You may select any FEHB plan in which you are eligible. Your child must pay the full premium plus 2% administrative charge. Coverage begins the day after the 31-day free extension. If coverage continues to the end of the 36-month TCC period, your child will have another 31-day extension to convert to a non-group contract.

Q: Can TCC coverage continue for 36 months?

A: Yes. Children can continue TCC for up to 36 months after:

• The qualifying event (age 26) if covered under a regular FEHB or PSHB enrollment, or

• The employee’s separation if the event occurs while the child is covered under TCC.

If a qualifying event occurs while you are enrolled for family coverage under TCC, the child may elect TCC independently, but coverage cannot extend beyond 36 months after your separation.

For more information, review OPM’s TCC pamphlet or the “Requests to lengthen 31-day extension of coverage” guidance.

Questions for this column can be sent to Tammy@retirefederal.com. General questions are answered in the column; personal or complex questions may receive one-on-one counseling.