Federal Employees and retirees who have health coverage through the Federal Employees Health Benefits (FEHB) or Postal Service Health Benefits (PSHB) program will see some changes in 2027. The Office of Personnel Management’s recently released Call Letter gives a clear picture of where things are headed.
The Call Letter, issued March 31, 2026, sets the policy priorities that insurance carriers must follow when submitting their benefit and rate proposals by May 31. Negotiations are expected to wrap up by mid-August, ahead of Open Season. Here’s what matters most for federal employees and retirees.
A Shift Toward Prevention and “Well Care”
OPM is moving the FEHB program toward a broader concept of whole-person health it’s calling “well care.” It’s an emphasis on preventing costly conditions before they develop rather than simply treating symptoms. Carriers will be expected to offer more lifestyle medicine options, behavioral interventions, and patient-centered care. Personal choice is a recurring theme, including a new direction on vaccines: carriers are being steered away from provider incentives tied to pediatric and prenatal vaccination rates, with OPM emphasizing informed consent and personal medical judgment.
GLP-1 Coverage Continues With Strings Attached
Coverage of GLP-1 medications like Ozempic and Wegovy will continue, but OPM is tightening the rules around access. Members will be required to participate in structured behavioral therapy programs, including nutritional counseling and intensive lifestyle intervention, both before starting anti-obesity medications and while taking them. Importantly, AI-only or app-based programs will not satisfy this requirement; human coaching must be part of the equation.
Gender Dysphoria Coverage Reduced
Starting in plan year 2027, carriers must eliminate any exceptions process that previously allowed members mid-treatment for surgical or hormonal gender dysphoria therapies to continue that coverage. Mental health counseling for gender dysphoria must still be covered and provided by a licensed mental health professional.
Premiums: OPM Is Pushing Carriers to Hold the Line
OPM is directing carriers to exhaust every cost-containment option before passing increases on to enrollees. This includes greater use of biosimilar drugs, tighter pharmacy benefit manager contracts, and site-of-care optimization — steering members toward lower-cost settings like urgent care and outpatient facilities when appropriate. The TrumpRx initiative, which makes select drugs available at prices tied to international benchmarks, is also being promoted as a cost-saving tool members should be aware of.
What This Means for You
FEHB open season is months away, but these changes signal that 2027 plan options could look meaningfully different from what federal employees and retirees have today. Reviewing your current coverage before open season is a smart way to make sure your health benefits still align with your needs and that you’re not paying for coverage that no longer fits.
