How much do retired Congress members pay out-of-pocket for FEHB coverage?

1. How FEHB payment splits work — the headline rule

The Federal Employees Health Benefits (FEHB) program funds premiums through a government contribution and an enrollee contribution; recent summaries state the federal government pays about three‑quarters of a participant’s premium (roughly 72–75%), leaving retirees responsible for the remainder as the “enrollee share” ^{[1] [2]}. That percentage is a program‑level description — not a flat dollar amount — so retirees’ actual monthly checks depend on which FEHB plan and option they pick ^[2].

2. Why there’s no single “retired Member of Congress” price tag

Members of Congress who satisfy FEHB retirement eligibility can enroll in FEHB in retirement, but plan selection matters: FEHB offers many plans and enrollment types (Self Only, Self Plus One, Self & Family) and premium splits differ by plan and year, so two retirees in the same program can pay very different sums ^{[4] [2]}. OPM and plan brochures publish biweekly and monthly premiums and the government’s contribution for each plan so retirees can calculate their out‑of‑pocket cost ^{[2] [3]}.

3. Recent premium trends that affect retirees’ bills

Coverage of 2024–2026 rate cycles shows sizeable enrollee increases: the enrollee share rose on average 13.5% for 2025 and reporting suggests an average 12.3% increase in 2026, so retirees should expect premium dollars owed to change materially year to year ^{[5] [1]}. Government Executive reporting highlights that many plans raised deductibles, catastrophic limits and other cost‑sharing elements for 2026, factors that can increase retirees’ total out‑of‑pocket spending beyond premiums ^[6].

4. Where to find the exact dollar amount for a given retiree

OPM’s premium pages list annual and biweekly/monthly premiums and the government share for every FEHB option; plan brochures (for example Blue Cross/Blue Shield or GEHA) give the plan‑specific premium tables and benefit design to calculate enrollee cost ^{[2] [3] [7]}. Consumer guides and independent sites that aggregate FEHB data (Checkbook, Federal Retirement, FedSmith) summarize choices and can help estimate typical yearly costs, but they rely on OPM and carrier rate sheets for exact figures ^{[8] [9] [10]}.

5. Special rules affecting Members of Congress and designated staff

Congressional Members and designated staff have particular enrollment mechanics (DC SHOP while serving, ability to purchase FEHB at retirement if they meet the five‑year continuous enrollment rule), but once retired and enrolled they face the same enrollee share structure as other federal retirees; CRS and Congress.gov material explain the five‑year rule and DC SHOP transition but do not list a distinct retiree premium subsidy unique to Members ^[4]. Available sources do not provide a unique dollar amount that “retired Congress members” pay differently from other federal retirees ^[4].

6. How to get a concrete dollar estimate today

To compute an individual retired person’s out‑of‑pocket premium: ^[11] pick a specific FEHB plan and enrollment type; ^[12] consult OPM’s premium table for that plan and year to see the total premium and the government contribution; ^[13] subtract to arrive at the enrollee share. OPM’s premium pages and plan brochures are the authoritative, plan‑level sources cited in current reporting ^{[2] [3]}.

Limitations and differences in reporting: sources summarize average government/ enrollee splits and trends but do not provide a single universal dollar figure for all retirees — premiums vary substantially across plans and years — and several news summaries emphasize rising costs which will change concrete out‑of‑pocket amounts for 2025–2026 ^{[1] [6] [5]}. If you give me a specific plan and enrollment type (for example, Blue Cross Standard, Self & Family, 2026), I will pull the cited OPM/plan‑brochure line items and compute the retiree share using the provided sources ^{[2] [3]}.