FSBP vs other FEHB plans for 2027, and the Self Plus One check

If two people are on your Foreign Service Benefit Plan (FSBP) High Option enrollment, check your enrollment code before December 14. For 2027, Self Plus One (code 403) costs $46.70 more per pay period than Self and Family (code 402), which comes to $1,214.20 over 26 pay periods for the same two people and the same benefits. Federal Benefits Open Season runs from Monday, November 9 to Monday, December 14, 2026, and your current code rolls over if you do nothing.

Quick note: this is our personal blog, not the State Department, OPM or AFSPA, and it isn't health, financial or benefits advice. We checked these numbers against OPM's 2027 rate table and the 2027 plan brochures listed at the end, but please verify them independently before you change anything. If you find an error, please email us at myforeignservicepal@gmail.com.

The 2027 FSBP rates

FSBP High Option tier	Code	2026 per pay period	2027 per pay period	Change	2027 for 26 pay periods
Self Only	401	$100.36	$143.75	+43.2%	$3,737.50
Self Plus One	403	$257.96	$429.35	+66.4%	$11,163.10
Self and Family	402	$248.27	$382.65	+54.1%	$9,948.90
Gap between 403 and 402		$9.69	$46.70		$1,214.20

If you pay monthly, for example as a retiree, the 2027 monthly shares are $930.26 for code 403 and $829.07 for code 402, a difference of $101.19 a month.

The gap comes from the government's share. In 2027 the government pays up to $767.53 per pay period toward a Self Plus One enrollment and up to $843.82 toward Self and Family, while FSBP's total premiums for the two tiers are only about $30 apart ($1,196.88 and $1,226.47). The bigger government share for Self and Family leaves you paying less for it.

Can two people enroll in Self and Family?

Yes. OPM's Open Season page says that when Self Plus One costs more than Self and Family, "enrollees who wish to cover one eligible family member are free to elect either the Self and Family or Self Plus One enrollment type." AFSPA's Open Season page says the same for FSBP: two-person families don't have to enroll in Self Plus One.

The brochure's deductibles, coinsurance and benefits are the same for both codes. The choice is yours to make, and OPM, your agency and the plan won't make it for you, so it's worth checking your code even if you've been on Self Plus One for years.

What else changes in the 2027 FSBP brochure

The 2027 brochure lists the premium increase and nine other changes. These are the ones most families will notice.

Benefit	2026	2027
Out-of-pocket maximum, Self Plus One and Self and Family	$8,000 in network and overseas ($10,000 out of network in the U.S.)	$12,000 in network and overseas ($16,000 out of network in the U.S.); Self Only stays $6,000 ($8,000)
Hospital and skilled nursing stays in the U.S.	No copay in network; $200 per admission out of network	$250 per admission in network; $500 out of network. Care outside the 50 states is still paid at 100%
GLP-1 drugs for weight loss	Earlier cost share	50% coinsurance with no deductible at in-network pharmacies and at pharmacies outside the 50 states
Wellness program	Simple Steps to Living Well Together, up to $400	Renamed LiveWell Rewards; adults 18 and older can still earn up to $400 a year toward eligible medical costs
Massage therapy	Up to 50 visits a year	Still up to 50 visits a year, now limited to one covered visit per person per day

The brochure also drops the myStrength and AbleTo online programs and stops offering the Preventive Care Coach overseas. Some things stay the same: the deductible is still $300 per person ($600 for a Self Plus One or Self and Family enrollment) for in-network care and care outside the 50 states. Coinsurance for most care is still 10%, and massage, chiropractic and acupuncture still pay up to $75 a visit with no deductible.

How FSBP works when you're overseas

FSBP was built for people at post, and the brochure spells out what that means. Providers outside the 50 states are paid at the in-network level with the lower deductible, and covered hospital care outside the 50 states is paid at 100%. The plan has direct billing arrangements with providers in a number of countries; elsewhere you usually pay the provider and file a claim, and FSBP translates the claim if you don't. For prescriptions bought at a pharmacy outside the 50 states, you pay 10% with no deductible (50% for GLP-1 weight-loss drugs).

Other plans aren't as far behind as people sometimes assume. The 2027 GEHA and Blue Cross brochures also pay overseas providers at their in-network or preferred level and handle translation and currency conversion. The real differences are the deductible, how drugs are covered, whether a hospital near you bills the plan directly, and how much paperwork you can handle from post.

Lower premiums aren't automatic either. For 2027 Self and Family, Blue Cross Basic ($387.54 per pay period) and MHBP Standard ($400.78) cost a little more than FSBP's $382.65, while GEHA Standard ($231.45) and the GEHA HDHP ($215.63) cost much less. Read the overseas section of any brochure on your shortlist before you switch.

If you're at post, remember that the State Department's medical program can act as a secondary payer for urgent overseas hospital stays, after your insurance pays and except for deductibles and copays (16 FAM 501.2). That rule depends on your plan covering the stay first.

The HDHP option for 2027

If you're thinking about a High Deductible Health Plan (HDHP) with a Health Savings Account (HSA), the main FEHB choice for 2027 is the GEHA HDHP (codes 341, 343 and 342). The MHBP Consumer Option leaves FEHB in 2027, and MHBP is moving its members to MHBP Standard.

GEHA HDHP, 2027	Self Only (341)	Self Plus One (343)	Self and Family (342)
Your premium per pay period	$81.62	$175.47	$215.63
For 26 pay periods	$2,122.12	$4,562.22	$5,606.38
Deposited into your HSA by GEHA	$1,000 ($83.33 a month)	$2,000 ($166.66 a month)	$2,000 ($166.66 a month)
In-network deductible	$1,800	$3,600 for the family	$3,600 for the family
Coinsurance after the deductible	5% for medical care in network and overseas	Same	Same
Prescriptions after the deductible	25% generic and preferred, 40% non-preferred	Same	Same
In-network out-of-pocket maximum	$6,000	$12,000	$12,000

On paper, the GEHA HDHP costs less than FSBP in most years. A family on Self and Family pays $4,342.52 less in premiums for 2027 and gets $2,000 in its HSA, so it starts about $6,300 ahead before anyone sees a doctor. Even in a year when the family hits GEHA's $12,000 maximum, the total stays lower than FSBP's premium plus its $12,000 maximum.

What FSBP buys for the extra premium is easier handling overseas. On the HDHP you pay the full plan allowance for care until the family meets the $3,600 deductible, drugs cost more after the deductible, and you may need to pay foreign providers up front and file a GEHA Overseas Claim Form with itemized bills and proof of payment. GEHA also requires an eligibility or medical necessity review for procedures and hospital admissions outside the U.S.

Two examples for a family on Self and Family in 2027, using plan allowances and leaving out prescriptions:

Year	FSBP Self and Family (402)	GEHA HDHP Self and Family (342)
Light: $1,500 of doctor visits and lab work	$9,948.90 premium + $690 out of pocket = $10,638.90	$5,606.38 premium + $1,500 out of pocket - $2,000 HSA deposit = $5,106.38
Heavy: $8,000 of doctor bills plus a $30,000 hospital stay outside the U.S.	$9,948.90 + $1,340 (the hospital is paid at 100%) = $11,288.90	$5,606.38 + $5,320 - $2,000 = $8,926.38

Foreign providers can bill more than a plan allows, and each plan sets its own allowances, so treat these as rough comparisons. The calculator above runs the same math for your household.

HSA rules to check before you switch

1. The 2027 HSA limit is $4,500 for Self Only and $9,000 for family coverage, plus $1,000 if you're 55 or older (IRS Revenue Procedure 2026-24). GEHA's deposit counts toward that limit, so subtract $1,000 or $2,000 before you set a payroll contribution.
2. You can't contribute to an HSA if you're enrolled in Medicare or covered by TRICARE or another plan that isn't an HDHP. You also can't if you or your spouse have a general-purpose Health Care FSA that can pay your costs. The FSAFEDS Limited Expense Health Care FSA works with an HSA. A general-purpose FSA carryover into 2027 can also block HSA contributions, so ask FSAFEDS how yours will be handled.
3. If you can't have an HSA, GEHA gives you a Health Reimbursement Arrangement credit of the same amount instead. It earns no interest, and you can't take it with you the way you can an HSA.

Employees already pay FEHB premiums with pre-tax pay, so moving to a cheaper plan doesn't create extra tax savings on its own. The tax benefit comes from any extra money you put into the HSA.

How and when to make the change

Open Season for the 2027 plan year runs from November 9 to December 14, 2026. For FEHB, the deadline is 11:59 p.m. on December 14 in the time zone of your agency's enrollment system; Employee Express lists 11:59 p.m. Eastern. FSAFEDS accounts don't roll over, so you have to re-enroll every year at fsafeds.gov.

Who you are	Where to make the change
State Department employee	Employee Express (employeeexpress.gov), signing in with Login.gov or your PIV card
Employee of an agency paid by the National Finance Center, such as USDA	NFC Employee Personal Page: Health Insurance, then Self-Service, then Change Plan
Employee of another agency, including Commerce	Ask your HR office which system it uses
Foreign Service retiree paid by the State Department	Follow the Open Season instructions the Office of Retirement posts on RNet (state.gov/rnet) in mid-November
Retiree paid by OPM (CSRS or FERS)	OPM Retirement Services

For employees, Open Season changes take effect with the first pay period of 2027, which starts January 10, 2027. Retirees' changes take effect January 1. Save your confirmation, then check the health benefits deduction on your first 2027 Earnings and Leave Statement.

If you miss December 14, you'll usually keep your current plan and code for all of 2027. The exception is a qualifying life event, such as marriage, a birth or adoption, or losing other coverage; OPM's life events page lists them all.

Your 2027 Open Season checklist

• [ ] Count who will be on your plan in 2027. Two people can choose code 402 instead of 403.
• [ ] Look up your current plan and code in Employee Express or your agency's system.
• [ ] Run your household through the calculator above, and look at the worst-case year as well as the typical one.
• [ ] If you're considering the GEHA HDHP from post, make sure you can pay up to the $1,800 or $3,600 deductible yourself while overseas claims are processed.
• [ ] If you choose an HDHP with an HSA, check Medicare, TRICARE and any general-purpose Health Care FSA for both of you, and pick the Limited Expense FSA instead.
• [ ] Set your HSA payroll contribution at no more than the 2027 limit minus GEHA's deposit.
• [ ] Re-enroll in any FSAFEDS account by December 14.
• [ ] Save your confirmation and check your first 2027 pay statement.

Quick answers

If there are only two of us, can we enroll in FSBP Self and Family?

Yes. OPM says enrollees covering one family member are free to elect Self and Family or Self Plus One when Self Plus One costs more, and AFSPA says two-person families don't have to enroll in Self Plus One. The brochure's benefits, deductibles and coinsurance are the same for both.

How much do we save by switching from code 403 to code 402?

For 2027 you save $46.70 per pay period ($429.35 minus $382.65), or $1,214.20 over 26 pay periods. Retirees paying monthly save $101.19 a month.

What changed in the 2027 FSBP brochure besides premiums?

The family out-of-pocket maximum rises to $12,000 in network and overseas. U.S. hospital stays now have a $250 in-network copay, while care outside the 50 states is still paid at 100%. GLP-1 weight-loss drugs move to 50% coinsurance, the wellness program is renamed LiveWell Rewards, and massage is limited to one covered visit a day.

When is Open Season, and where do State Department employees make changes?

Open Season runs from November 9 to December 14, 2026. State Department employees use Employee Express, and FSAFEDS accounts are renewed separately at fsafeds.gov.

Is an HDHP worth it when we're posted overseas?

On paper, the GEHA HDHP costs less than FSBP in most years, because the premium gap and the HSA deposit outweigh the higher deductible. The trade-off is handling: you pay up to the deductible yourself, drugs cost more, and you may need to pay foreign providers first and claim afterward. The MHBP Consumer Option isn't available for 2027.

Where I got this

1. 2027 Foreign Service Benefit Plan brochure (RI 72-001), AFSPA: 2027 rates, changes for 2027, deductibles, out-of-pocket maximums, overseas claims and prescriptions (accessed October 25, 2026).
2. AFSPA Open Season page: rate changes and the note that two-person families don't have to enroll in Self Plus One (accessed October 25, 2026).
3. OPM 2027 FEHB fee-for-service premium table (spreadsheet): enrollee and government shares for FSBP, GEHA, Blue Cross and MHBP (accessed October 25, 2026).
4. OPM Open Season page: "free to elect either" wording (accessed October 25, 2026).
5. OPM 2026 Open Season highlights for plan year 2027: dates and effective dates (accessed October 25, 2026).
6. 2027 GEHA HDHP brochure (RI 71-014) and GEHA HDHP page: deposits, deductibles, coinsurance, drugs, overseas claims and the HRA (accessed October 25, 2026).
7. MHBP Consumer Option page: the plan leaves FEHB effective 2027 (accessed October 25, 2026).
8. IRS Revenue Procedure 2026-24 and IRS Publication 969: 2027 HSA limits and eligibility rules (accessed October 25, 2026).
9. OPM premium conversion: employees pay premiums with pre-tax pay (accessed October 25, 2026).
10. 16 FAM 501.2: the State Department medical program as secondary payer for urgent hospitalization abroad (accessed October 25, 2026).
11. NFC Employee Personal Page help: health insurance: the NFC menu path (accessed October 25, 2026).
12. OPM qualifying life events: changes allowed outside Open Season (accessed October 25, 2026).