Key Takeaways
- The PSHB Open Season runs from November 11 to December 9, 2024, providing a key opportunity for USPS employees and retirees to review and select health plans.
- PSHB launches on January 1, 2025, transitioning USPS employees and retirees from the previous FEHB system under the Postal Service Reform Act of 2022.
Time to Evaluate Your Health Plan Choices
If you’re a postal worker or retiree, Open Season is here—running from November 11 to December 9, 2024. It’s your chance to evaluate your health coverage options for the coming year. As you may know, the Postal Service Health Benefits (PSHB) program officially launches on January 1, 2025, replacing the previous Federal Employees Health Benefits (FEHB) system. This change comes as part of the Postal Service Reform Act of 2022, and while the switch might sound overwhelming, I’m here to guide you through it and help you figure out the best plan for you.
The Basics: What is PSHB?
PSHB stands for Postal Service Health Benefits. Starting on January 1, 2025, USPS employees and retirees will be enrolled in a PSHB plan that mirrors their current FEHB coverage. This transition is automatic, but Open Season gives you a chance to review your plan and make changes. So, if you’re happy with your current level of coverage, you may not need to do anything. But if you’re looking for something more affordable or comprehensive, Open Season is the perfect time to explore your options.
What Stays the Same?
One of the biggest reliefs for many of us is that some key elements remain unchanged. Dental and vision coverage through the Federal Employees Dental and Vision Insurance Program (FEDVIP) will continue as it always has. You can expect the same level of care for routine dental exams, cleanings, prescription eyewear, and more. However, it’s worth noting that FEDVIP premiums are going up slightly in 2025. Dental coverage will see a 2.97% increase, while vision premiums will go up by a modest 0.87%.
Premiums Under PSHB: What to Expect
Now, let’s get to the part that impacts your wallet—premiums. You’ll be paying a portion of the premium, while the government will cover 72% of the cost. Here’s what the average total biweekly premiums will look like in 2025 for PSHB participants:
- Self Only: $397.35
- Self Plus One: $858.89
- Self and Family: $934.65
These figures include both your contribution and the government’s. Your share will be 28%, broken down as follows:
- Self Only: $111.26 biweekly (about $2,892.76 annually)
- Self Plus One: $240.49 biweekly (about $6,252.74 annually)
- Self and Family: $261.70 biweekly (about $6,804.20 annually)
Yes, healthcare costs can be steep, but there are also potential cost savings if you’re enrolled in Medicare Part B, which I’ll explain later.
How to Choose the Right Plan
Choosing the best health plan can feel daunting, especially with so many options. But don’t worry, I’ve broken it down into some simple steps to help you make the best decision for your situation.
Step 1: Review Your Health Needs
Start by looking at your health needs and those of your family. Do you have any chronic conditions? How often do you visit the doctor? If you require frequent medical attention or specific prescriptions, make sure to find a plan that covers your needs well.
Step 2: Compare Costs and Coverage
Once you’ve assessed your health needs, the next step is to compare different PSHB plans. The OPM plan comparison tool, available during Open Season, will make this easier. You can use this tool to compare premiums, deductibles, co-pays, and other out-of-pocket costs for each plan. Remember, the cheapest plan isn’t always the best—especially if it doesn’t cover essential services or medications.
Step 3: Consider Your Retirement Plans
If you’re planning to retire soon, it’s essential to consider how your health plan will work with Medicare. If you retire after January 1, 2025, you’ll need to enroll in Medicare Part B to keep your PSHB plan when you become eligible for Medicare. The good news is that many PSHB plans offer additional savings for those enrolled in Medicare Part B, including reimbursement for Part B premiums, waived deductibles, and lower out-of-pocket costs. If you’re nearing Medicare eligibility, this could lead to significant savings down the road.
What If You’re Already Retired?
If you retired on or before January 1, 2025, and haven’t enrolled in Medicare Part B, you’re in the clear! You’re not required to enroll in Medicare Part B to keep your PSHB coverage. This rule also applies to any family members covered under your plan. It’s a small but critical detail to keep in mind when making your decision this Open Season.
Prescription Drug Coverage
Another significant feature of PSHB plans is their inclusion of Medicare Part D prescription drug coverage for Medicare-eligible participants. This means you won’t have to pay for separate Part D premiums. However, it’s important to check the formulary (the list of covered medications) for each plan. Not all prescriptions may be covered, and the level of coverage can vary, so make sure your medications are included in the plan you choose.
Special Enrollment Period for Medicare Part B
From April to September 2024, a Special Enrollment Period (SEP) was available for retirees and their families who weren’t already enrolled in Medicare Part B. During this period, USPS covered late enrollment penalties for those who signed up. Although the SEP is over, it’s worth knowing that USPS has provided support to make this transition smoother for retirees.
Don’t Forget About Your FEDVIP Options
While PSHB is a significant shift, don’t forget that FEDVIP options are still available for dental and vision coverage. You can also review and adjust these plans during Open Season. If you’re satisfied with your current plan, you don’t need to make any changes. But if you feel like your dental or vision needs have changed, now’s the time to revisit those options too.
Wrapping It All Up
Open Season is your annual window to ensure your health plan is working for you and your family. With the introduction of PSHB, this year is particularly important. The Postal Service Reform Act of 2022 brought in significant changes, but by understanding your options, assessing your health needs, and using available comparison tools, you can find the best plan to cover your healthcare needs in 2025.
Don’t wait until the last minute. Take advantage of Open Season, which runs from November 11 to December 9, 2024, and start reviewing your options. This is your chance to make sure you and your family are covered when PSHB launches on January 1, 2025.
Making Health Plan Decisions Easier
Choosing a health plan can be overwhelming, but with the right tools and information, it’s manageable. Whether you’re an active USPS employee or already retired, the key to selecting the best plan is understanding your health needs and matching them with the right coverage options. Remember, health care is personal, so take the time to evaluate what works best for you.
