Key Takeaways:

• Medicare Advantage plans within the Postal Service Health Benefits (PSHB) program can provide additional benefits beyond Original Medicare, including dental, vision, and hearing coverage. However, plan details vary, so reviewing your options is essential.

• If you’re a Medicare-eligible Postal Service retiree, enrolling in Medicare Part B is a requirement to keep your PSHB coverage. Understanding how Medicare Advantage integrates with your health benefits can help you maximize coverage while minimizing out-of-pocket costs.

Understanding Medicare Advantage Within PSHB

As a Postal Service retiree or employee nearing retirement, you may have questions about how Medicare Advantage works within the Postal Service Health Benefits (PSHB) program. With so many healthcare options available, understanding how your benefits integrate with Medicare can help you make informed decisions about your coverage.

PSHB officially replaced FEHB for postal employees and retirees starting in 2025. If you’re eligible for Medicare, your options include Medicare Advantage plans that work alongside PSHB. But what exactly do these plans cover, and how do they fit into your overall healthcare strategy?

How Medicare Advantage Fits into Your PSHB Coverage

Medicare Advantage (Part C) plans are an alternative to Original Medicare, combining hospital (Part A) and medical (Part B) coverage. Many also include prescription drug coverage (Part D) and extra benefits like dental and vision care. Under PSHB, Medicare Advantage plans can offer cost-sharing reductions for those who enroll in both Medicare and a PSHB plan.

If you are a Medicare-eligible Postal Service retiree, you must enroll in Medicare Part B to keep your PSHB coverage. Some Medicare Advantage plans within PSHB may offer lower out-of-pocket costs or added benefits, making them an attractive option.

What Your PSHB Medicare Advantage Plan May Cover

Your Medicare Advantage plan under PSHB may provide several benefits beyond Original Medicare. Here’s a breakdown of what these plans typically include:

1. Medical and Hospital Coverage

• Covers inpatient hospital stays, outpatient care, and preventive services.

• Includes emergency care and specialist visits.

• May offer telehealth options for virtual doctor visits.

2. Prescription Drug Coverage

• Most Medicare Advantage plans within PSHB include Part D prescription drug coverage.

• May offer formularies that lower costs for generic and preferred brand-name drugs.

3. Dental, Vision, and Hearing Benefits

• Coverage for routine dental exams, cleanings, and procedures.

• Vision coverage for annual eye exams and prescription eyewear.

• Hearing aid allowances and hearing exams.

4. Cost-Sharing Reductions

• Some plans offer reduced deductibles, copays, or coinsurance for enrollees who have both Medicare and PSHB coverage.

• May include reimbursements or assistance with Medicare Part B premiums.

5. Wellness and Additional Perks

• Gym memberships, wellness programs, and nutrition counseling.

• Transportation benefits for medical appointments.

• Coverage for over-the-counter health products.

Since plan details vary, checking your specific PSHB Medicare Advantage plan documents is crucial to understanding what’s included.

The Requirement to Enroll in Medicare Part B

One major factor to consider is that Medicare-eligible Postal Service retirees must enroll in Medicare Part B to keep their PSHB coverage. This requirement applies to retirees and eligible family members unless they qualify for an exemption.

How This Affects Your Costs

• Medicare Part B requires a monthly premium, which varies based on income.

• Some Medicare Advantage plans within PSHB may help offset these costs.

• Enrolling in both Medicare Part B and a PSHB plan ensures you receive the most comprehensive coverage possible.

Ignoring this requirement could result in losing PSHB coverage, so timely enrollment in Medicare Part B is essential.

Choosing the Right Medicare Advantage Plan Within PSHB

With different Medicare Advantage plans available under PSHB, how do you decide which one is best for you? Here are a few key steps:

1. Assess Your Health Needs

• Do you require frequent specialist visits or prescription medications?

• Do you need additional coverage for dental, vision, or hearing care?

2. Compare Costs

• Look at monthly premiums, deductibles, and copays.

• Consider how much you typically spend on healthcare each year.

3. Review Provider Networks

• Some Medicare Advantage plans have network restrictions.

• If you have preferred doctors, ensure they are covered.

4. Check Prescription Drug Coverage

• If your plan includes Part D, confirm that your medications are covered.

• Compare formulary costs for generic and brand-name prescriptions.

By carefully evaluating these factors, you can select a PSHB Medicare Advantage plan that aligns with your healthcare needs and budget.

Making the Most of Your PSHB Medicare Advantage Plan

Once you’ve enrolled, maximizing your benefits is key. Here are a few ways to make the most of your coverage:

1. Schedule Preventive Screenings

Many plans cover preventive care at no additional cost, including:

• Annual wellness visits

• Flu shots and vaccines

• Cancer screenings

2. Take Advantage of Extra Benefits

• Use dental, vision, and hearing benefits to maintain overall health.

• Participate in fitness and wellness programs included in your plan.

3. Stay Informed About Plan Changes

• Medicare Advantage benefits can change each year.

• Review your plan details during the PSHB Open Season (November 11 – December 13, 2025) to ensure it still meets your needs.

4. Contact a Licensed Agent for Help

• Agents listed on this website can help you compare plans and understand your benefits.

• They provide guidance on selecting the best coverage based on your health and financial situation.

Understanding Your Medicare Advantage Choices Within PSHB

Medicare Advantage plans under PSHB provide an excellent opportunity to enhance your healthcare coverage. With added benefits like prescription drug coverage, dental care, and cost-sharing reductions, these plans can offer significant value.

Since Medicare Part B enrollment is required for PSHB retirees, choosing the right Medicare Advantage plan can ensure you get the best possible healthcare at the lowest out-of-pocket cost. Take time to review your options, compare plans, and reach out to a licensed agent listed on this website for personalized guidance.