Key Takeaways

• The transition from FEHB to PSHB in 2025 changes how postal workers access health benefits, making it crucial to understand new enrollment rules and Medicare coordination.

• Knowing cost-sharing factors like premiums, deductibles, and copays can help you choose the best PSHB plan for your healthcare needs.

Understanding Your PSHB Coverage in 2025

As a postal worker or retiree, your health coverage is undergoing significant changes in 2025 with the transition from the Federal Employees Health Benefits (FEHB) program to the Postal Service Health Benefits (PSHB) program. Whether you’re an active employee or retired, knowing how PSHB works is key to making informed healthcare decisions.

Here are five crucial facts to consider when reviewing your PSHB options.

1. PSHB Enrollment is Required for Postal Workers

The biggest change in 2025 is that USPS employees and retirees must enroll in a PSHB plan if they want to continue receiving health benefits. Unlike FEHB, which included a broader pool of federal employees, PSHB is specifically tailored for postal workers and their families.

Enrollment Periods and Deadlines

• Open Season: The annual Open Season, running from November 11 to December 13, 2025, allows you to choose a plan or make changes to your coverage.

• Special Enrollment Periods (SEPs): Certain life events, like retirement or losing other coverage, may qualify you for enrollment outside Open Season.

• Retirees and Auto-Enrollment: If you’re a retiree currently enrolled in FEHB, you’ll automatically transition into a PSHB plan unless you opt out.

Failing to enroll during Open Season may leave you without coverage, so be sure to review your options in advance.

2. Medicare Part B Enrollment May Be Required

For Medicare-eligible retirees, PSHB introduces a significant change: mandatory enrollment in Medicare Part B to maintain PSHB coverage. If you’re 65 or older and retired by 2025, you must enroll in Part B unless you qualify for an exemption.

Who Is Affected?

• Retirees who turn 65 in 2025 or later must enroll in Medicare Part B to retain PSHB coverage.

• Retirees who are already 65 but retired on or before January 1, 2025, are exempt from the requirement.

• Active USPS employees can delay Medicare Part B enrollment until they retire.

The Medicare & PSHB Advantage

Enrolling in both Medicare and PSHB can reduce your out-of-pocket costs, as PSHB plans may offer lower deductibles, reduced copays, and additional benefits for those with Medicare Part B.

3. Cost-Sharing: What You’ll Pay for Coverage

Understanding the costs associated with PSHB is crucial. While plan premiums vary, you’ll need to consider additional expenses like deductibles, copays, and coinsurance.

Key Cost Components

• Premiums: These vary based on plan selection and coverage level (Self Only, Self Plus One, or Self & Family).

• Deductibles: Some plans have higher deductibles but lower monthly premiums, while others have lower deductibles with higher monthly costs.

• Copays and Coinsurance: Your share of costs for doctor visits, prescriptions, and hospital stays depends on the PSHB plan you select.

To make an informed choice, compare plans carefully and weigh the trade-offs between lower monthly costs and potential out-of-pocket expenses.

4. Prescription Drug Coverage is Integrated with Medicare Part D

A major benefit of PSHB is its automatic integration with Medicare Part D for retirees enrolled in Medicare.

What This Means for You

• If you’re Medicare-eligible, your PSHB plan will automatically enroll you in a Medicare Part D Employer Group Waiver Plan (EGWP) to manage prescription costs.

• This coverage replaces stand-alone Part D plans, ensuring you receive cost-effective prescriptions without needing separate drug coverage.

• The 2025 Medicare Part D cap of $2,000 applies, limiting your out-of-pocket drug costs.

This integration helps lower medication costs and simplifies prescription drug management for retirees.

5. PSHB Plans Offer Varying Benefits and Provider Networks

PSHB plans aren’t one-size-fits-all. Each plan offers different provider networks, coverage levels, and supplemental benefits, so reviewing the details is essential.

Factors to Consider

• Network Providers: Ensure your preferred doctors and hospitals accept your PSHB plan.

• Extra Benefits: Some plans provide dental, vision, and hearing benefits, while others focus more on basic healthcare coverage.

• Out-of-Network Coverage: If you travel frequently or live in an area with limited in-network providers, check how out-of-network services are covered.

Choosing the right PSHB plan means balancing costs, benefits, and network access based on your healthcare needs.

Making the Most of Your PSHB Benefits

Switching to PSHB in 2025 marks a major shift for postal workers and retirees. Understanding enrollment requirements, Medicare coordination, cost-sharing structures, and plan options ensures you get the most out of your health coverage.

To find the best plan for your needs, speak with a licensed agent listed on this website who can guide you through the process and answer any questions you have about PSHB and Medicare.