Key Takeaways

• As of January 1, 2025, the Postal Service Health Benefits (PSHB) Program has officially replaced the Federal Employees Health Benefits (FEHB) Program for USPS employees and retirees.

• If you are a USPS retiree or Medicare-eligible family member, your Medicare Part B enrollment status directly affects your ongoing PSHB coverage and benefits.

Understanding the PSHB Transition in 2025

The PSHB Program is now fully active, marking a significant shift for all United States Postal Service employees, annuitants, and eligible family members. This transition from the FEHB Program to PSHB is part of a broader postal reform effort signed into law in 2022, aimed at improving long-term financial stability for the USPS.

If you’re a USPS retiree, you are now covered under a PSHB plan instead of a traditional FEHB option. This change took effect on January 1, 2025. It’s essential to understand the key differences in eligibility, Medicare requirements, and prescription drug coverage to ensure your benefits continue without interruption.

Who Is Affected by the New PSHB Rules?

You are affected by the PSHB rollout if you fall into any of the following categories:

• You are a USPS employee or annuitant.

• You are a family member enrolled under a USPS worker’s plan.

• You are Medicare-eligible or will be turning 65 soon.

The shift to PSHB does not apply to non-USPS federal employees or retirees, who continue to receive coverage through FEHB.

Automatic Enrollment and What to Expect

If you were enrolled in an FEHB plan as a USPS retiree in 2024, you were automatically transitioned to a corresponding PSHB plan on January 1, 2025. The Office of Personnel Management (OPM) ensured that enrollees did not face a coverage gap during this changeover.

However, while automatic enrollment occurred for most retirees, you are still encouraged to review your current plan. During the next Open Season in November–December 2025, you can switch to a different PSHB plan if your current one doesn’t suit your health or financial needs.

Medicare Part B Enrollment Requirements

One of the most impactful changes under PSHB involves Medicare Part B. Starting in 2025, enrollment in Part B is mandatory for certain Medicare-eligible USPS retirees and their family members to maintain full PSHB coverage.

Who Must Enroll in Medicare Part B:

• Retirees who are Medicare-eligible and did not retire on or before January 1, 2025.

• Covered family members who are also Medicare-eligible and meet the criteria.

Exemptions from the Requirement:

• You retired on or before January 1, 2025, and were already eligible for Medicare.

• You or your dependent reside permanently overseas.

• You receive medical benefits through Veterans Affairs (VA) or Indian Health Services (IHS).

Failing to enroll in Medicare Part B when required could result in a loss of certain PSHB benefits or termination of your prescription drug coverage.

Prescription Drug Coverage: Integrated and Streamlined

As a Medicare-eligible USPS retiree or family member, your PSHB plan now integrates your prescription drug coverage through a Medicare Part D Employer Group Waiver Plan (EGWP). This change streamlines your benefits and may reduce your out-of-pocket drug expenses.

Key Features in 2025:

• A $2,000 annual cap on out-of-pocket prescription drug costs.

• A $35 monthly cap on insulin costs.

• Broader access to pharmacy networks.

If you choose to opt out of the Medicare Part D drug coverage, you will lose prescription benefits under PSHB, and re-enrollment may not be allowed unless you qualify for a Special Enrollment Period in the future.

Open Season and Your Flexibility

The 2025 PSHB Open Season will occur in the traditional November–December window. This is your opportunity to:

• Change plans if your healthcare needs have evolved.

• Evaluate different cost-sharing models and provider networks.

• Add or remove eligible family members.

Even though your enrollment automatically transitioned, Open Season remains your best opportunity to make sure your coverage still aligns with your current needs.

Costs You Should Be Aware Of

While exact plan pricing varies depending on coverage level and plan selection, here are some general cost factors you should be prepared for:

• Monthly Premiums: These are now paid directly to the PSHB plan and may differ slightly from 2024’s FEHB rates.

• Deductibles and Coinsurance: In-network deductibles typically range from $350 to $2,000 depending on whether you choose a low-deductible or high-deductible plan. Out-of-network deductibles are higher.

• Copayments: You may expect to pay between $20 and $60 for primary and specialist visits, with higher copays for urgent and emergency care.

• Annual Out-of-Pocket Maximums: PSHB plans cap your in-network expenses at $7,500 for Self Only coverage and $15,000 for family plans. Out-of-network maximums vary.

Be sure to review your plan brochure or contact a licensed agent listed on this website to understand how your current coverage stacks up.

Keeping Your FEDVIP, FEGLI, and Other Benefits

The move to PSHB does not affect your eligibility for other federal benefit programs. You can continue enrollment in:

• FEDVIP (Federal Employees Dental and Vision Insurance Program)

• FEGLI (Federal Employees Group Life Insurance)

• FLTCIP (Federal Long-Term Care Insurance Program)

• FSAFEDS (Flexible Spending Accounts)

No changes are required in these programs, and they operate independently of PSHB.

Key Dates and Enrollment Processes

If you are newly eligible for Medicare in 2025 and subject to the Part B requirement, you need to ensure timely enrollment. Key timeframes to track include:

• Initial Enrollment Period (IEP): This 7-month window surrounds your 65th birthday (3 months before, your birth month, and 3 months after).

• Special Enrollment Period (SEP): If you missed the IEP due to FEHB coverage, a SEP was offered from April 1 to September 30, 2024. This was a one-time opportunity with no late penalties.

• Annual PSHB Open Season: Takes place every November–December. Coverage changes go into effect January 1 of the following year.

It’s important to act during the correct window to avoid penalties or lapses in coverage.

Where to Manage Your PSHB Benefits

Depending on your status, you’ll use different platforms to manage your benefits:

• USPS Employees: Use the LiteBlue portal for plan details and enrollment.

• USPS Annuitants: Visit KeepingPosted.org for information and to manage your health benefits.

You may also contact the PSHB Navigator Help Line at 1-833-712-7742 if you need assistance with navigating your choices or resolving enrollment issues.

Special Considerations for Family Members

Your spouse or eligible family members covered under your PSHB plan may also be subject to the Medicare Part B enrollment requirement. Be sure to:

• Confirm the Medicare eligibility status of each family member.

• Review whether they meet an exemption under PSHB guidelines.

• Coordinate enrollments during the proper timelines to prevent any loss of benefits.

What You Can Expect Going Forward

The PSHB Program will continue evolving as the USPS and OPM collect feedback and adjust based on participant needs. In 2025, here’s what you should watch for:

• Plan Adjustments: Minor changes to benefits, cost-sharing, or networks may occur in 2026 based on the 2025 rollout experience.

• New Guidance: You may receive mailings or digital alerts from OPM, USPS, or your health plan. These often include updates on benefits, cost changes, or new enrollment rules.

• Ongoing Coordination with Medicare: If you’re newly eligible for Medicare, expect more integrated services between your PSHB plan and Medicare going forward.

Staying informed and proactive will help ensure you make the most of your new PSHB coverage.

Planning Ahead Helps You Stay Protected

As a USPS retiree, this year marks a major change in how you receive and manage your health benefits. The PSHB program introduces both challenges and advantages, particularly if you’re coordinating with Medicare. By understanding your responsibilities—like enrolling in Medicare Part B—and by reviewing your options during Open Season, you can avoid any disruptions to your coverage.

If you still have questions, now is the time to speak with a licensed agent listed on this website for one-on-one guidance.