Key Takeaways:

1. Open Season for the Postal Service Health Benefits (PSHB) Program runs from November 11 to December 9, 2024. This is the time for postal workers, annuitants, and eligible family members to review, update, or switch health plans for 2025.

2. Medicare-eligible Postal Service annuitants and family members may need to enroll in Medicare Part B to maintain PSHB coverage in 2025, so double-check requirements to avoid coverage issues.

What is PSHB Open Season?

Each fall, the Postal Service Health Benefits (PSHB) Program gives postal employees, retirees, and eligible family members a chance to review and update their health plan options. Open Season is a critical time to adjust your coverage for the upcoming year, and this period from November 11 to December 9, 2024 is especially important, as it marks the official transition from the Federal Employees Health Benefits (FEHB) program to the new PSHB system.

Whether you’re reviewing benefits for yourself or family members, Open Season can seem overwhelming. But by understanding the timeline, requirements, and available choices, you can find a plan that matches your needs for 2025.

Key Dates and Timelines for PSHB Enrollment

The Open Season window is limited to about a month. Here’s a quick breakdown of important dates:

• November 11 to December 9, 2024: Open Season period
• January 1, 2025: Effective date of any plan changes made during Open Season

If you’re currently enrolled in FEHB, you’ll be automatically transferred to a similar PSHB plan. But don’t just rely on automatic enrollment; review your plan details and take the opportunity to make any necessary changes during Open Season.

Why It’s Essential to Review Your Health Plan Annually

Healthcare Needs Change Over Time

As life changes, so do healthcare needs. You may have developed new medical concerns, or perhaps a family member needs extra coverage. Reviewing options annually helps ensure your health plan matches your current needs.

Cost and Coverage Changes

Plans are updated each year, so what worked well last year may not be ideal this time around. Factors such as premium adjustments, deductibles, and out-of-pocket limits can significantly impact your expenses.

Who Should Enroll in Medicare Part B?

With the new PSHB program, some Medicare-eligible Postal Service retirees and their Medicare-eligible family members must enroll in Medicare Part B to keep their PSHB coverage. If you retired on or before January 1, 2025, and are not already enrolled in Part B, you may be exempt from this requirement. It’s crucial to confirm your eligibility and requirements during Open Season to avoid surprises in 2025.

Steps to Choosing the Right PSHB Plan for You

Step 1: Identify Your Priorities

Start by thinking about what matters most to you in a health plan. Key questions might include:

• How often do you visit the doctor? If you see doctors frequently or expect to need medical procedures, a plan with lower out-of-pocket costs might be ideal.

• What prescription drugs do you need? Make sure to check if the PSHB plans cover your prescriptions and at what level.

• Do you or family members need specialists? Some plans offer better networks or coverage for specialists than others.

Step 2: Compare Plans Based on Coverage

When evaluating plans, pay close attention to several key areas:

1. Premiums and Deductibles: A lower monthly premium might look appealing, but always consider the deductible and out-of-pocket limits. Lower premiums often come with higher deductibles.

2. Co-pays and Coinsurance: Review how much you’ll pay when visiting doctors, specialists, or filling prescriptions. Co-pays and coinsurance rates differ across plans.

3. Provider Networks: Ensure your current doctors and preferred healthcare providers are within the plan’s network.

Step 3: Use the Tools Available to You

Take advantage of any online comparison tools provided by the U.S. Office of Personnel Management or PSHB program to help narrow your options. These tools often let you filter by plan features, cost, or coverage, making it easier to zero in on what works for you.

Common Health Plan Options Explained

Understanding the types of plans available can make it easier to compare your options effectively:

• Health Maintenance Organizations (HMOs): HMOs require you to choose a primary care provider and often need referrals for specialists. While restrictive, they generally offer lower costs if you stay within their network.

• Preferred Provider Organizations (PPOs): PPOs offer more flexibility in choosing healthcare providers without referrals, though they may come with higher costs.

• High Deductible Health Plans (HDHPs): HDHPs typically feature lower premiums but higher deductibles. They can work well if you’re healthy and don’t expect frequent medical expenses.

Choose a plan type that aligns with your healthcare preferences and needs.

Don’t Forget About Family Coverage

If you’re covering family members, make sure their needs are met, too. Look at each family member’s healthcare usage and consider factors like dependents’ healthcare needs, age, or any special medical concerns.

Avoiding Common Pitfalls During PSHB Open Season

Skipping the Research

Relying on automatic enrollment might seem convenient, but it can lead to surprises if you end up in a plan that doesn’t fully meet your needs. Dedicate time to review plan options.

Not Checking for Medicare Coordination

If you’re Medicare-eligible, especially as a Postal Service retiree or annuitant, failing to check Part B requirements can lead to coverage disruptions. Remember, certain Medicare-eligible family members may also need Part B enrollment to keep PSHB benefits.

Ignoring Plan Changes

Plans can change annually, so don’t assume your plan will remain the same. Costs, coverage, or network changes can affect your out-of-pocket expenses. Reviewing plan documents can help you avoid unexpected costs.

Reviewing Your Options: Tips for Making the Best Decision

Set a Time to Review

Dedicate time to read through plan materials, compare benefits, and decide based on your family’s needs. Open Season is just a month long, so starting early gives you ample time to make a choice without feeling rushed.

Seek Additional Information if Needed

If you have questions about specific coverage, it’s a good idea to contact a PSHB representative or visit the U.S. Office of Personnel Management website for more detailed information.

Think Long Term

Remember, health insurance is a year-long commitment. While premiums may be a primary consideration, don’t overlook the importance of quality coverage, access to necessary services, and an established provider network.

Important Dates for Making Changes Outside Open Season

While Open Season is the primary time to make changes, certain life events may allow you to adjust your plan afterward. These Special Enrollment Periods include:

• Losing other health coverage (e.g., job loss)
• Moving to a new area where different plans are available
• Qualifying for Medicaid or other programs that change your eligibility

If any of these events apply, contact PSHB directly to make changes outside the Open Season window.

What to Do After Making Your Selection

Once you’ve chosen your plan, confirm the details and effective dates, and check for any further steps, especially if you’re enrolling in Medicare Part B. Staying proactive helps ensure a smooth transition when your new coverage starts on January 1, 2025.

Prepare for 2025 with Confidence

Selecting the right PSHB plan is more than a quick decision. By dedicating time now to evaluate your options and considering the needs of yourself and your family, you can make the best choice to support your health and financial goals in 2025. Remember, health coverage is a year-long commitment, and choosing the right plan today can make all the difference for the coming year.