Key Takeaways

• Enrolling in Medicare Advantage while already covered by a PSHB plan in 2025 may create overlapping coverage. While the two may seem to complement each other, they are not always cost-effective together.

• Medicare Part B is often required to maintain PSHB coverage once you’re eligible, but adding Medicare Advantage may not always enhance your benefits unless specific criteria are met.

Understanding the Role of PSHB in Retirement

The Postal Service Health Benefits (PSHB) Program launched officially in 2025, replacing the FEHB for Postal Service retirees and workers. It offers health coverage tailored to current and retired USPS employees. If you’re a postal retiree turning 65 or already enrolled in Medicare, you may now face a question that’s more relevant than ever: Does it still make sense to enroll in a Medicare Advantage plan if you already have PSHB?

Medicare Part B Is Required—But That Doesn’t Automatically Mean Advantage Plans Are

To maintain your PSHB coverage in retirement, you must enroll in Medicare Part B when eligible—unless you qualify for an exemption. Medicare Part B covers outpatient services and doctor visits, and it pairs with PSHB plans to reduce out-of-pocket costs. However, Medicare Advantage (Part C) is a separate, optional alternative that often replaces Original Medicare with a private health plan. So the key question becomes: Should you add this on top of your PSHB?

What Medicare Advantage Actually Offers

Medicare Advantage plans, or Part C plans, must provide at least the same level of coverage as Original Medicare (Parts A and B). In many cases, they also include:

• Additional benefits like vision, hearing, or dental

• Prescription drug coverage

• Coordinated care through network-based HMOs or PPOs

• Annual out-of-pocket maximums

These extras may sound appealing. But when you already have PSHB and Medicare Part B, some of these perks may be redundant or unnecessary.

What Happens When You Have Both PSHB and Medicare Advantage

PSHB plans already coordinate with Medicare Parts A and B. Many offer:

• Lower deductibles if you’re enrolled in Medicare

• Reduced copayments or coinsurance

• Waived out-of-pocket costs for certain services

• Integration with Medicare Part D through an EGWP (Employer Group Waiver Plan)

If you then add a Medicare Advantage plan on top, you might experience:

• Conflicting billing arrangements: Medicare Advantage becomes your primary payer, which may not align well with how your PSHB plan handles coordination.

• Loss of PSHB coordination perks: If your provider bills Medicare Advantage instead of Original Medicare, your PSHB plan may not reduce costs as it would with Parts A and B.

• Duplicate prescription coverage: You may end up with overlapping drug coverage unless you opt out of one plan’s Part D benefits.

In short, Medicare Advantage and PSHB are not always designed to work hand-in-hand.

Medicare Advantage Enrollment Timeline and Restrictions

You can only enroll in or switch Medicare Advantage plans during specific periods:

• Initial Enrollment Period: Starts three months before you turn 65 and ends three months after.

• Annual Enrollment Period: Runs from October 15 to December 7.

• Medicare Advantage Open Enrollment Period: From January 1 to March 31 each year, allowing current MA enrollees to switch plans or return to Original Medicare.

Keep in mind that PSHB plan enrollment runs from November to December each year, which overlaps with the Annual Enrollment Period. Planning your coverage decisions during this time is essential.

Why Medicare Advantage Could Still Be Useful for Some

Despite the potential conflicts, there are situations where a Medicare Advantage plan might benefit you:

• You spend significant time in a state where your PSHB network is limited.

• You find a Medicare Advantage plan offering out-of-pocket protections that align better with your medical needs.

• You don’t rely heavily on PSHB prescription coverage and want more tailored drug benefits.

• You are eligible for low-income subsidies or qualify for a Special Needs Plan (SNP).

Even then, you’ll need to compare carefully. Having two plans with different networks, billing processes, and formularies may create administrative headaches rather than savings.

How Medicare Part D Integration Works With PSHB

One major reason Medicare Advantage plans are attractive is their inclusion of drug coverage. However, your PSHB plan already integrates with Medicare Part D through an EGWP, which includes:

• A $2,000 annual cap on out-of-pocket prescription costs in 2025

• Waived or reduced deductibles for medications

• No coverage gap or “donut hole”

• National pharmacy networks

Adding a second drug plan through Medicare Advantage may result in automatic disenrollment from your PSHB prescription drug plan, which can lead to unexpected gaps or losses in coverage. Be very cautious before enrolling in an MA plan that includes Part D.

Cost Considerations in 2025

In 2025, Medicare Advantage premiums remain variable and can change depending on the plan and region. However, since your PSHB plan already reduces your cost burden when combined with Medicare Part B, the cost-effectiveness of adding a Medicare Advantage plan is questionable.

Also, remember:

• You are already paying the standard Part B premium, which is $185 per month in 2025.

• PSHB plans often waive deductibles or lower coinsurance for Medicare enrollees.

• Some PSHB plans even reimburse part or all of your Part B premium.

In this context, adding another premium for a Medicare Advantage plan may not provide enough added value.

Comparing PSHB and Medicare Advantage Plan Features

This comparison shows that while both options offer strong benefits, using them together may introduce complications.

Questions to Ask Before Adding Medicare Advantage

Before enrolling in a Medicare Advantage plan while keeping your PSHB coverage, consider:

• Will my PSHB plan coordinate with this Medicare Advantage plan?

• Does the Medicare Advantage network include my preferred providers?

• Could I lose any PSHB prescription drug benefits?

• Do I travel often or live in multiple states during the year?

• Is the added cost worth the limited extra benefits?

These questions can help you clarify if the decision aligns with your actual healthcare needs rather than just the advertised perks.

When PSHB Alone Might Be Enough

In many cases, your PSHB plan, when paired with Medicare Parts A and B, already provides robust coverage:

• You benefit from reduced or waived deductibles

• You access a strong national network of providers

• Your drug costs are capped under Medicare Part D’s new 2025 limits

• You avoid billing confusion that might arise from having competing plans

For most postal retirees in 2025, this combination is often more efficient, predictable, and easier to manage.

Why the Right Coordination Strategy Matters

Getting your health coverage to work together smoothly in retirement is less about piling on plans and more about alignment. PSHB plans are built to work with Medicare Part A and Part B. When you add a Medicare Advantage plan, you shift the structure—and that can disrupt how your benefits are applied.

If you’re drawn to the perks of a Medicare Advantage plan, review them carefully. Many of those features may already exist within your PSHB coverage once you’re enrolled in Medicare. The key is not just what you get, but whether it fits within the system you’re already part of.

Take Time to Weigh the Overlap

Whether you’re newly Medicare-eligible or reevaluating your coverage, consider how PSHB interacts with Medicare Advantage. Don’t assume more coverage automatically means better coverage. In some cases, it only means more confusion.

Before making any changes, speak with a licensed insurance agent listed on this website to fully understand how your coverage options work together—or against each other—in 2025.