Key Takeaways

  • Many Postal Service Health Benefits (PSHB) plans in 2025 strongly recommend enrolling in Medicare Part B when eligible, even if it’s not technically required.

  • Following that guidance can lead to major cost savings, better coordination of care, and continued access to full PSHB benefits—while ignoring it may result in higher costs and fewer benefits.

Why Your PSHB Plan Cares About Medicare Part B

Your PSHB plan isn’t just recommending Medicare Part B enrollment to make things complicated. The encouragement comes from the way your health benefits are now structured. As of 2025, PSHB plans are specifically designed to work in tandem with Medicare Part B. This isn’t a coincidence—it’s part of a deliberate integration.

In this new system, when you become eligible for Medicare (typically at age 65), your PSHB plan assumes that Medicare will become your primary payer. That means Medicare pays first for services covered under Part B, and your PSHB plan pays second.

If you’re not enrolled in Part B when you’re eligible, your PSHB plan may reduce what it pays, leave you exposed to higher out-of-pocket costs, or even deny certain claims that would have been covered had Medicare been in place. That’s why so many plans are sending a clear message: enroll in Medicare Part B.

What Happens When You Follow the Recommendation

Enrolling in Part B generally brings you three distinct advantages under PSHB:

  • Lower out-of-pocket costs: Once Medicare pays its share, your PSHB plan often covers most or all of the remaining balance.

  • Enhanced coordination: Claims are processed efficiently because Medicare and PSHB are set up to communicate.

  • Access to additional benefits: Some PSHB plans offer reduced deductibles, waived copays, or even reimbursements if you’re enrolled in Medicare Part B.

By participating in both systems, you get broader coverage and fewer financial surprises.

The Financial Impact of Ignoring Part B

Choosing to skip Medicare Part B doesn’t make your PSHB plan more robust—in fact, it does the opposite. Here’s what could happen if you decline Part B when eligible:

  • You may pay more: PSHB plans that expect Medicare to be primary may only pay secondary benefits—or nothing at all—for services covered under Part B.

  • You face late penalties: If you delay Part B enrollment without a valid exception, you’ll face a 10% penalty for every 12 months you went without it.

  • Future re-enrollment is limited: If you skip Part B now and change your mind later, you’ll need to wait for a General Enrollment Period (January 1 to March 31), and your coverage won’t start until July 1.

Over time, these consequences can add up to thousands in unexpected medical bills and gaps in care.

Who Must Enroll—and Who Doesn’t Have To

Under PSHB rules in 2025, not everyone is required to enroll in Medicare Part B, but many are. You are required to enroll if:

  • You are a Postal Service annuitant entitled to Medicare Part A

  • You were under age 64 as of January 1, 2025

You’re generally exempt if:

  • You retired on or before January 1, 2025, and are already over age 64

  • You live outside the U.S.

  • You’re covered under VA or Indian Health Services

Even if you’re exempt, your PSHB plan may still recommend enrollment in Part B to reduce costs and enhance your coverage. It’s not a requirement in those cases—but it is strongly encouraged.

The Role of Medicare Coordination in 2025

In this new PSHB landscape, coordination of benefits is key. If Medicare Part B is your primary payer, then PSHB picks up the rest—essentially giving you near full coverage. If you’re not enrolled in Part B, PSHB becomes the primary payer, but the plan may not fully cover what Medicare would have.

Plans are structured around this coordination. When you opt out of Medicare Part B, you break that structure. As a result, the plan’s ability to offer you full benefits may be significantly reduced. That’s not a penalty—it’s simply how the benefit design now works.

What Plans Are Doing to Encourage Enrollment

Many PSHB plans in 2025 are not just recommending enrollment in Part B—they’re providing incentives. These can include:

  • Waived deductibles for medical services when Medicare is primary

  • Lower copayments or coinsurance for office visits, diagnostic testing, and other outpatient services

  • Part B premium reimbursement (fully or partially) in some cases

  • No requirement to meet your PSHB deductible first if Medicare already paid its share

These features exist to reward coordination, and they can significantly reduce your costs. But they’re only available if you’re enrolled in Medicare Part B.

If You’re Still Working: Timing Matters

If you’re age 65 or older and still working for the Postal Service, you may be able to delay Medicare Part B without penalty, as long as you have active PSHB coverage due to your employment. But once you retire, the clock starts ticking.

At retirement, you have a Special Enrollment Period (SEP) to enroll in Part B. This period lasts 8 months and begins the day after your employer-sponsored coverage ends. If you miss this window, you’ll have to wait for the General Enrollment Period and may face penalties.

Even if you’re still working, it’s worth reviewing how your specific PSHB plan handles coordination with Medicare. Some plans may still offer enhanced benefits for those enrolled in Part B, even while working.

How This Affects Prescription Drug Coverage

In 2025, PSHB plans automatically integrate prescription drug benefits with Medicare Part D through an Employer Group Waiver Plan (EGWP). If you’re eligible for Medicare and you opt out of Part B, you risk being excluded from this integrated drug coverage.

This means:

  • You won’t have PSHB prescription coverage

  • You’ll be unable to rejoin the PSHB drug plan unless you re-enroll in Part B

  • You could face higher out-of-pocket drug costs

Prescription drug coverage is one of the most significant reasons to consider Medicare Part B. Even if your medical costs seem manageable now, medications can become one of your biggest expenses later in retirement.

Common Misunderstandings About Part B and PSHB

Many retirees assume PSHB alone is enough, especially if they’ve had strong FEHB coverage throughout their careers. But in 2025, PSHB plans are constructed with the expectation that Medicare will share the cost burden once you’re eligible.

Other common misconceptions include:

  • “It’s double coverage.” Not quite—Part B and PSHB coordinate, so you’re not paying for duplicated benefits.

  • “I’ll save money by skipping Part B.” Possibly in the short term, but over time you may lose access to plan enhancements and pay more out of pocket.

  • “I can enroll in Part B whenever I want.” That’s only partially true—if you miss your Special Enrollment Period, you’ll have to wait and potentially pay late penalties.

Making an Informed Choice in 2025

Every PSHB enrollee has a different situation, and while the recommendation to enroll in Medicare Part B is widespread, the final decision is yours. What matters is that you understand the full scope of the consequences.

Consider:

  • Your retirement date

  • Your Medicare eligibility status

  • Whether you fall into an exempt category

  • Your health care needs now and in the future

  • How your PSHB plan handles Medicare coordination

Don’t just guess. Review your plan brochure, compare benefits, and speak with someone who understands both PSHB and Medicare Part B.

Why It Pays to Pay Attention to Medicare Enrollment

The encouragement from your PSHB plan to sign up for Medicare Part B isn’t just a suggestion—it’s often a roadmap to more complete coverage. In 2025, plans are designed to reward those who coordinate benefits and penalize, in effect, those who do not.

What you do when you first become eligible for Medicare can shape your healthcare costs and access for the rest of your retirement. Taking action now—rather than fixing a costly problem later—is the most reliable way to protect your benefits.

To learn how this affects your specific circumstances, speak with a licensed agent listed on this website for personalized guidance.