Key Takeaways

  • Not all hospitals you’ve used before are guaranteed to be in-network under your new PSHB plan in 2025. Checking hospital network status now can prevent major billing surprises later.

  • Use official PSHB plan directories and confirmation calls to your hospital’s billing department to verify your coverage before you need care.

Why Hospital Networks Matter More in 2025

As of January 1, 2025, the Postal Service Health Benefits (PSHB) Program officially replaced FEHB coverage for USPS employees and retirees. While many enrollees assumed this change would be seamless, the truth is more complicated—especially when it comes to hospitals.

Your hospital’s in-network status directly affects your out-of-pocket costs. In-network hospitals have agreed to your plan’s payment terms, while out-of-network ones haven’t—and the price difference can be staggering. You could go from a standard deductible and copay to thousands in coinsurance if you’re not careful.

What Changed With the Shift to PSHB

  • Plan Networks Were Redefined: Many plans under PSHB redesigned their provider networks, even if they sound familiar.

  • New Contracts Took Effect: Hospitals that accepted your FEHB plan in 2024 might not have signed on with the corresponding PSHB plan in 2025.

  • Coverage Under Medicare Advantage Terms: For Medicare-eligible retirees, PSHB plans often pair with Medicare Part B and include a Medicare Advantage structure. Hospital coverage may vary in this setup.

This makes confirming hospital participation in your PSHB plan not just smart—but essential.

How to Check if Your Hospital Is In-Network

You have several options to verify hospital participation under your new PSHB plan:

1. Start With the PSHB Plan’s Directory

  • Log in to your PSHB plan’s member portal.

  • Use the online provider directory to search for your hospital.

  • Make sure you are searching under the correct plan year—2025.

Be specific when searching. Some hospital systems have multiple campuses, and not all are covered the same way.

2. Call the Hospital Directly

Contact the hospital’s billing or insurance verification department and ask:

  • “Is this hospital considered in-network under [insert exact plan name] in 2025?”

  • “Is this facility participating in the PSHB plan for postal retirees or employees?”

Get the name of the person you spoke to and note the date. If needed later, this documentation may help in a dispute.

3. Confirm With the Plan’s Customer Service

Reach out to the PSHB plan’s customer support and ask them to verify:

  • The network status of your hospital

  • The specific coverage terms (e.g., inpatient care, emergency visits)

Request a confirmation email or documentation for your records.

What Happens if You Use an Out-of-Network Hospital

When you use an out-of-network hospital under your PSHB plan:

  • You may face higher coinsurance, such as 40% to 50% instead of 10% to 30%.

  • Out-of-network deductibles are usually much higher—sometimes double or more compared to in-network.

  • Your total out-of-pocket costs can hit the higher cap, which for PSHB plans may be up to $15,000 for family coverage.

Keep in mind: emergency services are usually covered even out-of-network, but follow-up care at the same hospital might not be.

What to Ask Before You Need Hospital Care

Whether you’re planning a procedure or just want to be prepared, here’s what to confirm:

  • Is the hospital in-network for all departments? Some services, like imaging or outpatient surgery, may be billed separately.

  • Are the specialists at the hospital in-network? Your surgeon might be covered, but the anesthesiologist might not.

  • Does the hospital offer Medicare coordination under your PSHB plan? If you’re enrolled in Medicare Part B, this is critical.

Verifying these details ahead of time helps avoid coverage gaps and billing surprises.

Don’t Confuse Plan Names With Network Access

Just because a plan under PSHB has a familiar name, that doesn’t guarantee your hospital is in-network. Many large systems rebrand or reassign their networks when contracts change.

Example: Your plan may still carry the same insurer’s name, but the hospital agreement from 2024 may no longer be valid in 2025.

If You Need to Change Your Hospital

If your preferred hospital isn’t in-network:

  • Consider switching to a PSHB plan that includes it, but only during Open Season (November to December each year).

  • Look for nearby in-network alternatives that offer similar care quality.

  • Consult with your primary care doctor to transfer records if needed.

Being proactive can preserve your access to quality care while avoiding excess costs.

When Emergencies Happen

All PSHB plans are required to cover emergency care, even if you’re taken to a hospital that’s out-of-network. However:

  • Once you’re stabilized, your plan may require you to transfer to an in-network hospital for further treatment.

  • Ongoing care at an out-of-network facility could become costly.

It’s best to be prepared with knowledge of the nearest in-network hospitals in your area—even for emergencies.

Medicare-Enrolled? Check for Dual Participation

If you’re a Medicare-eligible annuitant, your PSHB plan likely integrates with Medicare Part B. But not all hospitals participate in both Medicare and your PSHB plan’s network.

To check:

  • Ask if the hospital accepts Medicare assignment.

  • Confirm if they are also contracted with your PSHB plan’s Medicare Advantage component (if applicable).

Some facilities accept Medicare but don’t participate in specific PSHB plan networks, especially for outpatient services.

Keep Your Info Updated

Make a habit of checking hospital network status every year during Open Season. Contracts change. Networks shift. What was true in 2025 may be different in 2026.

Also update:

  • Your emergency contacts

  • Your primary care provider listing in your PSHB plan’s system

  • Your preferences in your online portal

Staying current helps avoid confusion when it matters most.

Informed Choices Start Now

You shouldn’t wait until you’re in the ER to learn your hospital is out-of-network. Take the time now to:

  • Review your PSHB plan’s 2025 network

  • Contact your hospital’s billing office

  • Confirm your providers and specialists are covered

If something doesn’t line up, there’s still time to adjust for next Open Season—or explore care at a network facility now.

Act Now to Protect Your Health and Budget

Making sure your hospital is in-network under your 2025 PSHB plan isn’t just smart—it’s a financial and medical safeguard. With rising healthcare costs, you can’t afford to assume your past coverage equals current access. Get informed, verify early, and take the steps necessary to protect your peace of mind.

If you’re unsure where to start or need help reviewing your plan’s hospital network, speak with a licensed agent listed on this website for support tailored to your coverage.