Key Takeaways

  • Missing or misunderstanding key deadlines can lead to delays in PSHB coverage or unwanted changes in your health plan.

  • Failing to consider your Medicare status or ignoring plan details can result in higher out-of-pocket costs or loss of benefits.

Understand What Open Season Means for PSHB in 2025

The 2025 Open Season marks a major shift for Postal Service employees and retirees, as it is the first full year of enrollment under the new Postal Service Health Benefits (PSHB) Program. This Open Season occurs from November to December, giving you a limited window to review, change, or confirm your health plan for the upcoming year.

During this period, you must:

  • Enroll in a PSHB plan if you’re currently covered under the old FEHB program.

  • Review plan brochures to assess coverage changes, premiums, deductibles, and out-of-pocket limits.

  • Coordinate your plan choice with your Medicare status if you’re 65 or older.

1. Ignoring the PSHB Transition Requirements

If you’re still relying on your old FEHB coverage, you may be automatically transitioned to a PSHB plan. However, automatic enrollment does not mean it’s the best fit for your needs.

Here’s what to be mindful of:

  • Automatic enrollment is based on your current FEHB plan but may not offer the same cost-sharing or network access under PSHB.

  • You may lose access to certain features unless you actively choose a better-suited plan.

  • Retirees should ensure that family members are still eligible under the new plan.

Take time this Open Season to actively select a PSHB plan that reflects your health needs and financial considerations.

2. Failing to Consider Medicare Part B Enrollment

For Medicare-eligible retirees and their family members, enrolling in Medicare Part B is mandatory to maintain full PSHB coverage—unless you fall under a listed exemption:

  • Retired on or before January 1, 2025

  • Age 64 or older as of January 1, 2025

  • Living abroad

  • Receiving health benefits through Indian Health Services or the VA

Failing to enroll in Medicare Part B when required can mean losing access to the prescription drug coverage bundled with PSHB. Even if you are automatically transitioned into a PSHB plan, skipping Part B could disqualify you from important benefits.

3. Overlooking Prescription Drug Coverage Changes

Prescription drug coverage under PSHB is integrated with Medicare Part D through an Employer Group Waiver Plan (EGWP) for Medicare-eligible enrollees. If you opt out of this Part D coverage:

  • You will lose your drug coverage under PSHB.

  • You won’t be able to re-enroll until the next Open Season or qualifying life event.

  • Your out-of-pocket prescription costs could rise significantly.

The integrated Part D coverage also includes key features like a $2,000 out-of-pocket maximum and a $35 insulin cap. Be sure to read your plan’s drug formulary and benefit description to confirm your medications are covered.

4. Not Comparing Plan Options Thoroughly

Although you may be automatically enrolled in a comparable PSHB plan, the term “comparable” doesn’t always mean equal. Each PSHB plan may vary in:

  • Monthly premiums and biweekly deductions

  • Deductibles and coinsurance

  • Provider networks

  • Coverage for dental, vision, or preventive services

Use the Open Season window to compare these factors in detail. Evaluate plans using your:

  • Current providers and whether they’re in-network

  • Regular prescriptions and their cost under the plan’s drug list

  • Projected medical visits and potential out-of-pocket maximums

5. Missing Open Season Deadlines

Open Season typically runs from mid-November to mid-December, and in 2025, that time frame remains the same. Missing this period means:

  • You’ll be stuck with your default PSHB plan for the next year

  • You won’t be able to change plans unless you experience a Qualifying Life Event (QLE), such as marriage, divorce, or a move

  • You risk increased costs or losing access to preferred providers

Mark your calendar and take action early. Don’t wait until the final week of Open Season to review and enroll.

6. Assuming Your Plan Covers What It Did Last Year

Many retirees and employees assume that a similar-sounding plan under PSHB will offer the same benefits they had under FEHB. But 2025 marks a shift in:

  • Coinsurance rates (often between 10% and 30% for in-network services)

  • Copayments for office visits, urgent care, or specialist visits

  • Out-of-pocket maximums (up to $7,500 for Self Only and $15,000 for Self Plus One or Family)

Do not assume that plan benefits have remained unchanged. Review the 2025 PSHB brochures carefully for updates on:

  • Cost-sharing for labs, imaging, and emergency services

  • Preventive care and wellness benefits

  • Special features for Medicare enrollees (like premium reimbursements or reduced cost-sharing)

7. Ignoring Family Member Eligibility

Under PSHB rules, only eligible family members can remain on your health plan. This includes:

  • Your spouse

  • Your children under age 26

  • Disabled adult children if eligibility conditions are met

If your family member was eligible under FEHB but no longer qualifies under PSHB, they will lose coverage. You must update your enrollment during Open Season to reflect accurate dependent information.

Be proactive in checking your dependent list, and remove or add individuals based on updated eligibility rules.

8. Not Understanding Cost-Sharing Differences

Some PSHB plans are shifting more cost-sharing to enrollees. In 2025, plans commonly include:

  • Deductibles: Ranging from $350 for low-deductible plans to $2,000 for high-deductible plans

  • Coinsurance: Often 10%–30% for in-network services, up to 50% for out-of-network

  • Copays: $20–$40 for primary care, $30–$60 for specialists, and $100–$150 for ER visits

If you’re on a fixed income or expect higher medical utilization, these changes can have a big impact. Weigh these elements alongside premiums to see your true total cost of coverage.

9. Waiting Too Long to Seek Help

With the changes that PSHB brings, you may have questions about:

  • How to enroll

  • What plan fits best based on your Medicare status

  • What benefits you’ll retain or lose

Avoid waiting until the last week of Open Season to get help. Use available resources like:

  • The PSHB Navigator Help Line

  • Plan brochures on the OPM website

  • Licensed agents who specialize in PSHB transitions

Early support gives you more time to weigh your choices and avoid rushed decisions.

10. Assuming You’re Exempt from Action

Even if you fall under one of the exemption categories (like retiring before January 1, 2025), it’s still important to review your plan:

  • Exemptions only apply to Medicare Part B enrollment—not to PSHB plan participation itself

  • You still must confirm that the plan you’re enrolled in works with your current providers and prescriptions

  • PSHB costs may differ from your prior FEHB plan even if coverage seems similar

Exempt status doesn’t mean you can skip Open Season altogether. It only means you may avoid a specific Medicare requirement. You still need to stay informed and review your options.

Prepare Ahead and Make the Most of Open Season

The 2025 Open Season is a critical time for USPS employees and retirees to make informed decisions about their health benefits. With the transition to PSHB fully in effect, overlooking details—whether related to Medicare, plan comparisons, or coverage limits—can lead to unexpected costs and coverage gaps.

Give yourself time to:

  • Understand PSHB-specific rules and costs

  • Align your Medicare coverage correctly

  • Reassess your plan selection based on family needs, drug coverage, and provider access

If you’re unsure where to start or want expert input, get in touch with a licensed agent listed on this website for professional advice tailored to your situation.