Key Takeaways

  • Being auto-enrolled into a Postal Service Health Benefits (PSHB) plan in 2025 does not guarantee that the plan is the best fit for your specific needs or budget.

  • USPS employees and retirees should review their plan options annually during Open Season to ensure their coverage aligns with changing health needs and financial situations.

What Auto-Enrollment Means in 2025

If you’re a United States Postal Service (USPS) employee or retiree, you may already know that 2025 marks the official transition from the Federal Employees Health Benefits (FEHB) Program to the new Postal Service Health Benefits (PSHB) Program. As part of this shift, many enrollees are being automatically moved to a comparable PSHB plan to avoid lapses in coverage.

Auto-enrollment sounds convenient—and in some ways, it is. However, it does not mean you’re set for the long term. You’re automatically enrolled based on your current FEHB plan, but that doesn’t guarantee the new PSHB plan aligns perfectly with your future medical needs, prescription drug requirements, or financial goals.

Who Gets Auto-Enrolled?

The following groups are subject to auto-enrollment:

  • Current USPS employees and annuitants already enrolled in an FEHB plan as of late 2024.

  • Covered family members who are part of that FEHB plan.

You’ll be transitioned into a PSHB plan that closely resembles your existing FEHB coverage. However, resemblance isn’t always enough. This is particularly important if your health status or financial needs have changed—or will change soon.

What You Might Miss If You Don’t Review Your Options

1. Cost-Sharing Differences

Even if the plan you’re auto-enrolled into looks the same on paper, there could be key differences:

  • In-network deductibles may have increased.

  • Out-of-pocket maximums might be higher.

  • Coinsurance rates for specialty care or emergency services could differ.

You may also face changes in:

  • Copayments for primary care and specialists.

  • Prescription drug tiers and coverage.

  • Premium contributions, especially if you’re a retiree paying a fixed share each month.

2. Medicare Part B Coordination

If you’re eligible for Medicare, the PSHB plan you’re auto-enrolled in may coordinate differently with Medicare Part B than your previous FEHB plan. For instance:

  • Some PSHB plans waive deductibles or reduce copays if you’re enrolled in Medicare Part B.

  • Others offer additional support for high-cost prescriptions if you have Medicare.

However, if you aren’t enrolled in Medicare Part B—and you’re required to be—you could face a loss of drug coverage under the integrated Part D Employer Group Waiver Plan (EGWP). This is especially critical for annuitants retiring before January 1, 2025, who may not be exempt.

3. Network Changes and Provider Access

You could lose access to a doctor or specialist you currently see. Even if you stay within a similar plan, provider networks can change between FEHB and PSHB. Always check to confirm your preferred doctors, hospitals, and specialists are still considered in-network.

4. Prescription Drug Coverage Adjustments

In 2025, PSHB plans offer enhanced integration with Medicare Part D for eligible enrollees, including:

  • A $2,000 out-of-pocket cap on prescription drugs.

  • A $35 monthly insulin copay cap.

  • An expanded pharmacy network.

If you don’t compare options, you might miss out on these savings or, worse, opt out of Part D integration by mistake—losing access to drug coverage entirely under PSHB.

When You Can Make Changes

You aren’t locked into your auto-enrolled PSHB plan permanently. The Open Season runs from November to December each year, providing the window to:

  • Compare all available PSHB plans.

  • Evaluate your needs for the coming year.

  • Enroll in a different PSHB plan that better suits your health, financial, or family requirements.

Special Enrollment Considerations for Medicare Part B

Some USPS annuitants and their eligible family members are required to enroll in Medicare Part B to maintain drug coverage. If you haven’t done so yet, this can trigger a Special Enrollment Period (SEP).

The SEP in 2024 ran from April 1 to September 30, giving eligible individuals the chance to avoid penalties and maintain PSHB coverage in 2025. If you missed this SEP and didn’t enroll in Part B, your drug coverage under PSHB may be affected.

Not all retirees are required to enroll, though. You are exempt if you:

  • Retired on or before January 1, 2025.

  • Were 64 years old or older as of January 1, 2025.

  • Live abroad.

  • Receive care through Veterans Affairs or Indian Health Services.

Still, it’s essential to confirm whether you’re required to enroll or qualify for exemption.

Other Benefits That Remain Unchanged

Despite the transition, not everything changes. It’s important to know what stays the same:

  • FEDVIP: You can still enroll in the Federal Employees Dental and Vision Insurance Program separately.

  • FSAFEDS: Employees (not retirees) can still use Flexible Spending Accounts for eligible expenses.

  • FEGLI: Life insurance benefits under the Federal Employees’ Group Life Insurance continue without disruption.

  • FLTCIP: Long-Term Care Insurance for those already enrolled remains active, though new enrollments are still suspended.

Why Comparing Plans Matters More Than Ever

Every year brings new health challenges, aging concerns, and potential income changes. What was right for you in 2024 may no longer work in 2025. Relying solely on auto-enrollment can lead to:

  • Higher out-of-pocket costs.

  • Missed Medicare coordination benefits.

  • Inadequate prescription drug coverage.

  • Limited provider access.

By reviewing your plan options during Open Season, you take control of your health and financial future.

What You Should Do Now

To make sure you’re in the right plan for 2025:

  • Log into your benefits portal—LiteBlue for employees, KeepingPosted.org for annuitants.

  • Review the plan comparison tools provided.

  • Confirm your Medicare Part B enrollment status if you’re eligible.

  • Check your provider network.

  • Evaluate total cost—not just premiums, but also copays, deductibles, and drug expenses.

  • Watch for your Annual Notice of Change (ANOC) letter and compare the details.

Taking Control of Your Health Coverage

Auto-enrollment under the PSHB program keeps your coverage continuous, but it doesn’t ensure it’s the right fit. Make the most of Open Season each year by re-evaluating your needs and checking your plan against others. You could uncover better options for cost savings, coverage, and care access.

Need help sorting through your choices? Speak with a licensed agent listed on this website for guidance tailored to your situation.