Key Takeaways

  • Even though Open Season has ended, USPS employees and retirees still have limited opportunities to make changes to their health benefits in 2025.

  • Understanding Qualifying Life Events (QLEs), special exceptions, and available resources can help you stay proactive about your coverage.

Understanding Open Season and Its Limits

Open Season for the Postal Service Health Benefits (PSHB) Program ran from November to December 2024. If you’re a USPS employee or retiree and didn’t make any changes during that time, you might think your options are now locked in for all of 2025. However, there are still situations that allow you to update your benefits—even after the window has closed.

What You Can Still Do After Open Season

Missing Open Season doesn’t mean you’re stuck. Here are your current options to review, adjust, or reevaluate your health benefits:

Qualifying Life Events (QLEs)

You can change your enrollment outside of Open Season if you experience a Qualifying Life Event. In 2025, the PSHB program recognizes several QLEs, such as:

  • Marriage or divorce

  • Birth or adoption of a child

  • Death of a family member

  • A dependent losing or gaining other insurance coverage

  • You or a family member becoming eligible for Medicare

  • Moving out of your current plan’s service area

These events give you a 60-day window from the date of the event to make changes to your benefits.

Special Enrollment Periods for Medicare

If you or your covered spouse become eligible for Medicare Part B in 2025 and previously delayed enrollment, you may qualify for a Special Enrollment Period (SEP). This allows you to enroll in Medicare Part B without late penalties and take advantage of enhanced PSHB coordination benefits.

Some key timelines:

  • The SEP for certain eligible Postal retirees ran from April 1 to September 30, 2024.

  • If you qualify for a future SEP due to loss of employer coverage or relocation, the window typically lasts 8 months.

Medicare Integration and PSHB Coordination

Starting in 2025, the PSHB Program coordinates closely with Medicare. If you’re turning 65 or recently became eligible for Medicare, you must enroll in Part B to maintain full PSHB coverage unless you’re exempt. Exceptions apply to those who:

  • Retired on or before January 1, 2025

  • Were aged 64 or older as of January 1, 2025

  • Reside permanently overseas

  • Are covered by the VA or Indian Health Service

If you’re eligible and not enrolled, you risk losing parts of your PSHB plan, particularly prescription drug coverage.

Prescription Drug Coverage Changes

In 2025, PSHB integrates with Medicare Part D using the Employer Group Waiver Plan (EGWP) model. This change includes:

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

  • A $35 monthly cap on insulin

  • Automatic enrollment in the EGWP if you’re Medicare-eligible

If you opted out or missed Medicare Part B enrollment, you may lose prescription coverage under PSHB. However, limited opportunities may still exist to enroll and regain full benefits.

Key Actions If You Missed Open Season

You can still be proactive. Here’s what to focus on:

1. Evaluate Life Changes

Review any recent or upcoming life changes that might qualify you for a QLE. Even small changes—like a dependent turning 26—can open a brief window to update your plan.

2. Confirm Medicare Part B Status

If you or your spouse recently became eligible for Medicare, check your enrollment status. If you missed your Initial Enrollment Period and are not exempt under PSHB rules, explore whether a Special Enrollment Period applies.

3. Review Your Current PSHB Plan

Plans in 2025 offer varying levels of cost-sharing, coverage networks, and coordination with Medicare. Even if you can’t switch now, reviewing your current plan prepares you for the next Open Season.

Look into:

  • Deductibles (ranging from $350 to $2,000)

  • Copayments and coinsurance (10% to 50%)

  • Out-of-pocket maximums (up to $15,000 for family coverage)

4. Consider Other Federal Benefits

PSHB does not affect other federal benefits. You can still:

  • Enroll in or update your FEDVIP (dental and vision)

  • Adjust TSP allocations anytime

  • Evaluate FEGLI life insurance options during qualifying events

5. Call for Help When Needed

Resources are available year-round:

  • Visit LiteBlue (for current employees)

  • Use KeepingPosted.org (for annuitants)

  • Call the PSHB Navigator Help Line (1-833-712-7742)

Licensed agents listed on this website can also help you interpret your current options.

What to Expect Next Open Season

The next Open Season will take place from November to December 2025. During that time, you’ll be able to:

  • Enroll in a new PSHB plan

  • Switch between Self Only, Self Plus One, and Self and Family coverage

  • Add or drop eligible family members

Open Season changes take effect January 1, 2026. It’s a good idea to review your plan details in October when brochures and comparison tools are released.

If You Made Changes During Last Open Season

If you submitted changes between November and December 2024, those changes took effect on January 1, 2025. Still, it’s a good idea to verify:

  • Whether your new plan reflects what you selected

  • If all dependents are correctly listed

  • That premiums are being deducted correctly from your annuity or paycheck

Mistakes or discrepancies can sometimes be corrected within the first 30 to 60 days of the new plan year, especially if you act quickly.

Common Misunderstandings About Post-Open Season Options

Some USPS workers and retirees think there’s nothing they can do after Open Season. But that’s not always true. Let’s clear up some common misunderstandings:

  • Myth: “I can’t change anything until next year.”

    • Reality: QLEs and Medicare events can still open opportunities.

  • Myth: “If I miss Medicare Part B enrollment, I’m permanently locked out.”

    • Reality: You may qualify for a Special Enrollment Period, especially after losing employer coverage.

  • Myth: “My PSHB plan covers everything even without Medicare.”

    • Reality: Starting in 2025, some benefits—like prescription drugs—may be reduced or lost if you don’t enroll in Part B when required.

Keep Your Benefits Aligned With Your Needs

Life doesn’t always follow an annual schedule, and thankfully, neither does your ability to manage your federal benefits. If you missed the 2024 Open Season, you still have paths forward.

Take time now to:

  • Understand your QLE rights

  • Monitor upcoming eligibility for Medicare

  • Reassess your current PSHB plan benefits

If you’re unsure what steps to take, get in touch with a licensed agent listed on this website for guidance tailored to your situation.