Key Takeaways

  • Not every USPS retiree or employee is required to enroll in Medicare Part B in 2025, due to specific exemptions.

  • Understanding these exceptions can help you avoid unnecessary costs and preserve your existing health coverage.

Understanding Medicare Part B and Your USPS Coverage

As a current or retired United States Postal Service (USPS) employee, you’re probably aware of the transition to the Postal Service Health Benefits (PSHB) Program, which began in 2025. This program replaces the Federal Employees Health Benefits (FEHB) Program for postal workers and introduces new requirements—especially when it comes to Medicare.

Medicare Part B covers outpatient services, including doctor visits, preventive care, and some medical equipment. In 2025, monthly premiums and annual deductibles for Part B continue to rise, which makes understanding whether you’re required to enroll more important than ever.

When Medicare Part B Is Generally Required

For USPS annuitants and their covered family members, enrolling in Medicare Part B is generally required if both of the following apply:

  • You are entitled to Medicare Part A (usually premium-free for most retirees).

  • You are enrolled in the PSHB Program and are Medicare-eligible.

However, there are clearly defined exceptions in 2025 that allow certain individuals to forgo Medicare Part B enrollment without risking the loss of PSHB coverage.

Who Is Exempt from the Medicare Part B Requirement in 2025

Here are the groups of USPS retirees and employees who are currently exempt from the Part B requirement under the PSHB Program:

1. You Retired on or Before January 1, 2025

If you officially retired from USPS on or before January 1, 2025, you are not required to enroll in Medicare Part B to maintain your PSHB plan. You have the option to enroll later, but you will not be automatically removed from your PSHB plan if you choose not to.

2. You Are an Active USPS Employee Aged 64 or Older as of January 1, 2025

Active USPS employees who were 64 or older on January 1, 2025, are grandfathered into the system. This means that once you retire, you are not obligated to enroll in Medicare Part B to retain your PSHB benefits.

3. You Live Outside the United States

If you permanently reside outside the United States and its territories, you are not required to enroll in Medicare Part B. However, it’s important to know that Medicare does not provide coverage outside the U.S., so your decision may depend on your access to other forms of health care in your country of residence.

4. You Receive Health Care Through the Indian Health Service (IHS) or the Department of Veterans Affairs (VA)

You are exempt from the Medicare Part B enrollment requirement if you:

  • Are eligible for health services through the Indian Health Service (IHS), or

  • Receive benefits through the U.S. Department of Veterans Affairs (VA).

In these cases, PSHB coverage will remain intact without mandatory Medicare Part B enrollment.

5. You Have a Temporary Delay or Exceptional Circumstance

There are limited cases in which a temporary delay may be granted due to an exceptional circumstance. You must apply for a waiver and have it approved. This typically requires documentation of hardship or a qualifying event.

What Happens If You’re Not Exempt and Skip Part B

If you are required to enroll in Medicare Part B and choose not to do so, your PSHB coverage will no longer include benefits that coordinate with Medicare. In other words:

  • You could lose drug coverage if your PSHB plan includes a Medicare Part D component.

  • You may be responsible for higher out-of-pocket costs.

  • You may not be able to re-enroll in the same plan later without meeting specific criteria.

It’s important to carefully weigh your decision, as declining Part B without an exemption can affect both your health and your finances.

Prescription Drug Coverage and Part B Opt-Out Consequences

All PSHB plans for Medicare-eligible annuitants automatically include Medicare Part D prescription drug coverage through an Employer Group Waiver Plan (EGWP). If you opt out of Medicare Part B, you may also be removed from the EGWP drug benefit.

Key points to consider:

  • Your prescription coverage may be limited or lost.

  • You might not have an opportunity to enroll again unless you qualify for a future Special Enrollment Period.

  • Re-enrollment is restricted and not guaranteed, especially if you voluntarily declined Part B and lost eligibility.

Special Enrollment Periods (SEPs) and Late Enrollment

If you initially qualify for an exception but later become eligible or choose to enroll in Medicare Part B, a Special Enrollment Period (SEP) may apply. For example:

  • If you return to the U.S. after living abroad, you may qualify for an SEP.

  • If you lose VA or IHS eligibility, you might get another chance to enroll.

However, if no SEP applies and you missed your Initial Enrollment Period (IEP), you may have to wait until the General Enrollment Period (January 1 to March 31 each year), and your coverage wouldn’t start until July 1. Late enrollment also means you could face a lifelong penalty on your Part B premiums.

How USPS Annuitants Were Notified in 2024

In 2024, the Office of Personnel Management (OPM) sent notifications to USPS annuitants and eligible family members who would be required to enroll in Medicare Part B. These notices were issued before the PSHB Open Season began in November.

They included details like:

  • Whether the enrollee was subject to the new requirement.

  • Instructions for enrolling in Medicare Part B.

  • Information about available assistance.

If you were not notified in 2024, and you fall into one of the exempt categories, you are not expected to enroll in Part B in 2025.

What You Should Do Now If You’re Unsure

If you’re unsure whether you need to enroll in Medicare Part B:

  • Review the 2024 notification letter you received from OPM.

  • Contact the PSHB Navigator Help Line at 1-833-712-7742.

  • Talk to a licensed agent listed on this website for personalized guidance.

  • Check your retirement date and current age.

  • Consider your current residence and whether you qualify under IHS or VA services.

Staying Informed in 2025 and Beyond

USPS employees and retirees should stay up to date on evolving Medicare rules, especially if you’re approaching retirement. Keep the following in mind:

  • The PSHB Program requires annual review during Open Season (November to December).

  • Medicare eligibility typically begins at age 65.

  • Medicare Part A is usually premium-free, but Part B comes with a monthly premium.

  • The cost of late enrollment penalties can add up over time.

Understanding your responsibilities in 2025 helps you protect your health benefits, manage your expenses, and avoid gaps in care.

Make Informed Decisions About Your Part B Enrollment

Choosing whether to enroll in Medicare Part B as a USPS retiree or employee isn’t always straightforward. But knowing the exceptions can save you from making a costly mistake. Review your retirement status, age, and access to alternate healthcare sources like the VA or IHS. Don’t let uncertainty put your PSHB benefits at risk.

For tailored help, contact a licensed agent listed on this website who can walk you through your personal situation and recommend the best next steps.