Key Takeaways

  • If you missed the PSHB Open Season in 2024, your options in 2025 are limited unless you experience a qualifying life event (QLE).

  • Some retirees and employees may still maintain or adjust their coverage through special enrollment rules, depending on their specific circumstances.

Understanding the 2024 PSHB Open Season

The Postal Service Health Benefits (PSHB) Program officially replaced FEHB for USPS employees and annuitants beginning January 1, 2025. The Open Season ran from November 11 to December 9, 2024. If you did not take action during that period, you may be wondering where that leaves you now in 2025.

USPS employees and retirees who missed the enrollment window now need to understand what coverage they have, what they might have lost, and what limited options remain available to them.

What Happens If You Took No Action During Open Season

If you were already enrolled in an FEHB plan before Open Season, you were automatically enrolled in a corresponding PSHB plan as of January 1, 2025. The Office of Personnel Management (OPM) attempted to match you with a similar plan, often from the same carrier.

However, this automatic enrollment means:

  • You may not have the most cost-effective or comprehensive plan for your needs.

  • You cannot make changes now unless you qualify for a special enrollment period (SEP).

  • Your current coverage is locked in until the next Open Season or until you experience a QLE.

If you were not enrolled in FEHB prior to the 2024 Open Season, you were not automatically enrolled in PSHB and have no current coverage unless you meet certain exceptions.

Special Enrollment Period (SEP) Exceptions

There are limited scenarios where you may still be able to enroll or make changes to your PSHB coverage in 2025. These include:

1. Qualifying Life Events (QLEs)

USPS workers and retirees may qualify for a SEP if they experience life events such as:

  • Marriage or divorce

  • Birth or adoption of a child

  • Loss of other health coverage

  • Relocation to an area where your current plan isn’t offered

In these cases, you typically have 60 days from the event to request changes.

2. Medicare Part B Enrollment Exception

If you are a Medicare-eligible annuitant or family member and missed your opportunity to enroll in Medicare Part B in 2024, the PSHB-specific SEP for Part B ran from April 1 to September 30, 2024. If you failed to act, you are not eligible for another PSHB-specific SEP in 2025.

However, if you become newly eligible for Medicare in 2025, you will still have your Initial Enrollment Period (IEP), which lasts for seven months—three months before, the month of, and three months after your 65th birthday.

3. Error or Miscommunication

In rare cases, if you missed enrollment due to an error on the part of OPM or USPS, you may file a reconsideration request. Supporting documentation is required, and outcomes are not guaranteed.

Your Current Coverage Status in 2025

To understand where you stand, take the following steps:

  • Confirm your plan by checking your enrollment confirmation through LiteBlue (for employees) or KeepingPosted.org (for annuitants).

  • Review benefits and costs associated with your automatically assigned PSHB plan. These may include new copayments, deductibles, coinsurance, and out-of-pocket maximums.

  • Compare to 2024 to see if any key benefits changed.

Some plans have:

  • Higher in-network deductibles (up to $2,000 for families)

  • Copayments ranging from $20 for primary care to $150 for emergency room visits

  • Coinsurance of 10%-30% in-network, and as high as 50% out-of-network

What You Can Do Now to Prepare for the Next Enrollment

Even if you missed the 2024 window, it’s important to prepare for the next one in late 2025. Here are steps to take:

1. Track Key Enrollment Periods

  • The next PSHB Open Season will occur from November to December 2025.

  • Medicare’s Annual Enrollment runs from October 15 to December 7, 2025.

  • Watch for any notices from OPM or USPS regarding changes to eligibility, benefits, or plan offerings.

2. Review Plan Brochures

Each PSHB plan offers an official brochure outlining benefits, exclusions, and costs. Read these documents carefully to:

  • Identify cost-saving opportunities

  • Evaluate your provider network

  • Understand prescription drug coverage and limitations

3. Consider Medicare Coordination

If you are Medicare-eligible, especially if you’re retired, review whether you’re enrolled in both Parts A and B. Many PSHB plans integrate with Medicare and offer:

  • Waived deductibles

  • Lower cost-sharing

  • Expanded pharmacy networks

4. Update Personal Information

Make sure your address, dependent information, and Medicare details are current in the system to avoid delays or errors during the next enrollment period.

5. Talk to a Licensed Agent

A licensed agent can help you:

  • Understand your current benefits

  • Compare your PSHB plan to alternatives for the next enrollment

  • Determine whether your needs are being met

What If You Opted Out of Drug Coverage?

For Medicare-eligible annuitants, prescription drug benefits are integrated into PSHB via a Medicare Part D Employer Group Waiver Plan (EGWP). If you opted out of this coverage in 2024, you do not have prescription drug coverage through PSHB in 2025.

Important points:

  • Opting out limits your ability to re-enroll unless you qualify for a future SEP.

  • Drug coverage includes a $2,000 out-of-pocket cap for 2025 and insulin capped at $35 per month.

  • Missing drug coverage could lead to higher out-of-pocket spending.

FEDVIP, FEGLI, and Other Benefits Are Unaffected

Missing the PSHB Open Season does not impact your eligibility for other federal benefits. You can still:

  • Enroll in or make changes to FEDVIP (vision and dental)

  • Maintain your FEGLI (life insurance) policies

  • Participate in FSAFEDS during its own enrollment window

Retirees Living Abroad or Covered by VA or Indian Health Services

If you’re living outside the U.S. or covered under the VA or Indian Health Services, you may be exempt from the Medicare Part B requirement under PSHB. However, you still need to be enrolled in a PSHB plan to maintain coverage.

It’s essential to:

  • Contact OPM or a licensed agent to understand your exemption status

  • Verify whether your PSHB plan provides international coverage or coordinates with VA benefits

Don’t Wait for the Next Open Season to Get Help

Just because you missed the enrollment period doesn’t mean you have to stay in the dark. Take proactive steps now to ensure you’re ready for the next opportunity. Understanding your current plan, identifying any gaps, and preparing questions for a licensed agent will make the 2025 Open Season easier to navigate.

Make Sure You’re Ready for 2026

Missing the enrollment period may limit your options, but it doesn’t have to derail your long-term health coverage plans. Whether you’re a USPS employee, annuitant, or family member, knowing your current coverage and preparing early can set you up for better choices in the future.

Reach out to a licensed agent listed on this website for expert guidance tailored to your situation.