Key Takeaways

  • The Postal Service Health Benefits (PSHB) program provides exclusive health coverage for USPS employees, retirees, and eligible family members, replacing FEHB in 2025.

  • Understanding coverage options, costs, Medicare integration, and enrollment requirements ensures you make the best decision for your healthcare needs.

What You Need to Know About PSHB Benefits in 2025

The Postal Service Health Benefits (PSHB) program is now in full effect, providing tailored health coverage for USPS employees, retirees, and their families. With the transition from the Federal Employees Health Benefits (FEHB) program, you need to understand how PSHB works and how it impacts your healthcare options.

If you are part of the USPS workforce or a retired postal employee, knowing the details of PSHB can help you navigate your choices and avoid unnecessary costs. Here’s a breakdown of the four most essential aspects of PSHB coverage.

1. Who is Eligible for PSHB Coverage?

PSHB coverage applies specifically to USPS employees, retirees, and eligible family members. While it follows many of the same structures as FEHB, it is a separate program exclusively for postal workers. Here’s who qualifies:

  • Active USPS employees: If you work for the Postal Service, you are eligible to enroll in a PSHB plan.

  • Retired postal employees: Annuitants can continue coverage under PSHB, but eligibility rules differ slightly from active employees.

  • Spouses and dependents: Eligible family members, including spouses and children under 26, can be covered.

  • Survivors: Some survivors of deceased postal employees or retirees may also be eligible for continued coverage.

One significant change is that some retirees will need to enroll in Medicare Part B to maintain PSHB coverage. If you retired before January 1, 2025, you are exempt from this requirement, but anyone retiring afterward will need to enroll in Medicare Part B upon becoming eligible.

2. PSHB Costs and Premium Contributions

One of the biggest factors in selecting a health plan is cost. PSHB premiums are structured similarly to FEHB, with the federal government covering a significant portion of your premium. However, you are responsible for paying the remainder through payroll deductions (for active employees) or annuity deductions (for retirees).

What to Expect in Terms of Costs:

  • Premiums: Vary based on plan selection, coverage type (Self Only, Self Plus One, or Self & Family), and whether you are actively employed or retired.

  • Deductibles: Depending on your plan choice, in-network deductibles can range from a few hundred dollars to over a thousand.

  • Copayments and Coinsurance: Out-of-pocket costs for doctor visits, prescriptions, and hospital stays depend on whether you choose an in-network or out-of-network provider.

  • Out-of-Pocket Maximums: There are annual caps on how much you pay in a year before your plan covers 100% of costs.

To get the most out of your plan, reviewing cost-sharing details before selecting a PSHB plan is crucial.

3. Medicare Integration for Retirees

A major change with PSHB is how it integrates with Medicare. If you are a retired postal worker and eligible for Medicare, here’s what you should know:

  • Mandatory Medicare Part B Enrollment: If you retired on or after January 1, 2025, and are eligible for Medicare, you must enroll in Medicare Part B to keep your PSHB coverage.

  • Cost Savings for Medicare Enrollees: Many PSHB plans coordinate with Medicare to lower out-of-pocket costs, including reduced copayments and deductibles.

  • Prescription Drug Coverage: PSHB retirees who have Medicare are automatically enrolled in a Medicare Part D Employer Group Waiver Plan (EGWP) for prescription drug benefits, helping to manage medication costs.

This integration ensures that retirees have access to comprehensive healthcare coverage while taking advantage of Medicare benefits.

4. Enrollment and Open Season Deadlines

Enrolling in PSHB is only possible during designated enrollment periods unless you experience a qualifying life event (QLE). Here’s what you need to keep in mind:

Open Season for PSHB

The Open Season for PSHB takes place annually, typically from mid-November to mid-December. During this period, you can:

  • Enroll in a new PSHB plan

  • Make changes to your existing plan

  • Add or remove eligible family members

Special Enrollment Periods

Outside of Open Season, you can only make changes to your PSHB plan if you have a QLE, such as:

  • Marriage or divorce

  • Birth or adoption of a child

  • Loss of other health insurance coverage

  • Retirement or separation from USPS

Keeping track of these deadlines ensures you do not miss an opportunity to enroll in or adjust your plan.

Making the Right PSHB Choice for Your Needs

Choosing a PSHB plan depends on several factors, including your health needs, budget, and whether you are retired or actively employed. To make an informed decision, consider:

  • Plan Costs: Look at premiums, deductibles, copayments, and coinsurance.

  • Provider Networks: Ensure your preferred doctors and hospitals are in-network.

  • Medicare Coordination: If you are retired, check how PSHB integrates with Medicare to reduce your out-of-pocket expenses.

  • Prescription Drug Coverage: Review the drug formulary to ensure your medications are covered affordably.

Taking time to compare plans and understand your options ensures you select the best coverage for your situation.

Get Help from a Licensed Agent

Understanding PSHB benefits can be complex, but you don’t have to navigate it alone. Licensed agents listed on this website can help answer your questions, compare plan options, and guide you through the enrollment process. Speaking with an expert ensures you make an informed decision about your healthcare coverage.