Key Takeaways:

  • Postal workers must carefully evaluate their healthcare options during the first-ever Postal Service Health Benefits (PSHB) Open Season from November 11, 2024, to December 9, 2024, in order to ensure they have the best coverage in place for 2025.

  • If you’re not enrolled in Medicare Part B yet, and you’re nearing or past age 65, this Open Season is your last chance to sign up for the right PSHB plan, as enrollment becomes mandatory for future retirees to maintain PSHB coverage.

The Time to Act Is Now: PSHB’s First Open Season Kicks Off

The Postal Service Health Benefits (PSHB) program’s first Open Season is upon us, and it’s something that every postal worker and retiree should take seriously. The Open Season, running from November 11, 2024, to December 9, 2024, is your window to select the health plan that fits your needs, with changes going into effect on January 1, 2025. For many, this may feel like a monumental shift from the familiar FEHB system, but with the right knowledge and a little planning, you’ll make the transition seamlessly.

I get it—dealing with health insurance changes can be overwhelming, especially when it seems like the whole system is being revamped. But don’t panic. With this guide, I’ll walk you through everything you need to know about this Open Season and how to make sure you’re ready for the changes coming your way.

PSHB vs. FEHB: What’s Really Changing?

If you’ve been enrolled in the Federal Employees Health Benefits (FEHB) program, you’ve probably heard all the buzz about PSHB. The Postal Service Health Benefits (PSHB) program, created as part of the Postal Service Reform Act of 2022, is a new health plan tailored specifically for postal workers. This program replaces FEHB coverage for postal employees, and it’s being rolled out for the first time during the 2024 Open Season.

So, what’s different? For starters, PSHB is designed to cater to the specific needs of postal workers. While it will still offer similar coverage options to FEHB, premiums, benefits, and provider networks may differ. This means you can expect new plan designs and perhaps even new cost-sharing structures.

One major change to be aware of is the mandatory enrollment in Medicare Part B for future retirees. If you plan to retire and maintain your PSHB coverage, you’ll need to sign up for Medicare Part B when you become eligible (at age 65). This is crucial for ensuring that your PSHB plan stays active.

Medicare Part B—Why You Need to Pay Attention

A key part of the PSHB transition is the mandatory enrollment in Medicare Part B for retirees aged 65 and older. If you’ve already retired or you’re planning to retire soon, this requirement becomes essential for maintaining your health benefits under the new PSHB system.

Here’s the deal: If you’re 65 or older and not enrolled in Medicare Part B, now is the time to act. You’ll want to enroll before the end of this Open Season, as January 1, 2025 marks the start of the new PSHB plans, and you must have Part B coverage to keep your PSHB benefits intact.

This rule applies even if you’re still working and plan to retire in the near future. If you’re nearing age 65, plan your Medicare enrollment now so that you don’t face penalties or delays in coverage.

Evaluating Your Health Plan Choices: What to Look For

Choosing a new health plan can feel like navigating a maze, but it doesn’t have to be daunting. During this PSHB Open Season, you’ll have a range of plans to choose from, similar to how FEHB worked. The key is to know what factors to consider when reviewing your options.

1. Cost of Premiums and Out-of-Pocket Expenses

You’ll need to look closely at the total cost of the plans available. While premiums may be similar to what you’re used to with FEHB, some PSHB plans may have slightly different cost structures for co-pays, deductibles, and out-of-pocket maximums. Take the time to compare how each plan balances premiums with these additional costs, so you aren’t surprised down the road.

2. Provider Networks and Coverage

One of the biggest factors that could differ between plans is the network of healthcare providers. Make sure your preferred doctors, hospitals, and specialists are in the network for the plan you choose. No one wants to be in the position of switching doctors due to a plan change.

3. Prescription Drug Coverage

If you take regular medications, this is something you absolutely cannot ignore. Review the prescription drug formularies for each PSHB plan to ensure your medications are covered at a reasonable cost. Some plans may have better coverage for specific drugs, so you’ll want to dig into this.

4. Coordination with Medicare

For those of you nearing Medicare age or already enrolled, make sure you understand how your new PSHB plan will coordinate with Medicare. Many plans will offer secondary coverage after Medicare pays, reducing your overall healthcare costs.

Don’t Miss This Deadline—Act by December 9, 2024

Procrastinating is tempting, but trust me, you don’t want to wait until the last minute to make your health plan decision. The deadline for making any changes or selecting your new PSHB plan is December 9, 2024. After that, you’ll be locked into your selection for 2025, and the next opportunity to make changes won’t come until the next Open Season in late 2025.

Given the major changes this year, now is the time to review your current coverage and decide if it’s still the right fit under PSHB. If you do nothing, you’ll automatically be enrolled in a comparable PSHB plan. But do you really want to leave that decision to chance? It’s better to be proactive and ensure that the plan you pick is tailored to your needs.

The Clock Is Ticking for Retirees—Medicare Part B Enrollment Is Key

If you’re approaching retirement or already retired, your situation is a bit different. You’ll need to carefully review your Medicare Part B enrollment status. Without it, your PSHB plan won’t cover you the way you expect starting in 2025.

If you’re 65 or older and haven’t signed up for Medicare Part B, don’t wait any longer. You can enroll during the general enrollment period for Medicare, but the key to maintaining your PSHB coverage is making sure this is squared away before the PSHB changes take effect on January 1, 2025.

What Happens If You Miss the Deadline?

Let’s be real—missing the PSHB Open Season deadline would be a big mistake. If you miss the window from November 11 to December 9, 2024, your current health coverage might be automatically transferred into a comparable PSHB plan. That might sound fine, but it also means you won’t have control over your plan choice for the entire year of 2025. You could end up with a plan that doesn’t suit your healthcare needs, costs more than expected, or includes a different provider network than you’re used to.

Plus, if you haven’t handled your Medicare Part B enrollment, you could be facing gaps in coverage or extra costs you didn’t anticipate.

Key Steps You Should Take Now

Don’t wait until the last minute to start figuring this out. Here’s a quick rundown of the steps you should be taking now:

  1. Mark your calendar for November 11 – December 9, 2024—this is your Open Season window.
  2. Review your current health plan and see how it compares to the new PSHB options.
  3. Check if you’re eligible for Medicare Part B, and if so, make sure you’re enrolled to avoid penalties or coverage lapses.
  4. Research your new PSHB plan options to find one that fits your medical needs, doctor preferences, and budget.
  5. Act before December 9, 2024—if you miss this deadline, you’ll be stuck with whatever plan is automatically assigned to you.

Getting Ready for a Smooth Transition

The rollout of PSHB in 2025 marks a new chapter in healthcare for postal workers, and while it may seem like a big change, it’s designed to ensure long-term sustainability and better align coverage with the needs of postal employees. By taking the time to understand the changes and plan accordingly, you can make sure you’re not only covered but getting the best possible benefits.

So, as the year winds down, don’t delay. Use this Open Season to lock in the best health plan for your situation and ensure you’re ready for the transition to PSHB starting January 1, 2025.