Key Takeaways:
- Open Season for the PSHB program begins on November 11, 2024, and ends on December 9, 2024. This is the time to evaluate your health insurance options for 2025.
- Medicare Integration Alert: Medicare-eligible Postal Service annuitants and family members may need to enroll in Medicare Part B to maintain PSHB coverage, with some exceptions.
What Is Open Season for PSHB?
Each fall, federal employees, postal workers, and retirees have the opportunity to review and adjust their health plan choices for the following year. For postal workers, this year’s Open Season marks a new phase as it transitions from the familiar Federal Employees Health Benefits (FEHB) program to the Postal Service Health Benefits (PSHB) program.
Open Season for the PSHB begins on November 11, 2024, and continues through December 9, 2024. Any changes you make will take effect on January 1, 2025. During this time, you can evaluate your options, explore the details of the PSHB plans, and make adjustments based on your current health needs.
Who Is Affected by the PSHB Transition?
The PSHB program applies specifically to current USPS employees, annuitants, and their eligible family members. This new program is tailored to meet the needs of postal workers, with several plans offering flexible options to support your unique health needs and life situations.
If you’re already enrolled in an FEHB plan, you’ll be automatically transferred to a corresponding PSHB plan in 2025, but you can still review options during Open Season to ensure you’re enrolled in the best plan for your current health needs.
Key Dates and Deadlines
- Open Season Start: November 11, 2024
- Open Season End: December 9, 2024
- New Coverage Begins: January 1, 2025
Mark these dates on your calendar so you don’t miss your opportunity to evaluate and adjust your health insurance.
How to Review Your PSHB Options
During Open Season, it’s important to assess your current coverage, explore the new PSHB options, and decide whether a change would benefit you. Here are steps to get started:
- Log in to the PSHB Portal: Use the dedicated platform to access and compare available PSHB plans.
- Evaluate Plan Benefits and Costs: Look at each plan’s coverage, network, and out-of-pocket costs for things like premiums, deductibles, and co-pays.
- Check for Medicare Coordination: If you or a family member is Medicare-eligible, make sure you understand how each plan coordinates with Medicare, especially for Part B coverage.
Taking a little time to compare plans now can prevent surprise expenses and ensure you have the coverage you need for the coming year.
Medicare and PSHB: What You Need to Know
One of the big changes with the PSHB program is the requirement for Medicare Part B enrollment for certain Medicare-eligible annuitants and family members to retain PSHB coverage.
Do I Need Medicare Part B?
For most annuitants and eligible family members who are Medicare-eligible, enrollment in Medicare Part B will be mandatory to continue PSHB coverage in 2025. However, if you retired on or before January 1, 2025, and haven’t already enrolled in Part B, you’re exempt from this requirement.
Medicare Part B can bring additional benefits to your PSHB coverage, such as lower out-of-pocket expenses for medical services and expanded access to providers.
Coordination of Benefits
When you’re enrolled in both PSHB and Medicare Part B, Medicare becomes the primary payer, with PSHB as secondary. This setup can reduce or even eliminate out-of-pocket costs for certain services. Before making your decision, review the out-of-pocket costs for both Medicare and PSHB to get a clear picture of potential savings.
Making the Most of Open Season: Tips for Selecting a PSHB Plan
With several options on the table, it’s helpful to go into Open Season prepared to review what each plan offers. Here’s a checklist to guide you:
1. Assess Your Health Needs
Think about your current health needs and those of your family members. Do you anticipate any significant medical procedures, medications, or regular visits to specialists? If so, consider choosing a plan that offers robust coverage for the types of care you expect to use most often.
2. Calculate Your Budget
Review the out-of-pocket maximums, deductibles, and co-pays associated with each PSHB option. Lower premiums might be appealing, but if they come with higher deductibles or co-pays, they may not actually save you money in the long run.
3. Review the Provider Networks
If you have established relationships with certain doctors or hospitals, confirm that they’re included in the plan’s network. Out-of-network care can be costly, so choosing a plan with a wide network that meets your needs can help you avoid unexpected expenses.
4. Look for Preventive and Wellness Benefits
Many PSHB plans offer additional benefits for preventive care, including coverage for annual check-ups, screenings, and vaccines. Some may also have wellness incentives that help you stay on top of your health.
5. Consider Prescription Coverage
If you or a family member relies on regular medications, check each plan’s prescription coverage carefully. Consider what portion of the cost will be covered by the plan and whether there are any additional co-pays or limits for brand-name medications.
Planning for 2025: Long-Term Health Needs
While Open Season is primarily about choosing coverage for the coming year, it’s also a good opportunity to think about your long-term health needs and retirement goals. If retirement is on the horizon, it might be beneficial to select a PSHB plan that offers smooth integration with Medicare and meets your anticipated needs for years to come.
Making Your Selection Official: How to Enroll
Once you’ve chosen a plan, make it official by enrolling through the designated PSHB portal. The enrollment process is straightforward, but don’t wait until the last minute to confirm your selection. Give yourself time to ensure that your coverage will go into effect smoothly on January 1.
Why PSHB Is a Positive Change for Postal Workers
The switch to the PSHB program is part of a broader initiative to provide postal employees with tailored health coverage options that better reflect the specific demands of their jobs and lifestyles. With a program dedicated to postal workers, you’ll have access to plans that better align with the unique requirements and benefits of USPS employment. This includes options for managing chronic health conditions, preventive care, and family needs.
Key Resources for Open Season
If you have questions or need further information on choosing a plan, don’t hesitate to utilize the resources provided by the PSHB program, including:
- PSHB Program Portal: Explore plan details, premiums, and benefits.
- Postal Service Human Resources: Contact your HR department for assistance with understanding PSHB plan options or for help with the enrollment process.
- Online Plan Comparison Tools: Compare plan options side-by-side to make an informed decision.
Open Season is your chance to ensure your health coverage works for you. By planning ahead, asking questions, and carefully reviewing options, you can confidently make a choice that best meets your needs.
Ready for Open Season?
With Open Season here, take this opportunity to evaluate your options and secure the health coverage that best fits your situation. Whether you’re continuing with the same level of coverage or making adjustments, knowing your options and understanding the benefits of each plan can make a world of difference.
