Key Takeaways

• If you are enrolled in the Postal Service Health Benefits (PSHB) program, pairing it with a Medicare Part C (Medicare Advantage) plan may restrict your access to care—especially if you travel or move often.

• Medicare Part C plans typically rely on limited regional networks, which can present serious limitations when compared to the nationwide access provided through PSHB plans coordinated with Original Medicare.

Understanding the Role of PSHB and Medicare

As of 2025, the Postal Service Health Benefits (PSHB) program replaces FEHB coverage for USPS employees and retirees. While this new system mirrors many features of the Federal Employees Health Benefits (FEHB) Program, it adds Medicare coordination requirements for those who are eligible.

Once you turn 65, or earlier if you qualify for Medicare due to disability, your choices become more complex. You’re expected to enroll in Medicare Part B in order to keep your PSHB plan fully active. From there, many individuals ask: Should I also enroll in Medicare Part C instead of sticking with Original Medicare?

The answer depends heavily on how you use your benefits—and whether you travel frequently or relocate during retirement.

What Is Medicare Part C?

Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare (Parts A and B). Instead of the federal government managing your healthcare claims directly, Medicare Advantage plans are offered through private insurers and must cover at least what Original Medicare does.

However, the similarities end there. Part C plans often include extra features like:

• Vision, hearing, or dental coverage

• Prescription drug benefits

• Wellness programs or transportation

These extras can sound attractive. But what’s less obvious—until it’s too late—are the geographic restrictions, prior authorization requirements, and potential service area limitations that come with these plans.

Why Medicare Advantage May Clash with PSHB

The PSHB program is built to integrate seamlessly with Original Medicare. When you pair your PSHB plan with Medicare Parts A and B, many of your out-of-pocket expenses are reduced or eliminated. PSHB plans often waive or reduce copayments, deductibles, and coinsurance for services Medicare already covers. This coordination is automatic and nationwide.

Medicare Advantage, on the other hand, is a standalone replacement for Original Medicare. That means:

• Your PSHB plan will no longer coordinate benefits if you enroll in a standalone Medicare Advantage plan.

• You could lose access to PSHB’s nationwide provider network.

• Emergency and urgent care may still be covered out of area, but routine care might not.

This creates a situation where the more you rely on Part C, the less you benefit from PSHB.

Travel Limitations Can Affect Your Care

If you are a Postal retiree who spends parts of the year in different states, or you frequently travel across the country, Medicare Advantage can cause disruptions.

Most Medicare Advantage plans are regionally bound. They may operate in a single state or even within just a few counties. Once you go outside the plan’s service area, routine care is generally not covered.

Here’s how this affects you:

• If you’re out of your plan’s network, you may need to pay full price for any non-emergency care.

• You might have to travel back to your home region for scheduled procedures.

• Telehealth coverage may be limited to local providers within the network.

By contrast, Original Medicare (Parts A and B) is accepted almost everywhere in the U.S., and when combined with PSHB coverage, you can seek care from most providers nationwide.

Medicare Part C Doesn’t Replace the Value of Coordination

With PSHB, coordination with Original Medicare is a financial advantage. Many PSHB plans offer benefits like:

• Waived deductibles

• Lower copayments for Medicare-covered services

• Automatic crossover billing with Medicare

• Inclusion in national pharmacy networks through Medicare Part D EGWP

These features are not available if you leave Original Medicare and switch to a standalone Medicare Advantage plan.

In essence, Medicare Advantage severs the coordination that PSHB was designed to support. And while the extras may appeal to some, they often come at the cost of losing flexibility, especially for frequent travelers or snowbirds.

Prior Authorization and Provider Restrictions

Medicare Advantage plans commonly require prior authorization for services like imaging, physical therapy, hospital stays, or outpatient procedures. These authorizations must be approved in advance by the plan—not your doctor.

Compare that with Original Medicare:

• If your doctor says the service is medically necessary and Medicare agrees, you’re covered—no additional red tape.

• PSHB coverage automatically supplements what Medicare allows, often paying your remaining costs.

When you choose a Medicare Advantage plan, you risk being told:

• Your care isn’t covered unless approved.

• You must switch doctors or specialists.

• You’ll need to wait for a decision before proceeding with treatment.

This can be frustrating, especially when you’re already managing a chronic condition or planning treatment while away from home.

What Happens If You Move?

PSHB coverage stays with you anywhere in the country. But Medicare Advantage plans are often tied to specific zip codes and counties. If you move—even to another part of the same state—you may lose your current plan entirely.

While Medicare offers a Special Enrollment Period (SEP) when you move, you’ll need to:

• Find a new plan available in your new area

• Reassess provider networks, formularies, and benefits

• Potentially switch providers or pharmacies

This reshuffling can lead to lapses in care, surprise costs, or simply the inconvenience of changing healthcare teams.

Emergency Coverage Doesn’t Equal Full Coverage

Many people assume Medicare Advantage plans must cover everything Original Medicare does. While they must provide at least the same basic benefits, how they deliver those benefits can be very different.

Medicare Advantage plans must cover:

• Emergency care anywhere in the U.S.

• Urgent care even outside the plan area

But coverage for regular check-ups, routine specialists, lab work, or preventive screenings may be restricted to your home area network. That means unless it’s an emergency, you’re on your own for costs outside the plan’s region.

PSHB and Medicare Part B: A Better Match

As a PSHB enrollee, you’re strongly encouraged—or in some cases, required—to enroll in Medicare Part B once eligible. The PSHB plans are built to coordinate with Parts A and B. The integration results in significant cost savings and simplified billing.

In 2025:

• The Medicare Part B premium is $185/month.

• The deductible is $257/year.

Most PSHB plans reduce or eliminate out-of-pocket costs once Medicare pays first. You still retain your access to national provider networks, and your drug coverage continues through the PSHB plan’s Part D EGWP benefit.

Choosing to stay with Original Medicare and PSHB gives you flexibility across the country—something that can’t be promised under Medicare Advantage.

Avoiding the Pitfalls of Part C Enrollment

While Medicare Advantage plans can look appealing on the surface, it’s critical to review the long-term impact on your PSHB benefits.

Before you enroll in Part C:

• Confirm whether your PSHB plan will still coordinate benefits.

• Understand that you could lose access to national coverage.

• Check the provider network and service area limitations.

• Know the prior authorization rules.

• Consider how often you travel or expect to move.

The short-term extras from Medicare Advantage might not outweigh the year-round convenience and nationwide reliability of staying with PSHB and Original Medicare.

When Your Lifestyle and Coverage Need to Match

In retirement, your health plan should move with you—not the other way around. If you travel to visit family, relocate seasonally, or split your year between states, you need the portability and freedom that Original Medicare and PSHB together can provide.

You earned these benefits through a career with the Postal Service. You deserve coverage that supports your lifestyle, not one that limits it.

Making Smart Medicare Choices with Confidence

You don’t have to navigate your Medicare and PSHB options alone. Understanding how Medicare Advantage works—and where it falls short—can help you avoid costly and frustrating mistakes.

If you’re unsure about whether Medicare Part C is a good fit for your situation, especially if you travel often or want to keep your PSHB plan fully functional, speak with a licensed agent listed on this website. They can walk you through your choices and help you make the right decision for your retirement lifestyle.