Key Takeaways

• Dropping Medicare Part C can streamline your coverage and eliminate redundancy when you already have PSHB.

• PSHB plans in 2025 offer extensive coverage that often overlaps with or outperforms what many Medicare Advantage plans provide.

When Two Plans Feel Like One Too Many

If you’re a retired Postal Service employee, you’re probably already aware of the 2025 shift from FEHB to the Postal Service Health Benefits (PSHB) program. With PSHB now in place, many retirees are beginning to reconsider the necessity of holding on to their Medicare Part C (Medicare Advantage) plans. And for good reason.

PSHB offers broad coverage that is often more than sufficient on its own—especially when combined with Medicare Parts A and B. But when Part C enters the picture, things can get complicated fast.

Here’s why more and more postal retirees are deciding to drop Part C and stick with PSHB as their primary coverage.

Understanding What PSHB Covers in 2025

The 2025 PSHB plans were designed to work hand-in-hand with Medicare. If you are enrolled in Medicare Part A and B, most PSHB plans reduce or even waive:

• Annual deductibles

• Copayments for doctor visits and hospital stays

• Coinsurance for major services

• Prescription drug costs (via integrated Medicare Part D EGWP coverage)

In addition, some PSHB plans offer partial reimbursement of your Medicare Part B premium, further enhancing your value without the need for a Part C plan.

That’s a lot of coverage already. And if your PSHB plan includes these benefits, you may find that you’re duplicating coverage—and spending extra—by keeping your Medicare Advantage plan.

What Medicare Part C Tries to Offer

Medicare Advantage (Part C) plans are marketed as an all-in-one alternative to Original Medicare. They typically include:

• Hospital and medical coverage (Parts A and B)

• Prescription drug coverage (Part D)

• Extra benefits like dental, vision, hearing, and fitness

These sound appealing. But the overlap with PSHB becomes clear very quickly:

• PSHB already offers dental and vision coverage.

• Prescription drugs are covered via Medicare Part D EGWP within PSHB.

• Routine services and hospital care are already significantly covered when PSHB is paired with Parts A and B.

In other words, you’re likely paying for something you already have.

The Cost Question: What Are You Really Paying For?

While PSHB premiums are structured with Medicare integration in mind, Medicare Advantage plans involve their own set of costs:

• Separate monthly premiums in many cases

• Copayments and coinsurance that may differ from PSHB

• Network restrictions that can limit provider access

When you hold both PSHB and a Medicare Advantage plan, you could be footing bills for two insurance plans—while only using one. Worse, if you unintentionally sideline your PSHB plan by prioritizing your Part C plan, you could lose access to some of the cost-sharing advantages PSHB provides.

PSHB and Medicare Are Designed to Coordinate

The PSHB system in 2025 is built with Medicare coordination in mind, particularly Parts A and B. When you pair PSHB with Original Medicare:

• PSHB becomes your secondary payer, covering what Medicare does not.

• This coordination ensures lower out-of-pocket expenses.

• You maintain access to a broad national network of providers.

But when you introduce a Medicare Advantage plan into the equation, it replaces Medicare A and B altogether—and PSHB no longer functions as your secondary payer. You essentially shift away from the very coordination PSHB was optimized to support.

This disruption can lead to:

• Reduced coordination of benefits

• Unexpected out-of-pocket costs

• Denials or limitations in coverage

Confusion at the Pharmacy and the Doctor’s Office

Holding both a PSHB plan and a Medicare Advantage plan can cause delays or denials in service. Many providers and pharmacies don’t know which coverage to bill. You may be sent back and forth while trying to resolve:

• Which card to present

• Which plan is primary

• What your copay should be

PSHB, when paired with Original Medicare, provides a more seamless billing experience.

Network Differences Create Limitations

PSHB plans offer broad national networks and, in many cases, out-of-network benefits. Medicare Advantage plans, by contrast, often rely on limited local networks.

If you:

• Travel frequently

• Live in a different state part of the year

• Prefer a wider choice of specialists

…then PSHB may serve you better than a Part C plan with geographical limitations.

When Dropping Part C Actually Makes Financial Sense

In 2025, Medicare Advantage plans are still structured around tiered copayments, utilization management, and network restrictions. That means you may pay for services that PSHB would cover with fewer strings attached.

The financial decision to drop Part C becomes clear if:

• You’re duplicating benefits that PSHB already covers

• You’re paying an extra premium without added value

• You’re restricted to certain doctors and hospitals unnecessarily

By stepping away from Part C, you allow PSHB to operate as it was designed—with Original Medicare—to deliver more straightforward, less redundant healthcare.

The Psychological Cost: Less Is More

Health insurance can be confusing enough. Juggling two separate plans with overlapping benefits often means:

• More paperwork

• More ID cards

• More customer service calls

• More time spent figuring out what’s covered where

For many retirees, simplifying coverage means reclaiming peace of mind. Letting PSHB and Original Medicare work together can reduce daily friction and confusion.

When You Should Reconsider Dropping Part C

There are rare cases where keeping a Medicare Advantage plan might be beneficial—such as if your PSHB plan lacks a certain benefit you highly value (e.g., enhanced dental or vision coverage). But in 2025, many PSHB plans offer:

• Dental, vision, and hearing benefits

• Wellness programs

• Generous prescription drug coverage

Before dropping Part C, review both your PSHB and Advantage plan benefits side-by-side. Use OPM plan brochures or consult a licensed agent to be sure.

What About Prescription Drug Coverage?

Some Medicare Advantage plans include built-in Part D coverage. But if you already have PSHB and Medicare Parts A and B, your prescription needs are usually handled through the PSHB plan’s Employer Group Waiver Plan (EGWP).

This integrated drug benefit provides:

• A $2,000 annual out-of-pocket cap in 2025

• Access to an expanded pharmacy network

• Automatic enrollment (with the ability to opt out, though not recommended)

Keeping a Part C plan with drug coverage may interfere with or duplicate your existing prescription drug benefit through PSHB. That duplication doesn’t come with added benefit—only complexity.

Enrollment Considerations: Timing Is Everything

If you choose to drop your Medicare Advantage plan, timing matters. The Medicare Advantage Open Enrollment Period runs from January 1 to March 31 every year. During this window, you can:

• Switch to Original Medicare

• Drop your Part C plan

If you make this change, your PSHB plan will resume coordination with Medicare Parts A and B as expected. It’s important to avoid periods of dual enrollment where coverage becomes unclear.

Where to Get Help Before Making the Switch

The decision to drop a Medicare Advantage plan should not be made lightly. Always:

• Review your PSHB plan’s full benefit summary

• Compare it to your Medicare Advantage plan

• Look for coverage gaps or overlaps

Speak to a licensed agent listed on this website for personalized help. They can walk you through the implications and help ensure you aren’t giving up benefits you still want or need.

Simplify Your Coverage and Let PSHB Do Its Job

Holding onto a Medicare Advantage plan while also enrolled in PSHB and Medicare Parts A and B may seem like a way to get the best of both worlds. But in practice, it often results in duplication, added costs, confusion, and limitations.

PSHB was built to work with Original Medicare—not against it. In 2025, more postal retirees are recognizing that dropping Part C allows PSHB to function the way it was designed: as a powerful and comprehensive health plan.

If you’re ready to simplify your healthcare, reduce redundant costs, and restore clarity to your coverage, get in touch with a licensed agent listed on this website. They can help you evaluate your current plan mix and determine whether PSHB alone—with Medicare Parts A and B—is the smarter path forward.