Key Takeaways

• Missing the PSHB enrollment deadline in 2025 doesn’t mean you lose all access to coverage, but your options may become limited and more expensive.

• Some exceptions and special enrollment periods (SEPs) may apply depending on your circumstances, but reinstating coverage after the deadline may involve delays or penalties.

Understanding the PSHB Deadline in 2025

If you’re a United States Postal Service (USPS) employee or retiree, the transition to the Postal Service Health Benefits (PSHB) Program in 2025 represents a significant change from the Federal Employees Health Benefits (FEHB) Program. As of January 1, 2025, PSHB replaces FEHB for all eligible USPS workers and annuitants. This means that in order to maintain health coverage through your employer, you must enroll in a PSHB plan during the designated enrollment window.

The Open Season for this transition ran from November 11 to December 9, 2024. If you didn’t act during this time, the consequences depend on your status and whether you qualified for automatic enrollment or special exceptions.

What Happens if You Miss the Deadline?

Missing the PSHB enrollment window may not be the end of your access to health insurance, but it does introduce several complications. Here’s what you need to know:

1. Automatic Enrollment May Apply

If you were already enrolled in an FEHB plan as of December 2024 and did not make a change during Open Season, you may have been automatically transitioned to a similar PSHB plan for 2025. However, automatic enrollment only applies to current FEHB enrollees and doesn’t guarantee the plan you’re moved into is the best fit for your healthcare or financial needs.

2. You Could Lose Coverage if You Weren’t Previously Enrolled

If you weren’t already enrolled in FEHB prior to 2025 and failed to enroll in PSHB during Open Season, you might be left without employer-sponsored coverage. For retirees and employees alike, this could result in higher out-of-pocket costs or a period of being uninsured.

3. No Changes Allowed Without a Qualifying Life Event

Outside of the Open Season, you generally cannot change or enroll in a PSHB plan unless you experience a Qualifying Life Event (QLE), such as:

• Marriage or divorce

• Birth or adoption of a child

• Death of a family member

• Loss of other health coverage

• Relocation that affects plan availability

Without a QLE, your next opportunity to enroll or make changes will be the next Open Season in late 2025.

4. Special Enrollment Periods for Medicare-Eligible Annuitants

If you’re a Medicare-eligible annuitant, special rules apply. You may still be required to enroll in Medicare Part B in order to maintain your PSHB coverage. The special enrollment period for Medicare Part B ran from April 1 to September 30, 2024. If you missed both the SEP and the Open Season, you may face late enrollment penalties for Medicare Part B, in addition to limitations in your PSHB options.

Financial and Healthcare Impacts of Missing the Deadline

Missing the enrollment deadline doesn’t just complicate the administrative process—it can also hit your wallet and health hard.

Potential Financial Setbacks

• You may have to pay higher out-of-pocket costs if you’re forced into a plan that doesn’t align with your medical needs.

• Late Medicare Part B enrollment can result in a lifetime premium penalty—10% added for each 12-month period you were eligible but not enrolled.

• Without PSHB enrollment, you may have to purchase individual coverage or pay out-of-pocket for services.

Disruption in Care

• You could lose access to your preferred doctors if the automatically assigned plan has a different network.

• Prescriptions may no longer be covered or could cost more under a plan you didn’t choose.

• Any ongoing treatments could face interruption due to plan mismatches or authorization issues.

Can You Recover Coverage If You Missed the Deadline?

Yes, but options are limited, and timing matters. Here’s what to consider:

1. Explore If You Qualify for a Special Enrollment Period

If you’ve had a recent life change or anticipate one soon, check whether it qualifies you for a SEP. QLEs can trigger a 30-day window to make changes to your plan.

2. Contact the PSHB Navigator Help Line

The USPS and the U.S. Office of Personnel Management (OPM) have resources in place to assist those who missed the enrollment deadline. If you believe you missed the window due to a misunderstanding or unique circumstance, it’s worth reaching out.

3. Monitor the Next Open Season

The next Open Season will occur from November to December 2025. You can use this window to make corrections, change your plan, or enroll if you were left out previously. Keep track of this period and prepare your documents in advance.

Medicare Enrollment and PSHB: A Critical Link

In 2025, the PSHB program includes a built-in Medicare Part D prescription drug benefit for Medicare-eligible annuitants through an Employer Group Waiver Plan (EGWP). However, this benefit only applies if you are enrolled in Medicare Part B.

If you miss your Part B enrollment window, you could:

• Lose access to PSHB drug coverage.

• Face delays until the next Medicare General Enrollment Period (January 1 to March 31), with coverage starting July 1.

• Be unable to re-enroll in drug coverage for the rest of the calendar year unless you qualify for another SEP.

How PSHB Differs from FEHB

Missing the PSHB enrollment window is especially risky if you expect the same flexibility as FEHB. Unlike FEHB, the PSHB program has stricter rules regarding Medicare coordination and enrollment eligibility.

Key distinctions:

• Mandatory Medicare Part B Enrollment: For certain annuitants, PSHB requires enrollment in Medicare Part B to retain full benefits.

• Integrated Drug Coverage: Medicare-eligible members automatically get Part D drug coverage through PSHB, eliminating the need for a standalone plan.

• Fewer Plan Options: Depending on your location, PSHB may offer fewer plan choices than FEHB.

What Retirees Need to Know

For annuitants, your retirement status doesn’t exempt you from these deadlines. In fact, you may face even more limitations:

• If you were retired before January 1, 2025, and not already enrolled in Medicare Part B, you may be exempt from the mandatory enrollment rule.

• If you retired after January 1, 2025, you must comply with the new PSHB requirements.

Failing to act during the Open Season may result in:

• Involuntary disenrollment from prescription drug coverage

• Higher medical costs due to lack of Medicare integration

• Loss of eligibility for future PSHB plan options

What Employees Should Keep in Mind

If you’re an active USPS employee, the missed deadline affects you differently but still significantly:

• If you were enrolled in FEHB and didn’t make a change, you were likely auto-enrolled, but reviewing your plan now is essential.

• If you were not enrolled in FEHB prior to 2025 and did not enroll during the PSHB Open Season, you will have to wait for the next Open Season unless you qualify for a SEP.

• Delaying action could affect your future retirement benefits, especially related to Medicare coordination.

Key Steps to Take Now

• Check your current enrollment status on LiteBlue or with HR.

• Identify whether you qualify for a SEP based on any recent life changes.

• Prepare for the next Open Season by reviewing your healthcare needs and comparing plan options.

• Consider Medicare enrollment if you’re approaching eligibility, especially if you’re retiring soon.

• Seek professional guidance to understand your rights and options.

Don’t Let a Missed Deadline Derail Your Benefits

Missing the 2025 PSHB enrollment deadline doesn’t mean the door is closed, but it does make things more complicated. Timing is critical, and every delay could cost you money, coverage, or peace of mind. If you’re unsure where you stand or what steps to take next, speak with a licensed agent listed on this website for professional guidance tailored to your situation.