Key Takeaways

• Several important deadlines for the Postal Service Health Benefits (PSHB) Program affect your coverage in 2025, and missing them could mean losing access or paying more for healthcare.

• Understanding the specific enrollment periods and eligibility requirements tied to Medicare Part B and PSHB can help you avoid penalties and maintain continuous coverage.

What Makes 2025 Different for USPS Health Benefits

This year marks a significant shift for all United States Postal Service (USPS) employees and retirees. As of January 1, 2025, the new Postal Service Health Benefits (PSHB) Program officially replaces the Federal Employees Health Benefits (FEHB) Program for USPS participants. Administered by the U.S. Office of Personnel Management (OPM), this transition introduces new rules, deadlines, and enrollment procedures that you need to be aware of—especially if you’re retired or nearing retirement.

If you ignore these changes, you may experience interruptions in your healthcare coverage or face financial consequences. It’s important to mark your calendar now and stay informed.

Major Deadlines to Watch

Several PSHB-related deadlines in 2025 impact both employees and retirees. Each has implications for eligibility, coverage continuity, and healthcare costs.

1. Medicare Part B Enrollment Requirements

For many annuitants and their eligible family members, enrolling in Medicare Part B is now mandatory in order to maintain PSHB coverage. However, this rule applies only to those who:

• Are entitled to Medicare Part A,

• Are enrolled in a PSHB plan,

• And are not exempt from the requirement.

2. Exemption Status Deadline

You are exempt from the Medicare Part B requirement if you:

• Retired from USPS on or before January 1, 2025,

• Were age 64 or older as of January 1, 2025,

• Reside overseas,

• Or are covered under the VA or Indian Health Services.

If you believe you qualify for an exemption, confirm your status through the OPM or PSHB Navigator before attempting to opt out. There is no automatic exemption confirmation—so act early.

3. Reconsideration Request Window

If you were required to enroll in Medicare Part B but missed the initial special enrollment period (April 1 to September 30, 2024), you may still request reconsideration. Be aware, though, that reconsideration approvals are not guaranteed and must be submitted promptly.

The sooner you appeal, the better your chances of maintaining uninterrupted health coverage.

4. PSHB Enrollment Period for 2025 Coverage

The first official PSHB Open Season was held from November 11 through December 9, 2024. If you enrolled during that time, your coverage begins January 1, 2025. If you missed it, you must wait for the next Open Season—unless you experience a qualifying life event (QLE).

Common QLEs include:

• Marriage or divorce

• Birth or adoption of a child

• Loss of other health coverage

You typically have 60 days from the date of the QLE to make changes to your plan.

Prescription Drug Coverage Is Changing Too

One of the lesser-discussed but critical changes in 2025 is the integration of Medicare Part D benefits through a Medicare Employer Group Waiver Plan (EGWP). This applies to PSHB participants who are eligible for Medicare and enroll in Medicare Part B.

Opting Out Comes With Consequences

If you decline the integrated Part D coverage, you will lose all drug coverage under your PSHB plan. Re-enrollment in the drug plan may not be available until the next Open Season, and in some cases, not at all. This could mean paying full price for prescription drugs for the rest of the year.

Make sure to check whether your plan automatically includes Part D and what your responsibilities are to maintain this benefit.

What If You’re a Current Employee?

USPS employees currently enrolled in an FEHB plan were automatically transitioned to a corresponding PSHB plan as of January 1, 2025. However, you were still allowed to make changes during Open Season, and the same rules apply if you experience a qualifying life event.

While Medicare Part B enrollment is not required for current employees, it becomes mandatory once you retire and meet the eligibility criteria. Planning ahead can help you avoid rushed decisions or unexpected expenses.

Where and How to Enroll or Make Changes

The process for enrollment or changes varies based on your status:

• Current employees: Use the USPS employee portal, LiteBlue.

• Annuitants or retirees: Use the OPM portal or KeepingPosted.org.

Documents required may include:

• Medicare Part A and B confirmation,

• Proof of QLE if applicable,

• Government-issued ID,

• Supporting documents for dependents.

How PSHB Integrates With Medicare

When you have both Medicare and PSHB coverage, they work together to reduce your out-of-pocket costs. Many PSHB plans waive or reduce deductibles and copayments when Medicare is your primary coverage.

Key 2025 Medicare-related figures:

• Medicare Part B Premium: $185/month

• Part B Deductible: $257/year

• Part D Out-of-Pocket Cap: $2,000/year

These integrations are beneficial—but only if you meet all requirements and enroll on time. Delays or missed deadlines can limit your ability to receive full benefits.

Review Annual Notices and Communications

Don’t overlook your Annual Notice of Change (ANOC) or PSHB enrollment materials. These communications highlight:

• Premium adjustments,

• Deductible and copayment changes,

• New supplemental benefits,

• Changes in provider networks.

All notices are typically sent out by mail or electronically by October each year. Failing to read these documents may leave you unaware of changes that impact your costs or coverage.

Considerations for Dual Eligibility

Some retirees may qualify for both Medicare and Veterans Affairs (VA) or Indian Health Services benefits. In such cases, coordination between these programs and PSHB can be complex. However, Medicare coordination remains mandatory unless you qualify for a specific exemption.

To avoid overlapping coverage or paying more than necessary, consult with a licensed agent or the PSHB Navigator about your unique situation.

Planning Ahead for 2026 and Beyond

The transition to PSHB may feel like a one-time event, but it affects your healthcare planning for years to come. Beginning in 2026, the same enrollment and integration rules will apply annually, especially for:

• Those turning 65 and becoming Medicare-eligible,

• Spouses or dependents aging into eligibility,

• Individuals returning from overseas residence.

Each year’s Open Season remains your primary opportunity to change plans, adjust coverage, or add dependents unless a qualifying event occurs.

Staying Informed Is Your Best Defense

Whether you’re an annuitant or an active USPS employee, the key to avoiding costly mistakes lies in preparation. Set calendar reminders, save official emails, and maintain updated records of your Medicare and PSHB documentation.

If you’re uncertain about any step in the process—such as determining your exemption status, coordinating benefits, or confirming enrollment deadlines—reach out to a licensed agent for clarification.

Time-Sensitive Decisions Require Immediate Attention

These new PSHB rules are not suggestions—they’re deadlines with real consequences. Missing even one enrollment period could mean:

• Losing access to prescription drug coverage,

• Delayed healthcare enrollment,

• Financial penalties,

• Reduced benefits.

To ensure you’re covered now and in the future, take time this month to:

• Review your current plan and any changes,

• Verify Medicare Part B enrollment if applicable,

• Understand how your PSHB plan works with Medicare,

• Save all relevant documents and notices,

• Speak with a licensed agent if anything is unclear.

Get the Help You Need Before It’s Too Late

The PSHB transition is underway, and the clock is ticking. Don’t let confusion or missed deadlines put your health benefits at risk. For personalized support, get in touch with a licensed agent listed on this website today and make sure your coverage stays secure.