Key Takeaways
- Get Familiar with PSHB Changes: The Postal Service Health Benefits (PSHB) program replaces FEHB for USPS employees in 2025, bringing new options, rules, and enrollment requirements.
- Review and Choose Carefully: With automatic enrollment in PSHB plans, it’s essential to understand your new options and make adjustments if necessary to suit your healthcare needs.
Welcome to PSHB Open Season 2024: Get Ready!
The 2024 Open Season is a big one for postal employees and retirees as we transition to the new Postal Service Health Benefits (PSHB) program. If you’re a current USPS employee, annuitant, or family member, this Open Season will likely involve some important decisions about your healthcare options for 2025 and beyond. The Open Season window runs from November 11 to December 9, 2024, so don’t miss this limited opportunity to make any changes to your plan. The choices you make will take effect on January 1, 2025, ushering in the new PSHB system designed specifically for postal workers. Let’s dive into what you need to know to make informed choices for you and your family.Why This Year’s Open Season Matters
Switching from the Federal Employees Health Benefits (FEHB) program to PSHB for USPS employees brings new plan options, specific rules, and an opportunity to tailor coverage to fit your needs. Current FEHB participants will automatically roll over into a corresponding PSHB plan, but that’s no reason to skip checking your options! Use Open Season to carefully review any differences in coverage, premiums, and eligibility requirements.How Automatic Enrollment Works
If you’re already enrolled in an FEHB plan, don’t worry about starting from scratch. Automatic enrollment is in place, so you’ll be assigned a PSHB plan that closely matches your current FEHB coverage. But while this feature provides some continuity, it’s crucial to remember that automatic enrollment may not fully meet your needs. Make the most of Open Season to explore what each PSHB plan has to offer and compare coverage options to see if switching could be beneficial.Key Details on Automatic Enrollment:
- Enrollment Notification: Expect a notification from the Office of Personnel Management (OPM) about your new PSHB plan before Open Season. This gives you a chance to preview the plan you’re automatically enrolled in.
- Check Coverage and Premiums: Review your auto-enrolled plan’s coverage, premium details, and costs. This will help you determine if it’s a good fit or if adjustments are necessary.
- Option to Switch: You can make changes during Open Season, which is your only time to do so for the coming year.
Medicare Enrollment Requirements for Some Annuitants
One key difference in the PSHB program is its integration with Medicare Part B for Medicare-eligible USPS retirees and family members. If you’re eligible for Medicare and want to keep your PSHB coverage, you may need to enroll in Part B. This requirement doesn’t apply to everyone, so it’s essential to know your status.Medicare Requirement Essentials:
- Required for Certain Annuitants: Only annuitants and family members eligible for Medicare need to consider enrolling in Part B to retain their PSHB coverage.
- Exemptions: Retirees who left federal service before January 1, 2025, and aren’t already enrolled in Part B are exempt from this requirement.
- Enrollment During SEP: Medicare-eligible annuitants will have a Special Enrollment Period (SEP) for Part B, ensuring you can enroll without penalty if you fall into the required category.
What You Need to Do During Open Season
With the new program, it’s worth taking a few steps to ensure you’re covered in a way that matches your healthcare needs and budget.1. Evaluate Your Current and New Options
Even though automatic enrollment will assign you a plan, use Open Season as your opportunity to check other options. Take advantage of the PSHB program’s variety of plan types and ensure that your preferred providers and services are covered.2. Compare Costs and Benefits
PSHB plans are expected to offer varying levels of coverage and premiums based on plan type and geographic location. Comparing your new plan’s benefits, premiums, and out-of-pocket costs with other available options can help you make the best decision for your financial and health needs.3. Understand the Out-of-Pocket Costs
PSHB plans will have different deductibles, copays, and out-of-pocket maximums. Knowing what to expect for routine check-ups, emergency visits, and specialist care is essential for budgeting and managing healthcare costs.Don’t Forget to Consider Vision and Dental Coverage
Unlike Medicare, the PSHB program does not provide direct vision and dental benefits. However, if you need this coverage, you have access to Federal Employees Dental and Vision Insurance Program (FEDVIP) plans. Open Season is also the time to enroll in or make changes to FEDVIP if you need additional dental or vision coverage.Benefits of FEDVIP During Open Season:
- Separate Enrollment Period: Enroll or adjust FEDVIP plans separately from your PSHB plan.
- Comprehensive Coverage Options: Choose from a range of dental and vision plans tailored to cover everything from routine exams to more extensive procedures.
Choosing the Right PSHB Plan for You
Selecting a plan that fits your health needs and financial goals requires some strategy. Here are a few tips to guide you as you decide on your PSHB plan:Know Your Health Needs and Priorities
If you anticipate certain healthcare services, make sure to choose a plan that provides adequate coverage for those needs. For example:- Prescription Drug Costs: If you require ongoing medication, choose a plan with a strong prescription drug benefit.
- Network Considerations: Ensure that your preferred doctors, specialists, and hospitals are included in the plan’s network.
- Family Coverage: Consider plans with family-friendly benefits if you’re enrolling family members under your PSHB plan.
Weigh Premiums vs. Out-of-Pocket Expenses
It’s tempting to choose a plan with the lowest premium, but check the out-of-pocket maximums, copays, and coinsurance. A low-premium plan can sometimes mean higher costs when you actually need care, so weigh each plan’s potential impact on your budget.Important Dates and Deadlines
Here’s a quick recap of the critical dates for this year’s Open Season and Medicare Special Enrollment Periods for those who need it:- Open Season Dates: November 11 – December 9, 2024
- PSHB Coverage Start: January 1, 2025
- Special Enrollment for Medicare: Annuitants who are required to enroll in Medicare Part B will have an SEP to avoid late penalties if they need it.
