Key Takeaways:
- Open Season for the new Postal Service Health Benefits (PSHB) runs from November 11, 2024, to December 9, 2024, and it’s the perfect window to review and adjust your health coverage.
- With the PSHB program launching on January 1, 2025, it’s crucial to understand changes, particularly if you’re near retirement or considering Medicare.
Get Ready: Open Season Is Here
The Postal Service Health Benefits (PSHB) program is set to replace the Federal Employees Health Benefits (FEHB) system for
USPS employees and retirees, launching officially on
January 1, 2025. With the PSHB program launch,
Open Season (from
November 11 to December 9, 2024) offers a prime opportunity for you to ensure you’re covered under a plan that meets your needs.
Why the urgency? For one, the
Postal Service Reform Act of 2022 mandates these changes, and this transition affects everyone in the USPS workforce. It’s essential to take the time now to review your options thoroughly before this enrollment window closes. If you skip Open Season, you may end up with coverage that doesn’t work well for your situation—especially if you’re nearing retirement, considering Medicare, or have family members relying on your plan.
What’s Changing with the PSHB Program?
The PSHB program is not just a rebranding of the old FEHB program—it introduces structural shifts that you need to be aware of. A big change, especially for those nearing retirement, is the
Medicare Part B enrollment requirement. If you retire on or after
January 1, 2025, you’ll need to
sign up for Medicare Part B when eligible to maintain your PSHB coverage.
This might sound overwhelming, but PSHB plans are designed to integrate smoothly with Medicare, offering potential cost-saving benefits like lower out-of-pocket expenses, waived deductibles, and reimbursement for Part B premiums. If you already retired or plan to retire before this date, you’re exempt from this requirement.
Check Your Plan Before the Deadline
During Open Season, the biggest responsibility is
comparing plans to make sure your health insurance fits your needs. You’ll automatically transition to a PSHB plan similar to what you currently have, but that’s no reason to avoid reviewing your options.
The
Office of Personnel Management (OPM) will provide tools to compare PSHB plans based on things like coverage levels, premiums, and out-of-pocket costs. Dental and vision coverage through the
Federal Employees Dental and Vision Insurance Program (FEDVIP) remains unaffected, but with premium increases expected for 2025—
2.97% for dental and
0.87% for vision—it’s worth reviewing those too.
Making the right choice now will save you headaches later. If you don’t review your plan, you may face gaps in coverage or higher-than-expected costs, particularly when it comes to prescription drugs or medical services. Plans differ in how they handle these, and now is the time to find the one that covers your needs.
How Medicare Plays a Role
If you’re a USPS retiree or approaching retirement, the interaction between
PSHB and
Medicare Part B is one of the most significant aspects to consider during Open Season. Understanding when you need to enroll in Medicare Part B can save you a lot of money in
late enrollment penalties.
For those retiring after
January 1, 2025, you must enroll in
Medicare Part B as soon as you’re eligible (typically at age 65). The PSHB system is built to work in tandem with Medicare, and failure to enroll could result in the loss of your PSHB plan. However, if you retired before this date, you’re not required to enroll in Medicare Part B to maintain your PSHB benefits.
The integration of PSHB with Medicare Part B offers many
cost-saving features, such as lower deductibles and out-of-pocket maximums. PSHB plans will also cover
Medicare Part D prescription drugs, eliminating the need for separate premiums. It’s worth looking into whether your medications are covered under your chosen plan’s formulary to avoid paying more than necessary.
Balancing Family Coverage
If you’ve got family members on your plan, you’ll also need to think about how the PSHB changes will impact them. Anyone under your plan
who is eligible for Medicare (like a spouse) must also enroll in
Medicare Part B to maintain their coverage, or they may lose it. This applies to all family members, so don’t forget to consider how these changes impact the entire household.
There are a few exceptions to this rule. For instance, if you or a family member receives care through the
Department of Veterans Affairs (VA) or
Indian Health Services (IHS), you may not need to enroll in Medicare Part B. Always double-check these details during Open Season to avoid any disruptions in your healthcare.
What About Prescription Drugs?
Prescription
drug coverage is another area that can be affected by the PSHB changes. With Medicare Part D automatically integrated into the PSHB plans for Medicare-eligible participants, you won’t need separate
Part D coverage. This consolidation simplifies things, but it also means you’ll need to ensure that your current prescriptions are covered under your new plan’s formulary.
During Open Season, take a look at your medication list and see how different PSHB plans handle them. Some plans may have better coverage or lower out-of-pocket costs for certain drugs, so it’s worth exploring. You’ll also want to see if there are specific limitations on the types of medications covered or if you need prior authorizations.
FEDVIP Coverage Stays the Same (But Check the Costs)
While dental and vision coverage isn’t affected by the shift to PSHB, it’s a good idea to review your
FEDVIP options during Open Season too. With
dental premiums increasing by 2.97% and
vision premiums by 0.87% in 2025, you’ll want to ensure you’re still getting the most value for your money.
Routine services like dental exams, cleanings, and prescription eyewear are still covered, but the cost of these plans might shift your decision. Open Season is the perfect time to check if you’re happy with your current dental and vision plans or if you should make a change.
Planning for Retirement and Beyond
Open Season isn’t just about the immediate year—it’s also about planning for your long-term
healthcare needs. If you’re nearing retirement, now is the perfect time to double-check that your
health plan will support your future. With
Medicare Part B requirements and various
cost-saving features built into the PSHB plans, understanding how your benefits change in retirement is essential.
For those already retired, keeping an eye on changes in premiums and
prescription drug coverage will help ensure that you’re still getting the best care for your budget. The PSHB program has been designed to offer comprehensive care, especially for those coordinating their coverage with Medicare, so take advantage of these benefits during Open Season.
Time Is Ticking: Double-Check Your Coverage Now
The Postal Service Health Benefits Open Season offers an opportunity to take control of your healthcare. With the transition to PSHB happening soon, now is the time to make sure your plan is up to date, works for you and your family, and keeps your costs in check. This enrollment period doesn’t last long—
November 11 to December 9, 2024—so don’t wait until the last minute. Take a little time now to review your options so you can start 2025 with peace of mind.
