Key Takeaways
- Get Ready for Open Season: November 11 to December 9, 2024, is the period for Postal Service Health Benefits (PSHB) Open Season. Now’s the time to review your options and ensure you’re set up with the best coverage for 2025.
- Medicare Requirements for Some Retirees: Medicare-eligible retirees and family members may need to enroll in Medicare Part B to keep PSHB coverage, but exceptions apply if you retired before January 1, 2025.
PSHB Open Season—What You Need to Know
Welcome to the 2025 PSHB Open Season! This year, postal employees and retirees are experiencing a unique shift as the Postal Service Health Benefits (PSHB) program officially replaces the Federal Employees Health Benefits (FEHB) system. This transition offers a variety of coverage options tailored to postal workers’ specific needs, and understanding these changes can be crucial for making the right choice.
The Open Season period, from November 11 to December 9, 2024, is your window to enroll in a PSHB plan or switch plans for 2025. Whether you’re a current employee, a retiree, or an eligible family member, I’ll walk you through the essential steps and deadlines to help you make the most of this transition.
Understanding Open Season Basics
What Is Open Season?
Open Season is an annual opportunity for federal employees, retirees, and eligible family members to adjust or enroll in health benefits for the upcoming year. With the introduction of the PSHB, this year’s Open Season is especially important for USPS workers and retirees as it marks a transition from the FEHB to a program exclusively designed for postal employees and their families.
During Open Season, you can:
- Enroll in a new health plan
- Switch your existing plan
- Add or remove eligible family members from coverage
These changes go into effect on January 1, 2025. If you don’t make any updates, current FEHB enrollees will be automatically switched to a comparable PSHB plan.
PSHB vs. FEHB: What’s Different?
The PSHB program is similar to the FEHB in that it offers comprehensive coverage options, but it’s tailored to the needs of USPS workers. Key differences in the PSHB include:
- Exclusive to Postal Employees: Only USPS employees, retirees, and their eligible family members can enroll.
- Automatic Enrollment: If you’re currently covered under FEHB, you’ll be enrolled in a comparable PSHB plan unless you actively make a new choice.
- Medicare Part B Requirement: Some Medicare-eligible retirees must enroll in Part B to maintain PSHB coverage.
Important Dates to Remember
Open Season for PSHB runs from
November 11 to December 9, 2024. Mark these dates, as they’re your only opportunity to make changes for the upcoming year.
Starting in January 2025, all existing FEHB enrollees who transition to the PSHB will have new coverage, so ensuring your chosen plan meets your needs is essential.
Key Steps to Take During PSHB Open Season
1. Review Your Current Coverage
Take a close look at your current FEHB plan if you’re automatically transitioning to PSHB. Make a list of your healthcare needs, including any specific treatments or medications, and think about how your current coverage aligns with your needs. This will help you determine if you should stick with your new PSHB plan or explore other options.
The PSHB program offers various plan types—HMOs, PPOs, and high-deductible health plans (HDHPs). Comparing plans during Open Season is essential, especially if you or a family member has unique healthcare needs or requires regular treatments.
3. Check for Medicare Requirements
If you’re Medicare-eligible, be aware of PSHB’s Medicare Part B enrollment requirements. This applies to retirees and Medicare-eligible family members. Those required to
enroll in Medicare Part B include:
- Medicare-eligible postal retirees who retired after January 1, 2025
- Medicare-eligible dependents of retirees who are already enrolled in Medicare
However, retirees who are Medicare-eligible and retired before January 1, 2025, don’t need to enroll in Part B to keep PSHB coverage, though they have the option.
4. Estimate Your 2025 Healthcare Needs
Your healthcare needs can change year to year, so it’s wise to anticipate any upcoming healthcare
costs. For example, consider any planned surgeries, anticipated hospital stays, or regular prescription needs, which could affect your coverage choice.
Key Features of PSHB
Automatic Enrollment—What You Need to Know
For those currently in an FEHB plan, automatic enrollment means you’ll be switched to a similar PSHB plan. However, that doesn’t mean it’s your best choice. Be sure to review your options and confirm that the automatically chosen plan fits your needs.
Medicare Integration for Enhanced Coverage
The PSHB works hand-in-hand with Medicare, meaning retirees who sign up for
Medicare Parts A and B could receive more extensive coverage. Medicare helps cover hospital, outpatient, and some physician costs, which can reduce out-of-pocket expenses.
If you’re eligible and planning to keep PSHB into retirement, consider enrolling in Medicare Part B as a supplement to enhance your overall healthcare coverage.
Dental and Vision Coverage
PSHB also offers options for dental and vision care through the Federal Employees Dental and Vision Insurance Program (FEDVIP). Although FEDVIP isn’t automatically included with PSHB, you can add these benefits separately during Open Season if they align with your needs.
Choosing the Right Plan
High-Deductible vs. Low-Deductible Plans
PSHB offers both high-deductible health plans (HDHPs) and plans with lower deductibles. HDHPs may come with a lower premium but require more out-of-pocket spending until the deductible is met. For those who rarely use
healthcare services, HDHPs can be a cost-effective choice. If you have frequent medical needs, however, you might benefit from a plan with a lower deductible and higher premium.
Consider Out-of-Pocket Limits
Each PSHB plan has an annual out-of-pocket maximum—the highest amount you’ll pay for covered services within a plan year. This is especially important if you anticipate high healthcare costs in the coming year, as you’ll want to choose a plan with a manageable out-of-pocket cap.
Flexibility of Provider Networks
Different PSHB plans have different provider networks, and it’s essential to ensure your preferred providers and facilities are in-network for your selected plan. With a PPO, you can visit out-of-network providers, but this usually involves higher costs. HMO plans may be more restrictive, requiring you to stick with in-network providers.
FAQs About PSHB Open Season
Do I Have to Enroll in a New Plan?
No, you don’t have to enroll in a new plan if you’re already in an FEHB plan. However, it’s a good idea to review your coverage and make adjustments if needed.
What If I Miss the Open Season Window?
If you miss Open Season, you’ll be automatically enrolled in a comparable PSHB plan. However, you won’t have the option to switch until the next Open Season unless you qualify for a Special
Enrollment Period due to a life event.
Will My Premiums Change?
It’s possible, as premiums can change annually. Review your plan details during Open Season to get an updated sense of your monthly premium and any potential changes.
Think Ahead—Plan for a Smooth PSHB Transition
Open Season is your once-a-year opportunity to make sure you’re set up with the best health coverage for the year ahead. This year’s PSHB transition brings new plan options,
eligibility requirements, and Medicare integration features, all designed to cater to postal workers’ unique needs. Take the time to evaluate your options and make choices that will support your health and peace of mind.
