Key Takeaways
- Postal Service Health Benefits (PSHB) Open Season starts November 11, 2024, and runs until December 9, 2024. This is the window for you to select or make changes to your health plans for 2025, as the program officially launches on January 1, 2025.
- The Postal Service Reform Act of 2022 sets the stage for this significant shift in health benefits, transitioning USPS employees and retirees from the Federal Employee Health Benefits (FEHB) program to PSHB.
What’s Changing in 2025? Your PSHB Basics
By now, you’ve likely heard a lot about the Postal Service Health Benefits (PSHB) program. It’s a significant change affecting all USPS employees and retirees, replacing the Federal Employee Health Benefits (FEHB) program. This transition is part of the Postal Service Reform Act of 2022 and becomes effective on January 1, 2025. If you’re a current or retired USPS worker, this means you’ll need to review your healthcare options during the PSHB Open Season, which runs from
November 11 to December 9, 2024.
Why the Switch?
The Postal Service Reform Act of 2022 initiated this shift to the PSHB program to streamline healthcare benefits for USPS workers. By moving to PSHB, the goal is to create a program that specifically caters to USPS employees and retirees, offering plans that are designed around their needs. While this change might seem overwhelming at first, it’s intended to improve how health benefits are delivered.
Open Season – Your Time to Choose
During
Open Season (November 11 to December 9, 2024), you’ll be automatically enrolled in a PSHB plan that is similar to your existing FEHB coverage. However, this is also the time when you can explore other options within PSHB or adjust your dental and vision coverage under the
Federal Employees Dental and Vision Insurance Program (FEDVIP). It’s your annual opportunity to make changes that will affect you for the whole of 2025, so it’s essential to get informed and take action if needed.
FEDVIP Coverage: Still Intact
One of the great things to keep in mind is that while your primary
health insurance is shifting to PSHB, your dental and vision coverage remains unchanged. You’ll continue to access these services through FEDVIP, which includes things like routine dental exams, cleanings, and prescription eyewear. This ensures some continuity, so you don’t have to worry about losing any of your current dental or vision benefits.
That said, you might notice some changes in premiums for 2025. For instance, dental premiums are increasing by an average of
2.97%, and vision premiums are going up by
0.87%. While these changes are relatively modest, it’s something to factor into your budget when planning for next year’s healthcare costs.
If you’re nearing retirement or already retired, understanding Medicare’s relationship with PSHB is crucial.
Medicare Part B enrollment becomes a factor depending on your retirement timeline. If you retired on or before January 1, 2025, you won’t be required to enroll in Medicare Part B to keep your
PSHB coverage, even if you become eligible later. However, if your retirement occurs after that date, enrolling in Medicare Part B will be mandatory once you become eligible (usually at age 65). This also applies to your family members enrolled under your plan.
There are exceptions, though. For instance, if you live outside the United States, receive care through the Department of Veterans Affairs (VA), or use Indian Health Services (IHS), the Medicare Part B requirement may not apply to you. It’s always a good idea to look into these specific cases if you think you might be affected.
Earlier in 2024, there was a
Special Enrollment Period (SEP) for those
USPS retirees and their families who had not yet signed up for Medicare Part B. The good news is that if you took advantage of this SEP, the USPS covered any penalties related to late enrollment, giving you one less thing to worry about as you prepare for PSHB.
PSHB Premiums: What to Expect
Now, let’s talk money. While the shift to PSHB comes with several benefits, it also introduces new premium structures that you need to be aware of. Here’s a basic breakdown of what you can expect to pay for your health plan, based on the PSHB system starting in 2025:
- Self-Only Coverage: Average biweekly premium of $397.35
- Self Plus One: Average biweekly premium of $858.89
- Self and Family: Average biweekly premium of $934.65
These premiums are divided between you and the government. The government covers about
72% of the total premium, leaving you responsible for the remaining
28%. Over the course of the year, for a Self-Only plan, this would amount to around
$2,892.76 annually out of your pocket. If you’re covering yourself plus a dependent or family, the cost goes up accordingly, with
Self Plus One totaling around
$6,252.74 annually and
Self and Family coming in at
$6,804.20 annually.
Saving with Medicare Part B
Enrolling in Medicare Part B, once you’re eligible, can help reduce your overall healthcare costs, thanks to how PSHB integrates with Medicare. Many PSHB plans offer additional savings for those enrolled in Part B, including reduced out-of-pocket expenses, waived deductibles, and even reimbursement for Part B premiums. This Medicare-PSHB coordination is a great way to minimize the financial burden of healthcare in retirement.
Prescription Drug Coverage Under PSHB
Another important aspect of your PSHB coverage is
prescription drugs, particularly if you’re
eligible for Medicare. All PSHB plans for Medicare-eligible participants will include
Medicare Part D prescription drug coverage. This means you won’t have to pay for a separate Part D plan, potentially reducing your healthcare costs even further.
However, make sure to take a good look at your PSHB plan’s drug formulary—this will tell you how different
medications are covered, and it’s essential to ensure that your current prescriptions are included.
Don’t Forget the OPM Plan Comparison Tool
With so many factors to consider, making the right choice for your health coverage might seem a bit overwhelming. Luckily, the
OPM plan comparison tool will be available during Open Season. This tool allows you to compare different PSHB plans side-by-side, giving you the chance to weigh your options and make an informed decision based on factors like cost, coverage, and benefits.
Whether you’re looking for a low-cost plan, broader coverage, or a good fit with your Medicare options, this tool is a valuable resource to help you choose what’s best for you and your family.
What to Do Next?
You now have the key information you need as we approach the PSHB Open Season in November. As a USPS employee or retiree, the transition to the
Postal Service Health Benefits program is a big shift, but with the right information and tools at your disposal, it doesn’t have to be stressful. Mark your calendars for
November 11, 2024—that’s when you’ll have the chance to review your options, make changes, or stick with the plan that works best for you.
Remember, this is your annual opportunity to ensure that your healthcare coverage aligns with your needs. Whether it’s making adjustments to your medical plan, reviewing your FEDVIP dental and vision options, or figuring out how Medicare fits into the equation, Open Season is your time to take control.
Make Smart Choices Before the Deadline
With PSHB coming into play and a variety of options on the table, it’s important to get ahead of the game and understand what will best suit you and your family. Keep in mind that the Postal Service Health Benefits Open Season runs from November 11 to December 9, 2024, and the choices you make will directly impact your coverage for the entire year of 2025. Make sure you’re ready and informed to make the best decision.
