Key Takeaways

• Choosing the right Postal Service Health Benefits (PSHB) plan in 2025 depends on your current health needs, budget, and whether you’re enrolled in Medicare.

• You have from November to December during Open Season to make changes—don’t miss your chance to reassess your coverage annually.

Feeling Stuck? You’re Not Alone

Let’s be real—figuring out which PSHB plan to go with can feel like reading a foreign language. Deductibles, copayments, coinsurance, out-of-pocket maximums… it’s enough to make anyone’s head spin. Whether you’re a Postal Service retiree or still on the job, 2025 is the first full year under the new PSHB program, and the transition from FEHB might still feel fresh. The good news? You don’t have to make this decision blindly.

What Changed From FEHB to PSHB?

Before diving into how to choose a plan, let’s clear up what’s different about PSHB. This new program is specifically designed for Postal employees and retirees, and while it’s similar to the old FEHB system in many ways, a few big shifts stand out:

• Separate risk pool from non-postal federal employees

• Medicare Part B enrollment requirements for annuitants (with some exceptions)

• Enhanced coordination of benefits with Medicare

• New plan structures and possibly fewer plan options

It’s a new system, and it’s natural to feel overwhelmed. But with a bit of direction, you can find a plan that works for you—not just what sounds good on paper.

Step 1: Know When You Can Make Changes

You can make changes to your PSHB plan during the annual Open Season, which happens each year from November to December. Outside of that, you can only switch plans during certain life events—like marriage, retirement, or loss of other coverage. So mark your calendar.

If you’re already enrolled in FEHB, you were automatically transitioned into a PSHB plan for 2025. But that doesn’t mean you’re stuck. Use Open Season to re-evaluate if the default plan really suits your needs.

Step 2: Understand Your Coverage Needs

What you want out of your PSHB plan really depends on your current stage of life. Are you still working full-time? Nearing retirement? Already drawing your annuity?

If You’re Still Working:

• Look for plans with affordable deductibles and solid preventive care coverage

• Consider how often you visit doctors or specialists

• Think about upcoming surgeries or known health conditions

If You’re Retired or Planning to Retire:

• Review Medicare integration—plans may reduce out-of-pocket costs if you’re enrolled in Part B

• Check if the plan offers prescription drug benefits through Medicare Part D

• Confirm whether you qualify for premium or deductible savings by combining PSHB with Medicare

Step 3: Compare the Key Costs

Not all PSHB plans are built the same. Understanding the general costs you’ll encounter can help you narrow things down.

What to Focus On:

• Monthly Premiums – What comes out of your pocket every month?

• Deductibles – How much do you pay before your plan starts covering services?

• Copayments – Set amounts for visits, like $20 for a primary care doctor

• Coinsurance – A percentage you pay for services after meeting your deductible

• Out-of-Pocket Maximums – The most you’ll pay in a year before your plan covers 100%

2025 Estimates (General Ranges):

• In-network deductibles: Around $350 to $2,000

• Primary care copays: Roughly $20 to $40

• Out-of-pocket limits: Anywhere from $5,000 to $15,000

These numbers vary depending on your plan type—high-deductible, standard, or low-deductible. But the takeaway? Don’t just glance at the premium. Consider the whole picture.

Step 4: Factor In Medicare—Seriously

This one’s huge, especially if you’re retired or about to be. Under PSHB rules in 2025, most annuitants must enroll in Medicare Part B to keep their PSHB plan if they’re Medicare-eligible. But even if you aren’t required, enrolling can work in your favor.

Why Medicare Enrollment Matters:

• Many PSHB plans waive or reduce deductibles when paired with Medicare Part B

• You’ll often get lower copayments and coinsurance

• Prescription drugs are covered through Part D Employer Group Waiver Plans

• Plans may offer Medicare Part B premium reimbursements (varies by plan)

So if you’re 65 or older and retired, it usually makes sense to enroll in Medicare Part B to make the most of your PSHB plan.

Step 5: Don’t Ignore Prescription Coverage

You might assume all plans cover your medications the same way—but that’s far from the truth.

What to Check:

• Drug formulary – Is your medication on the plan’s list?

• Tiers – Drugs are placed in categories that affect cost

• Mail-order availability – Can you save by ordering a 90-day supply?

• Preferred pharmacies – Using them may cut your out-of-pocket expenses

If you rely on daily prescriptions, a little digging now could save you hundreds later.

Step 6: Pay Attention to Provider Networks

Before locking in a plan, make sure your doctors—and any specialists you regularly visit—are actually covered.

• Search the provider directory for each plan

• Look at in-network vs. out-of-network benefits

• Consider telehealth options if you live in a rural area or travel often

Not all networks are created equal, and going out-of-network can seriously drive up your costs.

Step 7: Don’t Forget About Vision, Dental, and Extra Perks

PSHB plans mainly focus on medical coverage, but you may also want to consider standalone dental and vision plans through FEDVIP if you’re eligible. Some PSHB options offer:

• Limited dental or vision services included

• Wellness programs or fitness memberships

• Nurse hotlines or telemedicine access

These perks might not be the deciding factor, but they can tip the scales if you’re comparing two similar plans.

Step 8: Use Available Resources—Seriously, Use Them

The Office of Personnel Management (OPM) provides plan comparison tools that are updated for 2025. You can:

• Compare costs across multiple PSHB plans

• Review detailed plan brochures

• Look at Medicare coordination features

If this still feels like too much? That’s exactly what licensed agents are for. Don’t be afraid to ask for help.

Picking the Right Plan Doesn’t Have to Be a Guess

At the end of the day, your health coverage shouldn’t be a gamble. Whether you’re a USPS employee trying to budget your health care costs, or a retiree balancing Medicare enrollment with new plan rules, the PSHB program gives you options—but only if you take the time to evaluate them.

You don’t need to be a benefits expert to make a smart choice. Just focus on:

• What health care needs you have today (and anticipate tomorrow)

• Which costs matter most to your budget

• How Medicare fits into your overall strategy

If you’re unsure, it’s always worth getting in touch with a licensed agent listed on this website to walk you through it all.