Key Takeaways:

• Your PSHB premiums are determined by multiple factors, including plan selection, coverage level, and government contributions. Understanding these costs helps you choose the best option for your healthcare needs.

• Enrolling in Medicare Part B can affect your PSHB premiums, often leading to lower out-of-pocket costs for medical services and prescription drugs.

Understanding Premiums in PSHB: What Every Postal Worker Needs to Know

The Postal Service Health Benefits (PSHB) Program is now in full effect, replacing the old FEHB system for USPS employees and retirees. As you explore your options, one of the biggest questions on your mind is likely, How much will I pay for health coverage? This is where PSHB premiums come into play.

Your premiums are the recurring payments you make to maintain your health coverage. While the government covers a substantial portion of your costs, you’re still responsible for a share of the premiums, which vary based on the plan and coverage level you choose. To help you navigate the ins and outs of PSHB premiums, let’s break down four key insights that every postal worker should know.

1. How PSHB Premiums Are Structured

Premiums under the PSHB Program work similarly to what you might be familiar with under FEHB. However, since PSHB is tailored specifically for postal workers, there are some differences. Your premium is influenced by:

• Your chosen plan type – Whether you select a Self Only, Self Plus One, or Self and Family plan affects your total premium.

• Government contribution – The USPS covers a significant portion of your premium, but the exact percentage depends on the plan.

• Medicare enrollment – If you are retired and enrolled in Medicare Part B, your PSHB plan may offer reduced premiums or reimbursements to help offset Part B costs.

It’s important to review your plan options carefully during Open Season to ensure you select the best fit for your healthcare needs and budget.

2. Government Contributions and What You Pay

One of the major advantages of PSHB is that the government helps subsidize your premiums. Typically, the federal government covers about 70% of your total premium costs, leaving you responsible for the remaining 30%. This percentage can vary slightly depending on the plan you choose, but understanding this cost-sharing structure is crucial when budgeting for healthcare.

For retirees, the introduction of Medicare Part B can further impact your PSHB premiums. Many plans offer premium incentives or lower out-of-pocket costs for those enrolled in both Medicare Part B and PSHB. If you’re nearing retirement, factoring in the benefits of Medicare alongside PSHB is essential.

3. How Medicare Part B Enrollment Affects Your Premiums

If you’re an active postal worker, your premiums are relatively straightforward—choose a PSHB plan and pay your share after government contributions. However, for retirees, Medicare enrollment plays a significant role in determining healthcare costs.

Since Medicare-eligible retirees must enroll in Part B to maintain PSHB coverage, this requirement can affect both your monthly premiums and out-of-pocket expenses. Here’s how:

• Premium Adjustments – Some PSHB plans reduce premiums for retirees enrolled in Medicare Part B, helping to offset the cost of Medicare.

• Lower Cost-Sharing – Combining PSHB with Medicare Part B often results in lower deductibles, copayments, and coinsurance costs.

• Prescription Drug Coverage – If you’re enrolled in both Medicare and PSHB, your prescription drug coverage is typically managed through a Medicare Part D Employer Group Waiver Plan (EGWP), which may offer better drug pricing and coverage.

Understanding the financial trade-offs of enrolling in Medicare Part B versus staying on PSHB alone is key to making an informed decision about your retirement healthcare.

4. When and How to Review Your Premiums

PSHB premiums aren’t set in stone—they can change each year. That’s why it’s important to review your plan during Open Season, which runs from mid-November to mid-December every year. During this time, you can:

• Compare premium rates for different plans.

• Check for any changes in government contributions.

• Assess whether enrolling in Medicare Part B could lower your costs.

• Make adjustments to your coverage to ensure you’re in the most cost-effective plan.

Additionally, qualifying life events (QLEs)—such as marriage, divorce, or the birth of a child—allow you to adjust your PSHB plan outside of Open Season. If your circumstances change, be sure to review your coverage options.

Making Sense of Your PSHB Premiums

As a postal worker, understanding your PSHB premiums is essential to making informed healthcare decisions. Whether you’re an active employee or preparing for retirement, knowing how government contributions, plan selections, and Medicare enrollment affect your costs can help you choose the best coverage for your needs.

To ensure you select the right plan, it’s always a good idea to consult a licensed agent listed on this website. They can provide guidance tailored to your personal situation and help you navigate the complexities of PSHB and Medicare integration.