Key Takeaways

• Understand how hospice care benefits are managed under PSHB and Medicare for postal workers and retirees.
• Get clear, actionable steps for enrolling in hospice care and coordinating coverage during and after the PSHB transition.

Hospice care plays a critical role for those facing serious illness and their families. If you’re a postal worker or retiree, recent changes in how your benefits are managed may affect your access to hospice services. Here’s a plain-English guide to help you untangle PSHB, Medicare, and what the 2025 transition means for your coverage options.

What Is Hospice Care?

Definition and Purpose

Hospice care focuses on comfort and quality of life for individuals with a life-limiting illness. Rather than seeking a cure, hospice supports you physically, emotionally, and spiritually, aiming to maximize comfort and dignity during this phase of care. Care is typically provided at home, but may also be available in hospice centers or certain facility settings.

Eligibility Requirements

Generally, to qualify for hospice care, a doctor must certify that you have a terminal illness with a prognosis of six months or less if the disease follows its normal course. You or your representative must choose hospice over curative treatments. Each benefit provider—like Medicare or PSHB—may have specific documentation or certification processes, but these core requirements remain consistent.

Common Services Included

Hospice services often cover medical and nursing care, pain and symptom management, medications related to terminal illness, emotional and spiritual support, caregiving education, and bereavement counseling for loved ones. These services are coordinated by a hospice team, ensuring that both you and your family receive holistic support during a challenging time.

How Does PSHB Affect Hospice Care?

PSHB Basics for Postal Workers

The Postal Service Health Benefits (PSHB) Program, launched in 2025, is now the primary health benefits program for United States Postal Service (USPS) employees, retirees, and eligible family members. PSHB replaced Federal Employees Health Benefits (FEHB) for most postal enrollees as of January 1, 2025. While similar in many respects, PSHB is distinct and has its own plan offerings and rules, tailored for postal workers.

Hospice Coverage After FEHB to PSHB Shift

After moving from FEHB to PSHB, your health plan still provides coverage for hospice care. However, there are important coordination rules—especially if you’re also eligible for Medicare. If you have both Medicare and PSHB, hospice benefits are usually provided under Medicare Part A, with PSHB acting as secondary coverage for services not covered by Medicare.

Transition Timeline and Key Dates

The official transition to PSHB occurred on January 1, 2025. If you were enrolled in FEHB as a USPS employee or retiree, your coverage moved to a PSHB plan unless you declined or were not eligible. All decisions about making changes typically happened in the Open Season prior to the changeover. Key dates for yearly enrollment or adjustment continue to align with federal benefits schedules, making it important to review your options annually.

Does Medicare Cover Hospice Care?

Medicare Part A and Hospice

If you qualify for Medicare, your hospice care is generally covered under Medicare Part A. You must meet Medicare’s eligibility criteria, which include: having Medicare Part A coverage, a terminal diagnosis certified by your physician, and electing to receive hospice care rather than curative treatment. Medicare covers the full range of hospice services, including medical equipment, medications, and support services related to your hospice condition.

Enrollment Considerations

To use Medicare for hospice, ensure you’re properly enrolled in Part A. If you’re a postal retiree who turned 65 before or during the PSHB switch, you were required to enroll in Medicare Part A. If you didn’t enroll when first eligible, delayed registration could result in late fees or limited coverage periods. Confirm your enrollment to prevent any interruptions in hospice care access.

Impact of Dual Coverage

If you have both Medicare and PSHB, Medicare usually pays first for hospice care. PSHB may help with services or expenses that Medicare doesn’t fully cover (like some medications or respite care). Review your plan summaries and coordinate with your hospice provider to clarify which insurer covers each service.

What Changes Occurred in 2025?

Key Transition Milestones

2025 marked the full rollout of PSHB, officially ending new FEHB enrollments for postal workers and retirees. USPS retirees and active employees alike transitioned to PSHB plans during the Open Season leading up to January 2025. The new program centralized benefits administration and aligned plan offerings more closely with current postal and federal health policies.

Shifts for USPS Retirees

For retirees, a major change was the required Medicare Part A enrollment at age 65 in order to keep PSHB coverage. This created a new layer of coordination for hospice services. Many retirees moved from familiar FEHB carriers to PSHB plans, requiring careful review of plan documents and communication about coverage specifics with providers.

Ongoing Support and Communication

Agencies like the Office of Personnel Management (OPM) and the USPS provided regular updates via mail, email, and online portals to help postal workers manage their benefits. Resources such as dedicated websites, helplines, and newsletters help keep you informed about deadlines, plan features, and how to get assistance with complex hospice care questions.

Which Plan Pays First for Hospice?

Coordination of PSHB and Medicare

When you’re eligible for both Medicare and PSHB, Medicare is generally the primary payer when it comes to hospice care. That means Medicare will pay first, and then your PSHB plan might step in to cover services that Medicare does not, subject to plan rules.

Primary vs. Secondary Payer Rules

If you are enrolled in Medicare Part A and PSHB, your hospice provider will usually bill Medicare first. PSHB plans are considered secondary—covering specific costs or non-covered services as described in your plan documentation. If you’re not enrolled in Medicare, PSHB is the primary payer (within plan limits).

Real-Life Scenarios Explained

Suppose you’re a USPS retiree enrolled in both PSHB and Medicare Part A. When you begin hospice care, your main hospice services are billed to Medicare. For prescription drugs unrelated to your terminal condition, or certain durable medical equipment, your PSHB plan may help cover those expenses. Always check with your provider and plan administrator to confirm current rules and benefit limits.

How to Access Hospice Care Benefits

Enrollment Steps

Start by talking to your physician or care team about a hospice referral. If you’re eligible under Medicare, your doctor will certify your need and help with election forms. For PSHB, follow your plan’s procedures—this might include calling member services or submitting specific forms, especially if Medicare isn’t involved.

Required Notices and Forms

You’ll be asked to sign a hospice election statement, which indicates your choice to receive palliative rather than curative care. Keep copies of all paperwork and ask the hospice or your plan if any additional PSHB or Medicare forms are necessary to initiate coverage.

Contacting OPM or Your Plan

If questions or confusion arise, contact your plan’s customer service hotline or visit the PSHB section of the OPM website. OPM and USPS routinely update their online FAQ pages and provide step-by-step instructions for accessing hospice care, including downloadable forms and checklists.

What Questions Do Postal Workers Have?

Choosing Between Plans

Many postal workers want to know whether PSHB or Medicare should be their primary insurance for hospice. The answer depends on eligibility: generally, Medicare pays first for hospice services if you’re enrolled. Your PSHB plan will coordinate secondary benefits as described in your coverage booklet.

Transition Tips

Stay proactive before and after major transitions like the FEHB to PSHB change. Keep all correspondence from OPM, USPS, and your health plan. Review plan comparison charts carefully before each Open Season, and contact your benefits administrator if you need personalized guidance.

Resources for Further Help

Reliable support is available from OPM’s PSHB information hub, USPS retiree bulletins, and Medicare’s official website. If you’re unsure where to turn, your plan’s member services team can direct you to educational materials, contact points, and help with specific hospice care access issues.