Key Takeaways

• In 2025, PSHB deductibles have increased across many plans, raising out-of-pocket costs for both active Postal Service employees and retirees.

• While premiums are partially subsidized, rising deductibles and shrinking benefits mean you now shoulder more of the actual care costs before your plan starts paying.

What a Deductible Actually Means for You

A deductible isn’t just a number on your benefits brochure—it’s the amount you must pay before your health plan begins to cover costs. If your deductible is $1,500, that means you’ll pay that full amount out of pocket before your plan pays anything beyond basic preventive services.

This matters because in 2025, PSHB plans are trending toward higher deductible thresholds. For in-network services, many standard options now have deductibles between $600 and $1,500, while high-deductible plans may go up to $2,000 or more. Out-of-network deductibles are often double.

Why Deductibles Keep Increasing

Several key factors contribute to the steady rise in deductibles in 2025:

• Inflation in healthcare costs: From hospital stays to specialist visits, the cost of care has surged in the last few years.

• Plan design shifts: To keep premiums manageable, plans raise deductibles to reduce how much they have to pay upfront.

• Higher utilization rates: More people are using more services, especially after deferred care from the pandemic years.

• Cost-sharing strategy: Plans push more costs to the enrollee in the form of deductibles and coinsurance to control spending.

This isn’t unique to PSHB—it’s a trend across the entire healthcare market—but you’re feeling the effects right now.

What Happens Once You Meet the Deductible?

After you’ve met your deductible, your PSHB plan begins sharing costs with you through coinsurance or copayments. But don’t confuse that with the plan covering everything.

You may still be responsible for:

• 20% to 30% coinsurance on in-network services

• 40% to 50% coinsurance for out-of-network care

• Copayments for office visits, prescriptions, and emergency care

So even after you’ve spent hundreds or thousands on your deductible, additional bills will still come.

Shrinking Benefits Are Subtler—but Just as Serious

In 2025, another trend is taking root: PSHB plans are quietly trimming benefits while raising deductibles. Here’s how that happens:

• Higher thresholds for coverage: Services that were once covered without applying to your deductible may now count toward it.

• Fewer covered services: Certain tests, therapies, or durable medical equipment may no longer be included unless medically necessary.

• Narrower provider networks: Some plans limit who you can see or require referrals where they didn’t before.

• Changes in drug formularies: Medications that were Tier 2 in 2024 may now be Tier 3 or require prior authorization.

These small changes add up, making it harder to predict your costs—or to access care affordably.

For Retirees, the Deductible Dynamic Shifts

If you’re retired and enrolled in both PSHB and medicare Part B, your deductible burden can be lower—but that depends on your specific plan.

Many PSHB plans in 2025 coordinate with Medicare in ways that reduce or waive your plan’s deductible for services Medicare already covers. However:

• Not all plans do this

• You must be enrolled in Medicare Part B

• You must follow your plan’s rules to access the coordination

If you’re not enrolled in Medicare, you face the full PSHB deductible, just like active employees. That could make your out-of-pocket burden significantly higher.

What You Can Do to Prepare in 2025

Even if deductibles feel out of your control, there are steps you can take now to better manage your healthcare budget:

1. Understand Your Plan’s Deductible Structure

Look carefully at your PSHB plan brochure. Find:

• The in-network and out-of-network deductible amounts

• Whether individual and family deductibles are combined or separate

• What services do not apply toward the deductible (e.g., preventive care)

This helps you plan ahead, especially if you or a family member expect high medical usage this year.

2. Check If Your Plan Waives Deductibles with Medicare

If you’re Medicare-eligible and enrolled in Part B, confirm with your PSHB plan whether your deductible is waived or reduced.

Some plans in 2025 offer:

• $0 in-network deductibles when combined with Medicare Part B

• Lower prescription cost-sharing

• Additional services without cost after Medicare pays first

Understanding this interaction can save you hundreds—if not thousands—this year.

3. Track Your Healthcare Spending Year-Round

Start tracking medical expenses from January 1 so you know how close you are to meeting your deductible.

• Use your plan’s online portal or app

• Keep receipts from pharmacies and provider offices

• Confirm which expenses count toward your deductible

Once you hit your deductible, your cost-sharing percentage kicks in—but only if your plan has recorded those expenses accurately.

4. Schedule Non-Urgent Services Strategically

If you’ve already paid down a significant portion of your deductible by mid-year, consider completing additional elective procedures before the end of the year. That way, your plan pays more of the cost.

Examples:

• Physical therapy sessions

• Cataract or knee surgery

• MRIs or diagnostic tests

Timing can make a major financial difference, especially in plans with high annual deductibles.

5. Reevaluate Your Plan During Open Season

Open Season occurs each year from November to December. This is your opportunity to compare your current deductible with those in other PSHB plans.

When comparing plans:

• Don’t just look at premiums—look at deductible amounts too

• Consider coordination with Medicare if you’re eligible

• Review out-of-pocket maximums in case of serious illness

A plan with a slightly higher premium but a lower deductible might actually save you money depending on your medical needs.

How Deductibles Compare to Other Costs in 2025

Deductibles are just one part of the overall cost-sharing equation. Here’s how they relate to other PSHB costs in 2025:

• Premiums: Often partially covered by the government, but your portion has increased.

• Copayments: Flat fees for services like urgent care or prescriptions—these usually don’t count toward your deductible.

• Coinsurance: A percentage you pay after meeting the deductible—this adds up fast for high-cost procedures.

• Out-of-pocket maximum: Once you hit this limit, the plan covers 100% of additional in-network costs—but the deductible and coinsurance count toward it.

Understanding how these costs interact helps you predict your annual financial exposure more accurately.

What If You Delay or Skip Care?

Some people respond to rising deductibles by putting off care. While this may lower short-term costs, it can backfire later. Delayed care often leads to:

• Worsening chronic conditions

• Emergency room visits that cost more

• Hospital admissions that could’ve been avoided

In 2025, you should not have to choose between your health and your finances—but the reality is, the deductible you carry influences that decision daily.

Rising Deductibles Require Smarter Planning

With PSHB deductibles higher than ever in 2025, and benefits being adjusted behind the scenes, being proactive is no longer optional. Whether you’re still working or are already retired, take time to understand your coverage and assess how much risk you’re carrying before your plan even kicks in.

You don’t have to do it alone. Get in touch with a licensed agent listed on this website to walk through your current plan and discuss better-aligned options for the coming year.