Key Takeaways

1. Big Changes in Health Coverage for Postal Workers
   The new Postal Service Health Benefits (PSHB) program is tailored specifically for USPS employees and retirees, with 2025 marking the transition from the FEHB system.

2. Enrollment Periods and New Requirements
   From November 11 to December 9, 2024, USPS employees, retirees, and their eligible family members have the chance to enroll in or adjust their PSHB coverage for 2025.

Get Ready: What’s New with PSHB for 2025

Hello, USPS family! Health insurance is a big part of our benefits, and starting in 2025, there’s a major shift happening. If you’ve been covered by the Federal Employees Health Benefits (FEHB) system, you’re moving over to the Postal Service Health Benefits (PSHB) program, which is just for us at USPS. This change will impact how you access healthcare, how you coordinate with Medicare if you’re Medicare-eligible, and, yes, even how you choose your plan options.

Understanding the New PSHB Program

The PSHB program was created under recent legislation to separate USPS health benefits from the larger federal employee pool. For those of us who’ve relied on the FEHB program for years, this might seem like a big shift, but PSHB is designed to cater specifically to postal workers and retirees.

So what does this mean in practical terms? You’ll still have health insurance options, but you may find that the benefits, coverage options, and requirements are a bit different from what you’re used to under FEHB. There will be different plan names, possibly new networks of providers, and—importantly—new rules regarding Medicare enrollment for some retirees.

When’s the Enrollment Period? Key Dates to Remember

The Open Season for PSHB is your chance to select or update your plan options for 2025. Here’s what you need to know about the timing and process:

• Open Season Start Date: November 11, 2024
• Open Season End Date: December 9, 2024
• Coverage Start Date for Selected Plans: January 1, 2025

If you don’t make any changes, you’ll be automatically enrolled in a plan that corresponds with your current FEHB coverage. While auto-enrollment helps ensure there’s no gap in your coverage, it’s still a great idea to review your options during Open Season. You might find a plan that’s better suited to your needs.

What’s Changing for Medicare-Eligible Postal Retirees?

If you’re a Medicare-eligible postal retiree or have Medicare-eligible family members, there are some specific changes you need to know about.

1. Mandatory Enrollment in Medicare Part B
   For the first time, some Medicare-eligible retirees and their Medicare-eligible family members will be required to enroll in Medicare Part B to maintain PSHB coverage. The main exception? If you retired on or before January 1, 2025, and aren’t already enrolled in Part B, you won’t be required to enroll now.

2. Coordination of Benefits
   The PSHB program will work alongside Medicare to cover a broader range of expenses. Medicare Part B will act as your primary insurance for outpatient services, with PSHB covering secondary expenses. This setup can significantly reduce your out-of-pocket costs for things like doctor visits and outpatient treatments.

3. How Medicare Enrollment Affects Premiums
   Medicare Part B comes with its own monthly premiums, so you’ll need to budget for this additional cost if it applies to you. Although PSHB doesn’t pay for Part B premiums, the reduction in out-of-pocket expenses may offset some of these costs.

Why Open Season Matters: Reviewing Your Options

Now that PSHB is in place, this Open Season is the perfect time to review your options and make sure you have the best possible coverage for your needs.

What’s Included in the PSHB Plans?

Each PSHB plan provides comprehensive benefits, including:

• Hospital and Outpatient Care: Coverage for hospital stays, surgeries, and outpatient treatments.
• Prescription Drug Coverage: PSHB plans include drug coverage, which can vary based on the plan tier.
• Preventive Services: Screenings, vaccinations, and other preventive services are covered to help you stay healthy.

Remember, this Open Season is a great opportunity to look over these benefits and decide if your current plan aligns with what you anticipate needing in the coming year.

What to Consider When Choosing a Plan

When reviewing plans, here are some important factors to keep in mind:

• Monthly Premiums: Look at the monthly cost of the plan, and make sure it fits within your budget.
• Out-of-Pocket Costs: Review deductibles, copays, and coinsurance amounts for each plan option. These can add up and make a significant difference.
• Provider Networks: Confirm that your preferred healthcare providers are in-network for any plan you’re considering.
• Prescription Drug Coverage: If you rely on certain medications, make sure the plan covers them at a level you can manage.

Don’t Forget Dependents: Eligibility for Family Members

The PSHB program allows postal workers, retirees, and their eligible family members to enroll in coverage. However, eligibility requirements and coverage costs can differ. Here’s a quick overview:

1. Spouse and Children
   Your spouse and children may be eligible for PSHB coverage. Just like under FEHB, you’ll have options for self-only, self plus one, or family coverage.

2. Dependent Children
   Coverage for dependent children under PSHB extends to age 26, just as it did under FEHB. However, if you have children with special needs who may require extended coverage, you’ll need to confirm that your selected plan can accommodate these needs.

3. Medicare-Eligible Dependents
   If you have family members who are Medicare-eligible, they might also need to enroll in Medicare Part B, just like you. Make sure to check how each plan works with Medicare to avoid surprises in coverage or costs.

Automatic Enrollment: What You Need to Know

One helpful feature of the PSHB transition is automatic enrollment. If you’re already enrolled in an FEHB plan and you don’t actively select a PSHB plan during Open Season, you’ll be automatically moved into a comparable PSHB plan for 2025. While this ensures that you’re covered, it’s worth exploring your options to make sure you’re getting the coverage that’s best suited to your situation.

When Should You Actively Enroll?

Automatic enrollment might work for some, but it’s a good idea to review your options if:

• You’ve had changes in your health needs over the past year.
• You want to adjust your plan to better fit your budget.
• You’ve experienced a significant life event, like marriage, divorce, or the birth of a child.

Let’s Wrap It Up: Make Your Health Coverage Work for You

This Open Season is your time to take control of your health coverage under the new PSHB program. For many, this will mean reviewing Medicare coordination, checking in on premium costs, and making sure your favorite healthcare providers are still in-network. Open Season doesn’t come around often, so use this time wisely to ensure your coverage is just right for 2025.

By staying informed and reviewing your options, you’ll be better prepared for any health needs that come your way in the new year.