Key Takeaways

• Even modest biweekly contributions to your Postal Service Health Benefits (PSHB) plan can quietly add up to a significant yearly expense.

• Factoring in your total health care spending—premiums, copays, coinsurance, and deductibles—can give you a more accurate picture of what your plan truly costs.

How Contribution Costs Can Sneak Up On You

At first glance, your PSHB contribution might not raise any red flags. When you see a biweekly deduction from your paycheck, it can seem manageable—especially when compared to the cost of care without insurance. But over time, that small amount accumulates. In fact, over a full year, many Postal Service employees and retirees find that these deductions are far more significant than expected.

You may already know that the government covers a large portion of your total premium—typically around 70%. However, your 30% share, spread across 26 pay periods, can total thousands by year-end, depending on your enrollment type.

Breaking Down Your Annual Health Plan Costs

To get a full understanding of what you’re really spending, you have to go beyond just your premium. Consider all of the following:

• Biweekly premium contributions

• Annual deductible payments

• Copayments for services like doctor visits, urgent care, and prescriptions

• Coinsurance for specialist visits, imaging, or hospital stays

• Out-of-pocket maximums

Each of these plays a role in your actual yearly spending, and when added together, they can easily exceed expectations.

Why 2025 Feels More Expensive Than Before

In 2025, several cost factors have shifted:

• Higher premiums: Most enrollees saw an average increase in premium contributions compared to 2024.

• Rising deductibles: Depending on your plan type, your deductible might now range between $350 and $2,000.

• More frequent copays: With more routine visits and specialty services, many members find themselves paying copays more often than anticipated.

Even if you haven’t used more care this year, the structure of your plan may be contributing to higher out-of-pocket totals.

Evaluating Your PSHB Contributions Over 12 Months

If you haven’t already done so, take a moment to review your health plan deductions from January through December. Multiply your biweekly premium contribution by 26, then add your known out-of-pocket costs.

For instance:

• 26 pay periods of biweekly contributions

• Multiple $20 to $60 copays for various services

• Any deductible amounts met throughout the year

• Coinsurance paid on more expensive procedures or tests

This exercise will give you a realistic estimate of what you’re actually investing in your health plan annually.

Considerations for Postal Retirees

If you’re a Postal Service annuitant, your contributions look slightly different from those of active employees. In 2025, your monthly premium contribution depends on your plan type and enrollment tier (Self Only, Self Plus One, or Self and Family). While the government still pays a portion, your share may be higher compared to when you were actively working.

Retirees are also more likely to encounter frequent or chronic care needs, which can drive up out-of-pocket costs through copayments, coinsurance, and prescription drug use.

Medicare-Eligible Annuitants and Dual Contributions

If you’re enrolled in both PSHB and Medicare Part B in 2025, you are paying two separate premiums. One for your PSHB plan and another for Medicare Part B, which currently costs $185 per month.

Although this dual coverage offers valuable benefits—such as waived deductibles and lower cost-sharing—it does increase your total monthly and annual contributions. This layered spending structure can surprise many annuitants who assumed Medicare would replace their plan, not add to it.

Hidden Costs Beyond the Premium

Even if your premium seems moderate, hidden costs can inflate your actual healthcare spending:

• Lab work and diagnostics often fall under coinsurance rather than flat copays.

• Specialist visits may require both a higher copay and additional coinsurance depending on the procedure.

• Urgent care or ER visits can come with $75 to $150 copays, plus coinsurance in some plans.

• Out-of-network care can lead to significant surprise billing if you’re unaware of network boundaries.

These charges may not hit you all at once, but over the course of 12 months, they add up substantially.

Why Open Season Matters More Than You Think

The PSHB Open Season, held from November to December, gives you the only regular chance to reassess your plan each year. Yet many Postal employees and retirees choose to stick with the same plan without comparing costs.

During Open Season, you should:

• Review how much you paid in total this year

• Compare deductible, coinsurance, and copay structures across available plans

• Factor in how Medicare integration affects cost if you’re eligible

• Evaluate if your current provider network still meets your needs

Skipping this review can leave you locked into another year of paying more than necessary.

How Cost-Sharing Influences Your Total Spending

Even a low premium plan might result in high yearly spending if the cost-sharing terms are unfavorable. On the other hand, a plan with a slightly higher premium but lower out-of-pocket costs could end up saving you money.

Here’s what to assess:

• Is the deductible manageable given your usage patterns?

• Do copays apply before or after meeting your deductible?

• What percentage is your coinsurance for higher-cost services?

• Have you ever reached your out-of-pocket maximum?

These questions reveal whether you’re truly getting value for your monthly and yearly contributions.

Evaluating Cost vs. Coverage

One common misconception is that the cheapest plan is always the best option. In reality, the value of your PSHB plan lies in how much it protects you when you actually need care.

You may want to pay a bit more per pay period if it means:

• Lower copays or coinsurance

• Reduced deductible requirements

• Broader access to specialists and hospitals

• Better coordination with Medicare Part B

Cost and coverage need to be evaluated together—not in isolation.

Preparing for the Next Plan Year

Use the remainder of 2025 to track your healthcare utilization and costs. Doing so positions you to make an informed decision during the next Open Season. Here’s how to stay prepared:

• Keep a record of all health-related payments

• Check your Explanation of Benefits (EOBs) monthly

• Track your progress toward your deductible and out-of-pocket maximum

• Monitor changes in your health that might affect your future needs

With this data in hand, you can make a change in your plan selection next November that actually reduces what you spend.

Your Total Health Plan Cost Isn’t Just a Number—It’s a Strategy

You don’t have to accept rising contributions and costs as inevitable. Instead, treat your PSHB plan as a financial decision, just like any other part of your household budget.

Consider the trade-offs:

• Do you want a low deductible or low monthly premium?

• Do you use healthcare frequently or rarely?

• Are you coordinating care with Medicare?

• Have your health needs changed over the past year?

Strategic selection and annual review can help you take more control over what you spend—without sacrificing quality care.

Looking Ahead: Don’t Let Another Year Go By Without a Closer Look

By the time you reach the last few pay periods of 2025, your total health plan contribution might surprise you. What felt like small amounts at the start of the year can add up to thousands in premiums and out-of-pocket expenses.

Before the next Open Season arrives, take stock of your spending. Evaluate if your current PSHB plan still aligns with your healthcare usage, budget, and coverage needs.

If you’re uncertain where to start, get in touch with a licensed agent listed on this website for professional advice and personalized plan guidance.