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Five Must-Know Facts About Postal Worker Health Benefits in the Coming Year

eduard hamamjian
June 7, 2025

Key Takeaways:

Postal workers and retirees need to stay informed about significant changes to their health benefits in 2025, including the shift to the Postal Service Health Benefits (PSHB) Program.
Medicare integration requirements and new cost structures may impact your coverage choices and overall healthcare expenses.

A New Era for Postal Worker Health Benefits

If you’re a postal worker or a retiree, 2025 brings transformative changes to your health benefits. The Federal Employees Health Benefits (FEHB) program has transitioned to the Postal Service Health Benefits (PSHB) program, which means you’ll need to understand the new system and make informed decisions. Whether you’re approaching retirement or already enjoying it, these updates could directly affect your healthcare and financial planning.

The Switch from FEHB to PSHB

The PSHB program officially replaces FEHB for postal employees and retirees starting this year. This shift simplifies health benefits for postal workers but comes with distinct differences:

Who’s Impacted: If you’re a current postal employee or a retiree, you must enroll in a PSHB plan to maintain your coverage. Exceptions apply if you’re covered under a family member’s FEHB plan.
Timeline: Enrollment decisions made during the last Open Season, which ended in December 2024, took effect on January 1, 2025. If you missed making changes, only qualifying life events allow adjustments until the next Open Season in November 2025.

Government Contributions to Premiums

Under the PSHB program, the government continues to cover approximately 70% of premium costs. While this contribution helps reduce out-of-pocket expenses, it’s crucial to review your plan to ensure it aligns with your needs. Understanding the cost-sharing structure, such as copayments, deductibles, and coinsurance, can help you anticipate annual expenses.

Medicare Integration Requirements

One of the most notable changes under the PSHB program is the requirement for Medicare integration. Here’s what you need to know:

Who Needs to Enroll: If you’re Medicare-eligible, enrolling in Medicare Part B is mandatory to maintain PSHB coverage, except for specific exemptions. Retirees who were 64 or older by January 1, 2025, and those who retired before this date are exempt.
Benefits of Integration: Many PSHB plans coordinate with Medicare to offer benefits like reduced deductibles, lower copayments, and Part B premium reimbursements.
Deadlines: Ensure you enroll in Medicare Part B during your Initial Enrollment Period (IEP) to avoid late penalties. If you missed this, you can enroll during the General Enrollment Period (January 1 to March 31) with coverage starting July 1.

How PSHB Plans Differ

Unlike FEHB plans, PSHB plans are tailored specifically for postal workers. While there are similarities, some notable differences include:

Prescription Drug Coverage: For Medicare-eligible retirees and family members, PSHB plans include prescription drug benefits through a Medicare Part D Employer Group Waiver Plan (EGWP). This change simplifies medication management and reduces costs.
Out-of-Pocket Maximums: In 2025, PSHB plans cap in-network out-of-pocket expenses at $7,500 for Self Only and $15,000 for Self Plus One and Self & Family coverage. Understanding these limits helps you plan for worst-case scenarios.

Open Season and Enrollment Periods

Navigating enrollment periods is crucial to ensuring uninterrupted coverage. Key timelines include:

Open Season: Occurs annually from November 11 to December 13. During this period, you can change plans, add dependents, or make other adjustments.
Special Enrollment Periods (SEPs): Triggered by qualifying life events, such as marriage, divorce, or the birth of a child.

Missing these periods could leave you locked into your current plan until the next Open Season.

Planning for Healthcare Costs in Retirement

Retirement often brings a fixed income, making it essential to budget for healthcare costs effectively. Here’s what to consider:

Premiums: While the government covers a significant portion, your share varies based on your chosen plan. Compare options carefully during Open Season.
Deductibles and Coinsurance: Low-deductible plans may have higher premiums but could save you money on frequent medical visits. High-deductible plans paired with Health Savings Accounts (HSAs) can be a smart option for some.
Prescription Costs: With the new $2,000 annual cap on out-of-pocket prescription drug expenses under Medicare Part D, budgeting for medications becomes more predictable.

Accessing Support and Resources

Making sense of these changes might seem overwhelming, but help is available. You can access plan brochures and resources through the U.S. Office of Personnel Management (OPM) website. Additionally, PSHB customer service representatives can clarify benefits, premiums, and enrollment details.

Annual Notice of Change (ANOC): Review this document carefully each year. It outlines any changes to your plan, helping you make informed decisions during Open Season.

Staying Ahead of Future Changes

Healthcare is an ever-evolving landscape, and staying proactive ensures you’re prepared for any updates. Keep these tips in mind:

Monitor Legislative Changes: Health benefit programs may adapt based on government policies. Staying informed helps you anticipate potential impacts on your coverage.
Review Coverage Annually: Even if your plan worked well this year, your needs might change. Open Season is your chance to reassess.
Understand the Fine Print: Pay attention to plan exclusions, cost-sharing details, and provider networks.

Why These Changes Matter to You

Understanding your health benefits isn’t just about avoiding surprises; it’s about ensuring you’re making the best decisions for your health and finances. The shift to the PSHB program marks a significant change, and staying informed will help you navigate this new chapter confidently.

Eduard Hamamjian

Over the past 35 years, I've purchased, sold, and developed multiple businesses and properties. This hands-on experience has given me a unique depth of expertise in all aspects of my counsel and advice. I find tremendous satisfaction in helping others, and I consider it a privilege to assist my clients in achieving their life goals.

My journey has been a remarkable one. In 1965, my parents gifted me the opportunity to emigrate from the former Soviet Union to the United States under the most challenging circumstances. Fast forward to 2023, and my wife and I were ringing the closing bell of the New York Stock Exchange. This is the kind of story that can only happen in America.

I'm a self-confessed analytical, and I relish the daily grind of crunching numbers. The time I spend counseling my clients provides me with immense satisfaction. I was born in Armenia, but I grew up in Cranston, Rhode Island. From an early age, through sports, I learned that real success is a by-product of discipline, execution, and calculated risk. There are no shortcuts in life, and the rewards we reap tomorrow are a direct result of what we are willing to do today.

When I'm not working, you can find me on the dance floor, practicing ballroom dancing, or playing a game of table tennis. I also enjoy boating. But above all, what I cherish the most is spending quality time with my family and friends. These moments are priceless and remind me every day why I strive to help others achieve their goals.

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