Key Takeaways

• The 2025 shift from FEHB to PSHB for Postal Service annuitants has created new Medicare integration rules and deadlines that directly impact your client conversations.

• As an agent, your credibility hinges on helping Medicare-eligible clients understand how PSHB plans now work with Part B—and what could happen if they don’t comply.

Understanding the PSHB and Medicare Crossroads

If your clients are retired Postal Service workers, 2025 brings a defining shift: they are now enrolled in the Postal Service Health Benefits (PSHB) Program instead of the Federal Employees Health Benefits (FEHB) Program. This change isn’t just administrative. It has real Medicare implications—particularly for those aged 65 and older.

The PSHB was created under the Postal Service Reform Act of 2022 and is officially effective as of January 1, 2025. If you haven’t updated your conversations to reflect the nuances of PSHB and its tight coordination with Medicare, you risk leaving your clients exposed to coverage gaps, delayed care, or permanent late enrollment penalties.

What’s New in the PSHB Framework?

Mandatory Medicare Part B Enrollment for Many

Here’s the critical update: most Medicare-eligible annuitants and their covered family members must now be enrolled in Medicare Part B to maintain full PSHB benefits. This is a major policy change.

However, there are exemptions:

• Retired on or before January 1, 2025, and not already enrolled in Part B

• Postal employees who were age 64+ as of January 1, 2025

• Residents of foreign countries

• Veterans using VA health services or members eligible for Indian Health Service

Even if your client is exempt, they may still benefit from enrolling in Part B due to cost-sharing incentives in most PSHB plans when paired with Medicare.

Integrated Part D Coverage

PSHB plans automatically provide prescription drug coverage through a Medicare Part D Employer Group Waiver Plan (EGWP) for Medicare-eligible members. There’s no need for clients to shop for a standalone Part D plan—but they also can’t opt into one outside PSHB without forfeiting PSHB drug coverage.

Key points for agents:

• Clients who opt out of the PSHB-provided Part D lose drug coverage under PSHB.

• There’s no standalone enrollment. EGWP is baked into the plan.

Different Enrollment and Change Periods

In 2025, the Open Season for PSHB occurred from November to December 2024. But going forward, your clients can:

• Make changes each November–December during Open Season

• Update their plan following a Qualifying Life Event (QLE)

• Use a Special Enrollment Period (SEP) if becoming Medicare-eligible mid-year

You need to track these windows carefully. Clients missing deadlines risk reduced access or higher costs.

What Happens If Clients Don’t Enroll in Part B?

For those who are required to enroll in Medicare Part B and fail to do so:

• They lose access to PSHB medical benefits entirely.

• They retain dental, vision, and prescription drug benefits only.

This isn’t a theoretical issue. It’s a real and avoidable risk if your clients misunderstand their obligations.

It’s your responsibility to educate them that Part B is not optional under PSHB the way it was under FEHB.

Comparing FEHB and PSHB From a Medicare Lens

From your clients’ perspective, the switch might seem seamless. Premiums may look similar. Carriers might appear familiar. But the rules of engagement with Medicare have changed dramatically:

Aspect	FEHB (pre-2025)	PSHB (2025 onward)
Part B Required?	No	Yes (with exceptions)
Part D Needed?	Optional	Provided automatically
Late Enrollment Penalties?	Based on Medicare rules only	PSHB plan access can be denied
Coordination with Medicare	Optional	Central to coverage

This table should become part of your outreach material. Keep it simple, visual, and clear. Use it in review sessions.

Talking Points Clients Need to Hear

Use clear language to drive home what your clients should act on immediately. Here are core talking points to build into every Medicare-related consultation for PSHB annuitants:

• “If you’re Medicare-eligible, you must enroll in Part B unless you’re exempt.”

• “PSHB plans automatically give you drug coverage—but opting out removes all pharmacy benefits.”

• “Missing your enrollment window can leave you without full coverage for a year—or permanently.”

• “We’ll look at your exemption status together. You might still benefit from enrolling in Part B.”

Your tone should be assertive, not alarmist. Clarity wins over fear.

Medicare Enrollment Logistics for PSHB Clients

For those turning 65 in 2025 or who are already eligible and not enrolled in Part B, Medicare provided a Special Enrollment Period (SEP) that ran from April 1 to September 30, 2024. Those who missed that SEP now face:

• General Enrollment Period from January 1 to March 31 each year

• Late enrollment penalties (10% for every 12 months delayed)

• Coverage starting July 1 following enrollment

It’s critical to inform clients that late enrollment can’t always be reversed, and penalties can last for life.

Cost Considerations Under PSHB and Medicare

While individual plan premiums vary, here’s what clients can generally expect in 2025:

• Medicare Part B Premium: $185 per month

• Part B Deductible: $257 annually

• Prescription Drug Deductible: Up to $590

• Annual Part D Out-of-Pocket Cap: $2,000

When paired with Medicare, many PSHB plans offer:

• Reduced deductibles

• Lower coinsurance

• Waived or reduced copayments

• Out-of-pocket maximums around $7,500 (Self Only)

These savings can offset Part B premium costs—another angle to include in your strategy session.

Compliance and Retention in a Post-FEHB World

This transition has made Medicare compliance a retention issue. A client who doesn’t enroll in Part B might disappear from your book if they lose access to care. Worse, they may hold you accountable for not warning them.

Ways to reinforce compliance:

• Build a PSHB checklist to review with Medicare-eligible clients

• Send reminders during Medicare enrollment windows

• Confirm clients’ exemption status in writing

• Include PSHB education in all annual reviews

Helping clients stay compliant is not just service—it’s client protection and business preservation.

Your Role Is Now More Critical Than Ever

The PSHB shift means you’re no longer just explaining Medicare basics. You’re now acting as a vital translator between two complex systems. Postal retirees aren’t always aware of the intricacies until it’s too late.

That’s why your positioning in 2025 must include:

• Proactive outreach to annuitants turning 65

• Deep knowledge of PSHB plan integration

• Awareness of current Medicare timelines

• An organized way to track client eligibility and deadlines

Your ability to simplify the rules and anticipate client confusion is what will set you apart from other agents who aren’t prepared.

Bring It All Together for Your Clients

This is the year to cement your role as a trusted Medicare advisor—especially for Postal Service annuitants facing a maze of new requirements. The stakes are higher, and the timelines are stricter. When you show up with clarity, updated knowledge, and a simple action plan, your clients will feel secure and stay loyal.

We built BedrockMD to help agents like you confidently support clients through Medicare’s most complex changes. Our CRM tools, compliance prompts, and Medicare training modules are tailored for today’s environment. When you sign up with us, you’re never navigating transitions like PSHB alone.