Federal Employees & Postal Workers

FEHB, PSHB & Medicare: What Changed in 2025–2026

If you're a federal employee, retiree, or USPS postal worker turning 65, the rules around Medicare just got more complex — especially for postal workers under the new PSHB program. I help you navigate every decision at no cost.

Important 2025 Change for Postal Workers

As of January 1, 2025, USPS employees and retirees moved from FEHB to the new Postal Service Health Benefits (PSHB) program. Most Medicare-eligible postal retirees are now required to enroll in Medicare Part B to keep their PSHB coverage. If you're turning 65 in 2026, this affects you directly.

How FEHB Works with Medicare

The Federal Employees Health Benefits (FEHB) program covers roughly 8 million federal employees, retirees, and their families — making it one of the largest employer-sponsored health insurance programs in the country. When you turn 65 and become eligible for Medicare, FEHB and Medicare can work together powerfully.

When you have both Medicare Parts A and B and an FEHB plan, Medicare pays first (as the primary payer) and your FEHB plan pays second. Most FEHB plans waive their deductibles, copays, and coinsurance when Medicare has already paid — leaving you with little to no out-of-pocket cost for most medical services.

  • Medicare Part A (hospital) is free for most federal retirees with 10+ years of federal service
  • Medicare Part B ($202.00/month in 2026) is optional for FEHB retirees — but often worth it
  • FEHB acts as secondary payer, filling gaps Medicare leaves behind
  • No need for a separate Medigap plan — FEHB already fills the gaps
  • Most FEHB plans have creditable drug coverage — no need for Part D

The New PSHB Program (Postal Workers Only)

The Postal Service Health Benefits (PSHB) program launched January 1, 2025, replacing FEHB for all USPS employees, retirees, and eligible family members. PSHB is administered by the Office of Personnel Management (OPM) and offers similar plan options to FEHB — but with one critical difference for retirees.

Feature
FEHB (Non-Postal Federal)
PSHB (Postal Workers)
Eligibility & Enrollment
Who is covered
Federal civilian employees, retirees, and eligible family members
USPS employees, retirees, and eligible family members (as of Jan 1, 2025)
Administered by
OPM — Office of Personnel Management
OPM (separate program from FEHB)
Plan options
200+ plans nationwide across multiple plan types
Subset of FEHB-style plans specifically for postal workforce
Active employee eligibility
Must work for a federal agency
Must work for USPS
Retiree eligibility
Must have 5+ years of FEHB coverage before retirement
Must have 5+ years of FEHB/PSHB coverage before retirement
Medicare Coordination
Medicare Part B required for retirees?
No — entirely optional
Yes — required for most Medicare-eligible retirees to keep PSHB coverage
Consequence of not enrolling in Part B
None — FEHB coverage continues unchanged
Loss of PSHB coverage unless grandfathered or exempt
Medicare pays first?
Yes, when enrolled in both Parts A & B
Yes, when enrolled in both Parts A & B
FEHB/PSHB pays second?
Yes — acts as secondary payer, waiving most cost-sharing
Yes — acts as secondary payer, waiving most cost-sharing
Part B premium incentive/credit?
Varies — some plans offer modest credits
Yes — most PSHB plans include a Part B premium credit to offset the $202/mo cost
Need a separate Medigap plan?
No — FEHB fills the gaps Medicare leaves
No — PSHB fills the gaps Medicare leaves
Benefits Coverage
Medical / hospital coverage
Yes — comprehensive inpatient and outpatient
Yes — comprehensive inpatient and outpatient
Prescription drug coverage
Yes — most plans have creditable drug coverage
Yes — most plans have creditable drug coverage
Need separate Part D plan?
No — FEHB drug coverage is typically creditable
No — PSHB drug coverage is typically creditable
Dental coverage
Limited — most plans offer some dental; separate FEDVIP available
Limited — most plans offer some dental; separate FEDVIP available
Vision coverage
Limited — most plans offer some vision; separate FEDVIP available
Limited — most plans offer some vision; separate FEDVIP available
Mental health coverage
Yes — parity with medical benefits required
Yes — parity with medical benefits required
Preventive care
Yes — covered under most plans
Yes — covered under most plans
Foreign travel emergency
Varies by plan — many offer some coverage
Varies by plan — many offer some coverage
Cost Sharing (with Medicare Parts A & B)
Deductibles waived when Medicare pays first?
Yes — most FEHB plans waive deductibles
Yes — most PSHB plans waive deductibles
Copays waived when Medicare pays first?
Yes — most FEHB plans waive copays
Yes — most PSHB plans waive copays
Coinsurance waived when Medicare pays first?
Yes — most FEHB plans waive coinsurance
Yes — most PSHB plans waive coinsurance
Typical out-of-pocket with both Medicare + plan
Very low — often near $0 for covered services
Very low — often near $0 for covered services
Key Difference — The Bottom Line
Part B enrollment impact
Optional
Choosing not to enroll in Part B has no effect on your FEHB coverage. You keep full benefits either way.
Required for Most
Failing to enroll in Part B when Medicare-eligible means losing your PSHB coverage entirely — unless you qualify for a specific OPM exemption.

The Part B requirement is the single biggest difference between FEHB and PSHB for retirees. If you're a USPS retiree turning 65 in 2026 and you don't enroll in Medicare Part B, you risk losing your PSHB coverage entirely — unless you qualify for one of the narrow exemptions below.

Who Is Exempt from the PSHB Part B Requirement?

Not every postal retiree is required to enroll in Part B. OPM established the following exemptions:

Already Medicare-eligible before January 1, 2025

If you were already eligible for Medicare (age 65 or older, or on Medicare due to disability) and enrolled in FEHB before January 1, 2025 without Part B, you are grandfathered and not required to enroll in Part B to keep PSHB.

Permanent residence outside the United States

Postal retirees who permanently reside outside the U.S. are exempt from the Part B requirement since Medicare generally does not cover overseas care.

Medicare Part B enrollment would cause financial hardship

OPM has indicated limited hardship exemptions may be available in certain circumstances. Contact OPM directly for details.

Not sure if you qualify for an exemption? Call William at (386) 871-3858 for a free review of your specific situation. Getting this wrong can cost you your health coverage.

Should You Enroll in Medicare Part B? (FEHB Retirees)

For non-postal federal retirees, Part B enrollment is a choice — not a requirement. Here's how to think through the decision:

Enroll in Part B if…

  • You have frequent doctor visits or specialist care
  • Your FEHB plan waives cost-sharing when Medicare pays first
  • You want near-zero out-of-pocket costs for most services
  • You have a high-deductible FEHB plan
  • You want the most comprehensive coverage possible

Consider skipping Part B if…

  • You are in excellent health with minimal medical needs
  • Your FEHB plan already has low cost-sharing without Medicare
  • The $202.00/month Part B premium is a significant budget concern
  • You have a comprehensive FEHB plan with low deductibles
  • You plan to return to federal employment (active employee coverage)

Important: If you delay Part B and later decide you want it, you may face a 10% permanent premium penalty for every 12-month period you were eligible but didn't enroll — unless you qualify for a Special Enrollment Period. Federal employees with FEHB do qualify for an SEP when they retire, so you won't be penalized for delaying while actively employed.

Your Medicare Enrollment Timeline (Federal Retirees)

3 Months Before Your 65th Birthday

Your Initial Enrollment Period (IEP) begins. You can sign up for Medicare Parts A and B through SSA.gov or your local Social Security office. Part A is usually free — enroll even if you're skipping Part B.

Your 65th Birthday Month

The middle of your 7-month IEP. Coverage starts the month you turn 65 if you enrolled in the 3 months prior.

3 Months After Your 65th Birthday

Your IEP closes. If you haven't enrolled in Part B yet, you'll need to wait for the General Enrollment Period (Jan 1–Mar 31 each year) or qualify for an SEP.

When You Retire from Federal Service

Your 8-month Special Enrollment Period begins. You can enroll in Part B without penalty during this window. This is your safety net if you delayed Part B while working.

After Enrolling in Part B

Notify your FEHB plan that you now have Medicare. Most plans will automatically coordinate benefits. Review your FEHB plan's Medicare coordination rules to maximize your savings.

Frequently Asked Questions

2026 Key Numbers

Medicare Part B Premium$202.00/mo
Part B Deductible$283/year
Part B Coinsurance20% after deductible
Part A Deductible$1,736/benefit period
Part A Copay (days 61–90)$434/day
Part A Lifetime Reserve$868/day
Skilled Nursing (days 21–100)$217/day
IRMAA Threshold (single)$106,000 MAGI
Part B Late Penalty10% per 12-mo delay
PSHB Part B RequirementMost postal retirees

Confused by PSHB or FEHB?

William has helped dozens of federal and postal retirees navigate this transition. Call for a free review.

(386) 871-3858Schedule a Free Medicare Review

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Federal Retirement Planning

Questions About Your Federal Retirement Options?

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Federal Employee or Postal Worker Turning 65?

The FEHB and PSHB rules are complex — especially with the 2025 PSHB changes. William Gray helps federal and postal retirees make the right Medicare decisions at no cost to you.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY: 1-877-486-2048) to get information on all of your options.

Not affiliated with or endorsed by the U.S. government or the federal Medicare program. This is an advertisement for insurance. William Gray and affiliated licensed agents are independent insurance agents, not government employees or representatives. Medicare has neither reviewed nor endorsed this information.

Not all plans or types of coverage may be available in your area. Plan availability, benefits, and premiums vary by county and ZIP code. Enrollment in any plan depends on contract renewal. Benefits, premiums, and cost-sharing may change on January 1 of each year.

Independent Agent & Compensation Disclosure. William Gray is an independent licensed insurance agent (FL License #W690237) and is not employed by or exclusively affiliated with any single insurance company. William is compensated by insurance carriers when you enroll in a plan. This compensation does not affect the premium you pay — your premium is the same whether you enroll through a broker or directly with the carrier. Affiliated agents are independent contractors solely responsible for their own conduct and representations.