PSHB & Medicare
PSHB replaced FEHB for postal employees and annuitants on 1 January 2025, and it handles prescriptions differently in a way that catches people out. You cannot hold two Medicare drug plans at once — and joining a second one takes away the first.
No plan described here is a veterans plan, a VA plan, a military plan or a federal employee plan. Medicare Advantage and Part D plans are private insurance. None is issued by, sponsored by, endorsed by or affiliated with the Department of Veterans Affairs, the Department of Defense, any branch of the armed services, or the Office of Personnel Management. Your VA, TRICARE, CHAMPVA, FEHB or PSHB coverage is administered by those agencies and nothing on this page changes it.
Joining another Medicare drug plan removes your PSHB drug coverage
PSHB delivers prescription coverage to Medicare-eligible members through a Medicare Part D arrangement inside the PSHB plan. A person cannot be enrolled in more than one Medicare Part D plan at the same time. So enrolling in a separate Part D plan — or in a Medicare Advantage plan that includes Part D — takes you out of the PSHB one, and OPM's guidance is blunt about the result: you then do not have PSHB prescription drug coverage. Your PSHB premium does not go down to match. If a Medicare Advantage plan fits your situation, the structure that protects your PSHB drug benefit is one with no Part D in it.
PSHB & Medicare, step by step
PSHB is its own programme now
The Postal Service Health Benefits programme replaced FEHB for postal employees and annuitants effective 1 January 2025. Guidance written for FEHB does not automatically apply to it — OPM has issued PSHB-specific guidance, and some FEHB letters state on their face that they do not apply to PSHB enrollees. If you are postal, confirm anything you read against current PSHB guidance specifically.
Confirm with: OPM — Postal Service Health Benefits, 1-888-767-6738
Part B is generally required for Medicare-eligible enrollees
Subject to specific exceptions. This is a real difference from the way many postal retirees understood their coverage to work before 2025, and it is worth confirming how it applies to you rather than assuming either way.
Confirm with: OPM — Postal Service Health Benefits, 1-888-767-6738
The drug benefit is the thing to protect
See the box above — it is the most consequential paragraph on this page. The PSHB drug benefit reaches you through a Medicare Part D arrangement, and Medicare's rules allow only one Part D enrolment at a time. Anything that enrols you in a different Part D plan removes the PSHB one. That includes a Medicare Advantage plan with drug coverage built in, which is easy to sign without realising it carries Part D.
Confirm with: OPM — Postal Service Health Benefits, 1-888-767-6738
Keep, suspend, cancel — and never cancel
The same three options exist here as in FEHB, with the same asymmetry. Keeping PSHB and adding a Medicare Advantage plan with no Part D leaves your drug benefit intact. Suspending is a specific administrative action with its own form and its own closed list of permitted destinations. Cancelling is generally permanent and takes the government's premium share with it. Confirm which options are open to you under current PSHB guidance before you file anything — the rules here are newer and thinner on the ground than the FEHB ones.
Confirm with: OPM Retirement Services — 1-888-767-6738
If anyone else is on your enrolment
As with FEHB, a suspension generally applies to the enrolment rather than to you personally, so anyone covered under it is affected. Work out replacement coverage for every person on the enrolment before filing, particularly for a spouse who is not yet Medicare-eligible.
Confirm with: OPM Retirement Services — 1-888-767-6738
Where the drug coverage question lands
Every kind of coverage on this page already includes prescription drug coverage that Medicare counts as creditable — meaning it is at least as good as a Part D plan, so you are not building a late-enrollment penalty while you hold it. That one fact decides the shape of any Medicare Advantage plan that would make sense next to it.
A Medicare Advantage plan that carries no Part D drug coverage is usually written as “MA-Only” or a medical-only plan. It covers what Part A and Part B cover, plus whatever extras the plan includes, and it leaves your existing drug coverage alone. For two of the programmes below, that is not a preference — adding Part D takes a benefit away.
Check this yourself
Nothing here is a decision about your benefit. These are the people who administer it and can tell you how it applies to you.
- OPM — Postal Service Health Benefits — 1-888-767-6738 · www.opm.gov
- Medicare — 1-800-MEDICARE · www.medicare.gov
Talk it through with somebody who knows how these fit together
No medical questions, no pressure, and no application on the first call. If the honest answer is that your existing coverage already does the job, that is the answer you will get.
The ones that come up every week
Does enrolling in a Medicare Advantage plan affect my VA health care?
No. Your VA enrolment, your Priority Group and your disability compensation are administered by VA and are not changed by a private insurance enrolment. What a Medicare Advantage plan does is give you a way to get care outside the VA system. It pays nothing toward care you receive at a VA facility.
I use the VA for all my prescriptions. Do I need a Medicare drug plan?
Generally no. VA pharmacy benefits are creditable prescription drug coverage, which means you are not building a Part D late-enrolment penalty while you use them. The same is true of TRICARE, CHAMPVA and federal plan drug benefits. Confirm your own situation with the programme that administers your coverage.
Can I keep my FEHB plan and take a Medicare Advantage plan at the same time?
OPM states that an individual may enrol in a Medicare Advantage plan and also remain enrolled in an FEHB plan. If you do, OPM requires you to tell your FEHB plan, because it needs to know whether you have Original Medicare or a Medicare Advantage plan in order to coordinate benefits correctly. Confirm the specifics with your own carrier and with OPM at 1-888-767-6738.
What is the difference between suspending and cancelling FEHB or PSHB?
Suspension is reversible — an annuitant can return during a later Open Season, or immediately if a Medicare Advantage plan is involuntarily lost. Cancellation is generally permanent, and takes the government's share of the premium with it. They are different administrative actions. Before filing either, call OPM Retirement Services at 1-888-767-6738 and get the answer for your own enrolment.
I get my CHAMPVA medications in the mail. Should I take a Medicare drug plan?
VA states that Meds by Mail is available only to CHAMPVA beneficiaries with no other prescription coverage, and that you do not need Part D to get CHAMPVA. A Medicare drug plan would end Meds by Mail rather than add to it. Confirm with CHAMPVA at 1-800-733-8387 before changing anything.
Will a Medicare Advantage plan lower my Part B premium?
Some plans include a Part B premium reduction, often called a giveback. It is a feature of particular plans in particular counties rather than something Medicare Advantage does generally, and the amount varies. It is worth asking about for your own county, and worth checking on Medicare.gov rather than taking anyone's word for it — including ours.
Does TRICARE For Life end if I join a Medicare Advantage plan?
No. You still have Medicare, the Medicare Advantage plan becomes the primary payer, and TRICARE For Life remains the second payer for TRICARE-covered services. Note that TRICARE's guidance says Medicare Advantage claims do not cross over automatically, so a claim may occasionally need following up. Dropping Part B, on the other hand, does end TRICARE For Life.