Medicare 2026

Postal Retirees and PSHB: When Medicare Part B Is Required, and Who Is Exempt

If you're a Postal Service retiree — or a family member on a retiree's health plan — the rules about Medicare Part B changed in a meaningful way starting in 2025. The Postal Service Health Benefits (PSHB) Program replaced FEHB for postal workers, retirees, and their families, and PSHB comes with a Part B enrollment requirement that FEHB never had. The good news: several groups are exempt. The important part: if you're not exempt and you skip Part B, you can lose access to PSHB entirely — and you can't fix it later by signing up for Part B down the road.

Here's a plain-English overview of how the Part B requirement works, who is exempt, and where to look for answers.

Why PSHB is different from FEHB

Under FEHB, there was never a rule forcing Medicare-eligible annuitants to sign up for Part B to keep their health plan. PSHB changed that for the postal community. Certain Medicare-eligible Postal Service annuitants and their Medicare-eligible family members now must enroll in Part B to maintain PSHB coverage, unless an exception applies.

The Office of Personnel Management (OPM), which administers PSHB, has been clear on one point that catches people off guard: if you retire after January 1, 2025 and don't enroll in Part B when you should, you won't be eligible for PSHB in retirement — and enrolling in Part B later does not restore the option. In OPM's own example, a retiree's spouse who didn't enroll in Medicare and doesn't qualify for an exception is not eligible for PSHB coverage and is dropped from the retiree's enrollment.

Who is exempt from the Part B requirement

The requirement doesn't reach everyone. The main exceptions:

• Retired on or before January 1, 2025 and not already enrolled in Part B. You don't have to sign up now to keep PSHB. Family members in this group are also exempt.
• Age 64 or older on January 1, 2025. Postal employees who were at least 64 on that date are not required to enroll in Part B after they retire. Their family members are also exempt.
• Living outside the United States and its territories. You must document your residency abroad, and the exception can be lost if you move back.
• Certain VA health care benefits.
• Indian Health Service eligibility.

When the annuitant qualifies for the exception through VA or IHS, the annuitant's family members are exempt too.

What about current postal employees?

The Part B requirement applies to annuitants, not current workers. OPM says employees are exempt while working. Postal Service compensationers (those receiving workers' compensation benefits) aren't required to enroll in Part B to be in a PSHB plan, regardless of whether they have Part A — though they may need to enroll in Part B at retirement if no exception applies.

The one-time Part B sign-up window and late-enrollment penalties

Social Security ran a one-time Part B Special Enrollment Period for eligible postal annuitants and family members from April 1 through September 30, 2024, with Part B coverage starting January 1, 2025. That window is now closed.

For people who used it and incurred a Part B late enrollment penalty, the Postal Service pays that penalty directly to Medicare — as long as the person keeps an active or suspended PSHB enrollment. If someone cancels PSHB, they become responsible for the penalty.

What Part B costs in 2026

For 2026, the standard Part B premium is $202.90 a month. Beneficiaries whose 2024 modified adjusted gross income was above $109,000 (individual) or $218,000 (married filing jointly) may pay an income-related monthly adjustment (IRMAA) on top of the standard premium.

The 2027 Part B premium, deductible, and IRMAA brackets have not yet been announced. CMS typically releases those figures in the fall — watch Medicare.gov for the official numbers.

How this fits with the rest of Medicare in 2027

A few other dates and figures are already set:

• Annual Enrollment for 2027 runs October 15 through December 7, 2026; choices take effect January 1, 2027.
• The Part D out-of-pocket cap is $2,400 in 2027 (it is $2,100 in 2026).
• The maximum Part D deductible any plan may charge in 2027 is $700.
• The Part D base beneficiary premium for 2027 is $41.33, which is used in the national late-enrollment penalty formula; actual plan premiums vary.
• The Social Security Administration announced a 3.6 percent cost-of-living adjustment for benefits payable beginning January 2027.

If you have Medicaid or Extra Help, since 2025 you have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can join an integrated D-SNP in any month.

Original Medicare + Medigap vs. Medicare Advantage

Postal retirees who enroll in Part B still face the same broad choice every Medicare beneficiary faces. Original Medicare paired with a Medigap policy and a stand-alone Part D plan offers broad provider access and predictable cost-sharing, but typically comes with separate premiums. Medicare Advantage plans bundle coverage, often include extras, and may have lower premiums, but use networks and prior authorization. Neither is "better" — it depends on your providers, medications, travel patterns, and budget. PSHB itself coordinates with Medicare in ways specific to each plan, so read your plan brochure carefully.

Where to go next

For official, personalized information, start at Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24/7. For PSHB-specific questions — exceptions, documentation, and what happens at retirement — check the materials OPM sends to postal annuitants and families.