APWU Health Plan FAQ

Postal Service employees and annuitants’ eligibility determines spousal and family PSHB coverage. If the enrollee is not required to enroll in Medicare Part B, neither will dependent family members. 

As an annuitant, enrolling in PSHB and Medicare may reduce your out-of-pocket costs for healthcare. Though there is a premium cost for Medicare Part B, it is important to consider your long-term health care needs. As you get older you may realize a greater benefit from having PSHB and Medicare coverage. 

While annuitants will have an additional cost associated with Medicare Part B coverage, many PSHB plans may eliminate cost-sharing and reimburse part of the Part B premium for Medicare enrollees. Also, annuitants may be able to select a lower cost PSHB plan when enrolling in Medicare. These savings may offset the costs of Medicare Part B coverage.  

Yes. For Medicare-eligible annuitants and your Medicare-eligible family members, Medicare would become the primary payer for your medical claims, with your PSHB plan becoming your secondary payer.  

Medicare coordination requires certain Medicare-eligible Postal Service annuitants to enroll in Medicare Part B in order to maintain their PSHB coverage in retirement. Enrollment in Medicare Part B does not cancel your PSHB coverage or reduce the benefits that are available to you under your federal health insurance plan. The idea is to coordinate your PSHB and Medicare coverage when you become eligible for Medicare.  

Yes, there are a few exceptions to the requirements to enroll in Medicare Part B. As a Postal Service annuitant, these exceptions will also apply to your covered family members. 

Family members may also be eligible for their own exception, even if the annuitant is required to enroll in Medicare Part B. Postal Service annuitants and family members may be responsible for providing proof of eligibility for the applicable exceptions. These exceptions are: 

• Residing outside of the United States and its territories. (You are required to follow the policy and procedures set forth by USPS to be eligible for this exception.)  
• Enrolled in health care benefits provided by the Department of Veterans Affairs. 
• Eligible for health services provided by the Indian Health Service. 

Maybe. If you are an active employee under the age of 64 as of January 1, 2025, you are required to enroll in Medicare Part B after you retire and become entitled to Medicare Part A, typically at age 65, unless you qualify for an exception.  

Maybe. If you are an annuitant on or before January 1, 2025, and you are enrolled in Medicare Part B on January 1, 2025, you are required to remain enrolled in Medicare Part B to continue coverage under PSHB, unless you are eligible for an exception. 

Also, if you are the spouse of an annuitant who is already enrolled in Medicare Part B, you are required to enroll in Medicare Part B when you become entitled to Medicare Part A, unless you are eligible for an exception.  

Yes, you may qualify for an exception if you: 

• Demonstrate that you reside outside the United States and its territories  
• Are enrolled in health care benefits provided by the Department of Veterans Affairs  
• Are eligible for health services from the Indian Health Service 

Covered family members may have their own exception, even if you do not, if they can demonstrate meeting any of these exceptions. Individuals will be responsible for providing proof of eligibility for the applicant exception(s) to the designated agency.