APWU Health Plan FAQ

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.  

No. If you are an active Postal Service employee age 64 or older on or before January 1, 2025, you are not required to enroll in Medicare Part B to continue your PSHB health insurance coverage in retirement. This is because you are eligible for an exception to the Medicare Part B enrollment requirement. This exception will also apply to your covered family members.  

While you are not required to enroll in Medicare Part B, you may choose to enroll in Medicare Part B. If you qualify for an exception as an active employee aged 64 or older on or before January 1, 2025, if you enroll in Medicare Part B, you are not required to maintain Part B enrollment to continue your PSHB insurance coverage. 

No. If you are an annuitant on or before January 1, 2025, and are not enrolled in Medicare Part B on that date, you are not required to enroll in Medicare Part B to retain your PSHB health insurance coverage, regardless of your age.  

Depending on your age and whether you are an annuitant on or before January 1, 2025, you may be required to also enroll in Medicare Part B to continue PSHB coverage in retirement.