Do postal retirees have to take Medicare Part B?

Most who retire now do. Under 5 CFR 890.1604, a Postal Service annuitant who is entitled to Medicare Part A must be enrolled in Part B to enroll or stay in PSHB. The exceptions: you were already a postal annuitant on or before January 1, 2025 without both Parts A and B that day; you were a postal employee aged 64 or older on January 1, 2025; you live outside the United States; you are enrolled in VA health care; or you are eligible for the Indian Health Service.

I was 64 on January 1, 2025. Do I need Part B when I retire?

No. If you were a Postal Service employee and 64 or older on January 1, 2025, the requirement doesn't apply to you (5 CFR 890.1604(d)(1)(ii)), and a covered family member is excepted through you too.

Does my spouse also need Part B?

If you are required to have Part B, a covered family member who is entitled to Part A must be enrolled in Part B too, unless that person has their own exception (living abroad, VA health care, Indian Health Service). If you are excepted, your covered family members are excepted as well (5 CFR 890.1604(b) and (d)(2)).

What happens if I'm required to have Part B and don't?

You aren't dropped right away. OPM's rule gives you one opportunity to enroll in Part B during your next Medicare enrollment period, which may be the next General Enrollment Period. If you don't, you can be disenrolled from PSHB and can't re-enroll (5 CFR 890.1608(b)).

Do postal employees who are still working need Part B?

No. The rule applies to annuitants. OPM's PSHB annuitant page says that to get PSHB coverage in retirement you must be enrolled in Part B unless an exception applies, so plan the timing before you retire.

PSHB Medicare Part B Requirement, Explained

Since January 1, 2025, Postal Service employees and retirees get their health plans through the Postal Service Health Benefits (PSHB) Program. The law that created it (5 U.S.C. 8903c) added a rule FEHB never had: many postal retirees must have Medicare Part B to keep their PSHB plan. Here is the rule as OPM wrote it into the regulations, 5 CFR 890.1604, and who it leaves out.

The rule

"A Postal Service annuitant who is entitled to Medicare Part A must be enrolled in Medicare Part B to enroll or continue enrollment in a health benefits plan under this subpart" (5 CFR 890.1604(a)). The same goes for a covered family member who is entitled to Part A (890.1604(b)).

Three things follow from that wording:

It applies to annuitants. While you work for the Postal Service, you aren't required to have Part B.
It is triggered by Part A entitlement. Most people get premium-free Part A at 65; once you are entitled to it, Part B becomes a condition of PSHB.
It covers your spouse too, if they are on your enrollment and entitled to Part A.

The five exceptions

The requirement does not apply to a postal annuitant who (5 CFR 890.1604(d)(1)):

was already a Postal Service annuitant on or before January 1, 2025 and did not have both Part A and Part B on that date;
was a Postal Service employee aged 64 or older on January 1, 2025 (born on or before January 1, 1961);
lives outside the United States, and shows it. Here the United States includes the states, DC, Puerto Rico, the Virgin Islands, Guam, American Samoa and the Northern Mariana Islands;
is enrolled in VA health care, with documentation from the VA; or
is eligible for Indian Health Service care, with documentation from the IHS.

A covered family member is excepted when the annuitant is (exceptions 1 to 5), or on their own when they live abroad, are enrolled in VA health care, or are eligible for the IHS (890.1604(d)(2)).

Already had Parts A and B on January 1, 2025? Keep Part B.

Exception 1 only helps annuitants who did not have both parts that day. If you had both, the requirement applies to you, and dropping Part B counts as ending your PSHB enrollment (890.1604(g)).

How you claim an exception

OPM Form 2809, the health benefits election form for CSRS and FERS annuitants, has a section for postal annuitants in a PSHB plan who claim an exception. It lists the reasons (VA health care, Indian Health Service, living outside the United States, "not required to enroll" under the January 1, 2025 rules, and a rare Part A case) and the documents to attach, such as a VA letter confirming enrollment. OPM's note: documentation must be provided before a change can take effect.

If you're required and don't have Part B

The regulation spells out what happens (5 CFR 890.1608(b)):

You aren't disenrolled immediately.
You get one opportunity to stay: enroll in Part B in your next Medicare enrollment period, which may be the next General Enrollment Period (January 1 to March 31).
If you don't, OPM can disenroll you from PSHB (or remove a family member), and a disenrolled annuitant can't re-enroll in PSHB.
OPM won't disenroll you if you were never told about the requirement, or if removing you would be "against equity and good conscience" (890.1608(b)(2)).

Signing up in a General Enrollment Period can also mean a Part B late penalty: 10% of the standard premium for each full year you went without Part B or job-based coverage, for life.

Medicare drug coverage comes with your PSHB plan

OPM's PSHB annuitant page adds one more rule of thumb: if you are eligible for Part D, your PSHB plan enrolls you in its Medicare drug coverage automatically. If you opt out and don't join a separate Part D plan, you have no drug coverage at all.

What to decide in Open Season

If Part B is required for you, the question becomes which PSHB plan to pair it with. Plans differ a lot once Medicare pays first: some waive all their cost-sharing, some keep a deductible, some pay back part of the Part B premium, and several have a Medicare Advantage plan for retirees with Parts A and B. Our FEHB/PSHB check tells you free whether the requirement applies to you, and the paid report prices each PSHB plan for you.

Should you take Part B with FEHB or PSHB in 2027?.Start the free FEHB/PSHB check

The PSHB Medicare Part B requirement, explained