PSHB Medicare Part B Requirement: Who Must Enroll, Who Is Exempt and What It Costs in 2027

PSHB Medicare Part B Requirement: Postal workers and retirees have until 11:59 p.m. Eastern on December 14, 2026 to change their health plan for 2027, and one rule decides how much that plan really costs them. Under the PSHB Medicare Part B requirement, certain Medicare eligible Postal Service annuitants and their Medicare eligible family members must be enrolled in Part B to keep their Postal Service Health Benefits plan. FEHB has no such rule. The Part B premium is paid separately from the PSHB deduction, and the Medicare trustees project it at $209.50 a month for 2027, up from $202.90. CMS usually confirms the final number in November. Open season runs from November 9 to December 14, the government will pay at most $689.50 a month toward self only PSHB coverage, and the average enrollee share is rising about 8.2 percent.

The rule has exceptions that matter, and many retirees are not sure which side they fall on. Annuitants who retired on or before January 1, 2025 and did not have Part B generally do not have to enroll. Employees who were 64 or older on that date are also exempt. People who live abroad or who are eligible for certain VA or Indian Health Service care have their own exceptions. Everyone else who is Medicare eligible and retiring later should plan on Part B. This guide explains who is covered, what the exceptions are, how Part D works inside PSHB, what you will pay and what to do before the deadline. We’ll be updating this article monthly.

PSHB Medicare Part B Requirement Key Numbers

Key Dates for PSHB Annuitants and Employees

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Who Must Enroll in Medicare Part B to Keep PSHB?

The rule applies to Medicare eligible Postal Service annuitants and their Medicare eligible family members. It is built around when you retire and whether you already had Part B on a key date.

Future retirees are the main group. Postal employees who were under 64 on January 1, 2025 are expected to enroll in Part B when they become eligible and retire, if they want to keep PSHB in retirement. Annuitants who already had Part B on January 1, 2025 must keep it to stay in PSHB, unless an exception applies. If you drop Part B and you are required to have it, you can lose PSHB coverage.

A few details that surprise people:

• While you are still working, the rule does not require Part B to stay in your plan. It matters once you retire and are entitled to Medicare Part A.
• Survivor annuitants who are entitled to Part A must enroll in Part B to continue PSHB, unless an exception applies. They keep any exception the deceased annuitant had.
• If you choose not to enroll in Part B, or if you disenroll from it, you must tell OPM or the Postal Service in writing.
• If you are required to have Part B but do not, OPM’s final rule gives you a one time chance to enroll during the next available Medicare enrollment period, and you are not removed from PSHB until that period ends.

Spouses and other family members follow the annuitant. If the annuitant is exempt, the family members are exempt as well.

Who Is Exempt From the PSHB Part B Requirement?

Two cautions apply. If you rely on the overseas exception and later move back to the United States, you may lose it and be required to enroll in Part B. And if you were already enrolled in Part B on January 1, 2025, the earlier retiree exception does not mean you can drop it and keep PSHB. Check with the Postal Service or OPM before you cancel anything.

What Happens If You Do Not Have Part B but Should?

The rules are more forgiving than many people fear, but the costs can add up. A person who is required to have Part B and does not has a one time chance to enroll in the next available Medicare enrollment period, and PSHB coverage continues until that period ends. After that, the risk is losing PSHB.

Medicare also has its own late enrollment penalty. Part B penalties are generally 10 percent of the premium for each full 12 month period you could have had Part B and did not, and the penalty lasts as long as you have Part B. In 2024, the Postal Service ran a special enrollment period for eligible annuitants who did not have Part B, from April 1 to September 30, 2024, and the Postal Service covered the late penalty for those who enrolled, with Part B coverage starting January 1, 2025. That window is closed.

If you missed it because of a communication problem, you may be able to ask for equitable relief. NARFE reports that you can contact the PSHB Navigator Help Line at (833) 712-7742 or retirementbenefits@usps.gov, and the Postal Service must provide a letter showing a communication delay. Do not assume you will qualify, and act quickly.

How Part D Works Inside PSHB: The Auto Enrollment Rule

Part B is only half of the Medicare story for postal retirees. OPM’s final rule requires PSHB carriers to provide prescription drug benefits to Part D eligible annuitants and family members through a Medicare Part D employer group waiver plan, often called an EGWP. Carriers must automatically enroll eligible people each year, and the cost of the drug plan is built into your PSHB premium.

The most important detail is the opt out rule. If you opt out of the group Part D plan, or later disenroll, you lose prescription drug coverage under your PSHB plan, and your PSHB premium is not reduced. Many retirees opt out by mistake after getting a Medicare mailing. If you opted out because of an error, OPM allows enrollment within 90 days of the date your Part D coverage would have started, though OPM has not defined what counts as an error. People who live abroad and cannot enroll in Part D are not group enrolled and keep drug coverage through the PSHB plan.

Part D formularies in these plans must cover the same medications as the PSHB formulary with the same or lower cost sharing. If you have high income, the Part D income related surcharge can still apply. For 2026, Part D IRMAA runs from $14.50 to $91.00 a month per person, according to one benefits group, and it is deducted from Social Security if you receive it. Otherwise Medicare sends a separate bill.

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What Medicare Part B Costs in 2027: Premium, Deductible and IRMAA

The projected Part B premium for 2027 is $209.50 a month, which is $6.60 more than 2026. That works out to $2,514 a year, compared with $2,434.80 this year, a difference of $79.20. The projected deductible is about $292, up from $283. These are trustee estimates, and CMS usually releases final numbers in November.

Higher income retirees pay more. In 2026, the income related surcharge starts above $109,000 for a single filer and $218,000 for joint filers, based on income from two years earlier. The 2027 thresholds have not been announced. If your income dropped because of retirement, you may be able to ask Social Security to reconsider the surcharge using a life changing event form.

If you receive Social Security, the Part B premium is usually deducted from your monthly benefit. If you do not, Medicare bills you. Either way, it is separate from the PSHB premium that comes out of your annuity, so you will see two costs, not one.

Is PSHB Plus Part B Worth It?

A worked example shows why the numbers matter. Take a self only plan priced at the average. The government pays up to $689.50 of a plan’s premium, and for a plan priced exactly at the $957.62 average, the enrollee share is about $268.12 a month, or $3,217.44 a year. Add the projected Part B premium of $209.50 a month, or $2,514 a year, and the combined cost is $5,731.44 a year before any extras.

That sounds like a lot, but Part B can reduce what you pay elsewhere. Medicare becomes your primary coverage, and the PSHB plan is designed to work as a wraparound. Many PSHB plans waive deductibles and copays for Medicare enrollees, and some offer Part B premium reimbursement or other savings, though the details vary by plan. For someone who uses a lot of care, the out of pocket savings can offset much of the Part B premium. For a healthy retiree who rarely sees a doctor, the extra premium may not pay for itself. If you are exempt, you have a choice. If you are required, the real question is which plan makes Part B work best.

PSHB Medicare Part B Cost Calculator

The calculator that comes with this article compares your yearly cost with and without Part B. Enter your plan’s monthly enrollee share, the Part B premium, any Part B surcharge, any Part D surcharge, the monthly Part B reimbursement your plan gives, and your expected yearly out of pocket medical costs with Part B and without it. If you only know the plan’s total premium, enter it and the tool will estimate your share using the government maximums for your coverage type. It is an estimate. Plan benefits, reimbursements and your health costs differ, so read your plan brochure and ask the carrier how it coordinates with Medicare.

PSHB Medicare Part B Requirement: How to Enroll?

If you are required to enroll, or you want Part B, here is the usual path.

1. Confirm whether you are required or exempt, using the table above and your retirement date.
2. Check that you are entitled to Medicare Part A, which most people with enough Medicare covered work are, at no premium.
3. Apply through Social Security online, by phone or at a local office, and ask for Part B.
4. Note the effective date and the premium Social Security gives you.
5. Tell your PSHB plan and, if you opt out of Part B as an exempt person, notify OPM or the Postal Service in writing.
6. Keep your Part D group plan unless you are sure you want to give up your PSHB drug coverage.
7. Review your plan options before December 14 and choose the one that works best with Medicare.

If you are close to turning 65, your initial Medicare enrollment period begins three months before your birthday month and ends three months after, so plan ahead.

Processing Time: How Long Does Part B Enrollment Take?

Medicare enrollment through Social Security is often quick if you apply online and your records are in order, but it can take longer if documents are missing or if SSA needs to verify work history. Apply well before you retire. Coverage dates depend on when you sign up, so ask for your effective date in writing.

For PSHB open season changes, your election takes effect January 1, 2027, and cancellations take effect December 31, 2026. If you do not act and your plan is ending, you are moved to the default plan. UnitedHealthcare Choice Plus Primary Postal East is the plan leaving, and its default replacement is the Blue Cross Blue Shield Service Benefit Plan FEP Blue Focus. If you are adding a family member, you must submit documents proving eligibility, so do not wait until the last day.

Payment Schedule: How You Pay for PSHB and Part B

The two bills move on different tracks, and that is where retirees sometimes get confused.

If your premium changes in January, you will see the new amount in your first payment of the year. Employees see changes when their pay period begins in January. Keep your confirmation from the open season system and check your annuity statement in January.

What to Check Before the December 14 Deadline

• Whether your current plan is still offered in 2027
• Your plan’s monthly premium compared with the $689.50 self only government maximum, or the matching self plus one and family amount
• Whether you are required to have Part B or exempt
• How your plan coordinates with Medicare, including any deductible waivers and Part B reimbursement
• Whether your prescriptions are covered under the Part D group plan
• Whether your family members are on the plan and whether you need documents to add or keep them
• Whether your income might push you into a Part B or Part D surcharge

If you are unsure, the PSHB Navigator Help Line and your carrier’s Medicare team are better sources than social media posts.

Common Mistakes Postal Retirees Make

• Dropping Part B when it is required
• Opting out of the Part D group plan and losing PSHB drug coverage
• Assuming the 2024 special enrollment window is still open
• Forgetting that the Part B premium is separate from the PSHB deduction
• Waiting until the last day to change plans
• Moving abroad or back to the United States without checking exceptions
• Ignoring letters from the Postal Service or OPM

Scam warning: no one from OPM or the Postal Service will ask for your Medicare number or bank details to fix a PSHB problem by phone. If a call or text feels pushy, hang up and use the official numbers.

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Official Resources for the PSHB Medicare Part B Requirement

FAQs About the PSHB Medicare Part B Requirement

Conclusion: What to Do Before December 14

The PSHB Medicare Part B requirement is the rule that turns a plan comparison into a two bill decision. Decide first whether you are required or exempt, then compare plans with the Part B premium included, and keep your Part D group plan unless you are sure you want to lose PSHB drug coverage. Watch for CMS’s November announcement of the final Part B premium, and finish your changes before 11:59 p.m. Eastern on December 14.

Use the calculator, rely on OPM, the Postal Service and Medicare for the final word, and call the PSHB Navigator Help Line if your situation is unusual. This article is general information, not legal or financial advice. We’ll keep adding new OPM and CMS updates as they appear.

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