Medicare Part B Special Enrollment Period (SEP)

As part of the transition from coverage under the Federal Employees Health Benefits (FEHB) Program to the Postal Service Health Benefits (PSHB) Program, Postal Service annuitants not already enrolled in Medicare Part B may be eligible for a one-time SEP, which began on April 1, 2024 and will end on September 30, 2024. Eligibility notices for the SEP were mailed by the Postal Service to annuitants and eligible family members in early 2024. Individuals who enroll in Part B during the SEP will have any applicable Part B Late Enrollment Penalty (LEP) paid by the Postal Service.

Cost Savings for PSHB Enrollees enrolled in Medicare

Many 2025 PSHB plans will offer cost savings to their enrollees who are also enrolled in Medicare. While the SEP is for Part B enrollment, these charts also include Medicare Advantage enrollee cost savings since enrollment in Part A and Part B is required in order to enroll in a Medicare Advantage plan.

Examples of cost savings may include Part B premium reimbursement, waived deductibles, and waived cost-sharing for certain medical services.

Enrollees are encouraged to review plan brochures for more information.

Notes About the Charts

• Benefits that have reduced member costs (such as deductibles and copays) with Medicare Part B or a Medicare Advantage plan accessed through your PSHB plan enrollment are italicized and noted with asterisks (***).
• Medicare Advantage  plans accessed through your PSHB plan are listed in the tables. An 'N/A' is used for plan options where access to Medicare Advantage plans isn't offered.
• Medicare Part D prescription drug coverage information is not included in these charts.
• A full glossary of health insurance terms can be found here.
• Deductibles and out-of-pocket limits are listed with the “Self Only” value to the left of the slash and the “Self Plus One” and “Self and Family” value to the right of the slash. For example, “$2,000/$4,000” means the Self Only deductible is $2,000 and the Self Plus One and Family deductible is $4,000. There are some plan options in which the Self Plus One deductible or out-of-pocket limit differs from the Self and Family amount. In these instances, the Self Plus One amount is the middle value (e.g., $2,000/$4,000/$6,000).
• FEHB 2024 enrollment codes are listed under each plan option name with the corresponding PSHB 2025 enrollment codes. The third digit of the enrollment code indicates the enrollment type. Enrollment codes ending in “1” or “4” in FEHB, or “A” or “D” in PSHB, represent Self Only. Enrollment codes ending in “2” or “5” (FEHB) or “B” or “E” (PSHB) represent Self and Family. Enrollment codes ending in “3” or “6” (FEHB) or “C” or “F” (PSHB) represent Self Plus One
• The Medicare Part B premium reimbursement amounts listed in the charts are the maximum per person dollar amounts members would be reimbursed for their Part B premiums annually.
• Cost-sharing amounts are for in-network services only; out-of-network costs are not included in the charts.
• The out-of-pocket limits listed in the charts are for medical services only. Plans may have separate out-of-pocket limits for prescription drugs.
• All plan and cost-sharing information listed is for the 2025 plan year. Plans are listed in alphabetical order by Carrier, and all 2025 PSHB Plans are included regardless of whether they offer cost savings for Medicare enrollees.

2025 Medicare Part B and Medicare Advantage Benefit Comparison Tables

Aetna Advantage

(FEHB 2024 enrollment codes Z24, Z25, Z26; PSHB 2025 enrollment codes HLD, HLE, HLF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $1,200 max ***
Deductible	$2,000/$4,000	$2,000/$4,000	*** Deductible waived ***
Out-of-Pocket Limit	$7,500/$15,000	$7,500/$15,000	*** $2,000/$4,000 ***
Primary Care Office Visit	30%	30%	*** $0 ***
Specialty Office Visit	30%	30%	*** $0 ***

Aetna HealthFund HDHP

(FEHB 2024 enrollment codes 224, 225, 226; PSHB 2025 enrollment codes G3D, G3E, G3F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$1,800/$3,600	$1,800/$3,600	N/A
Out-of-Pocket Limit	$6,900/$13,800	$6,900/$13,800	N/A
Primary Care Office Visit	15%	15%	N/A
Specialty Office Visit	15%	15%	N/A

Aetna Direct

(FEHB 2024 enrollment codes N61, N62, N63; PSHB 2025 enrollment codes G3A, G3B, G3C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $900 max ***	N/A
Deductible	$1,600/$3,200	*** Deductible waived ***	N/A
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	N/A
Primary Care Office Visit	20%	*** $0 ***	N/A
Specialty Office Visit	20%	*** $0 ***	N/A

Aetna Value Plan

(FEHB 2024 enrollment codes G54, G55, G56, H44, H45, H46, JS4, JS5, JS6, EP4, EP5, EP6, F54, F55, F56; PSHB 2025 enrollment codes GRD, GRE, GRF, HHD, HHE, HHF, JDD, JDE, JDF, KDD, KDE, KDF, L7D, L7E, L7F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$700/$1,400	$700/$1,400	N/A
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	N/A
Primary Care Office Visit	$25	$25	N/A
Specialty Office Visit	$40	$40	N/A

Aetna HealthFund CDHP

(FEHB 2024 enrollment codes G51, G52, G53, H41, H42, H43, JS1, JS2, JS3, EP1, EP2, EP3, F51, F52, F53; PSHB 2025 enrollment codes GRA, GRB, GRC, HHA, HHB, HHC, JDA, JDB, JDC, KDA, KDB, KDC, L7A, L7B, L7C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $1,000 max ***	N/A
Deductible	$1,000/$2,000	$1,000/$2,000	N/A
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	N/A
Primary Care Office Visit	15%	15%	N/A
Specialty Office Visit	15%	15%	N/A

Aetna Open Access: Basic Option

(FEHB 2024 enrollment codes JN4, JN5, JN6; PSHB 2025 enrollment codes G8D, G8E, G8F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	None	None	N/A
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	N/A
Primary Care Office Visit	$25	$25	N/A
Specialty Office Visit	$55	$55	N/A

Aetna Open Access: High Option

(FEHB 2024 enrollment codes JN1, JN2, JN3; PSHB 2025 enrollment codes G8A, G8B, G8C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	None	None	N/A
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	N/A
Primary Care Office Visit	$15	$15	N/A
Specialty Office Visit	$30	$30	N/A

Aetna Saver

(FEHB 2024 enrollment codes QQ4, QQ5, QQ6; PSHB 2025 enrollment codes HXD, HXE, HXF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$1,000/$2,000	$1,000/$2,000	N/A
Out-of-Pocket Limit	$6,500/$13,000	$6,500/$13,000	N/A
Primary Care Office Visit	30%	30%	N/A
Specialty Office Visit	30%	30%	N/A

APWU Health Plan: High Option

(FEHB 2024 enrollment codes 471, 472, 473; PSHB 2025 enrollment codes 23A, 23B, 23C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $1,200 max ***
Deductible	$450/$800	*** Deductible waived ***	*** Deductible waived ***
Out-of-Pocket Limit	$6,500/$13,000	$6,500/$13,000	*** $0 ***
Primary Care Office Visit	$25	*** $0 ***	*** $0 ***
Specialty Office Visit	$25	*** $0 ***	*** $0 ***

APWU Health Plan: Consumer Driven Option

(FEHB 2024 enrollment codes 474, 475, 476; PSHB 2025 enrollment codes 23D, 23E, 23F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $1,200 max ***	N/A
Deductible	$2,200/$4,400	$2,200/$4,400	N/A
Out-of-Pocket Limit	$6,500/$13,000	$6,500/$13,000	N/A
Primary Care Office Visit	15%	15%	N/A
Specialty Office Visit	15%	15%	N/A

Blue Cross and Blue Shield Service Benefit Plan: Standard Option

(FEHB 2024 enrollment codes 104, 105, 106; PSHB 2025 enrollment codes 33D, 33E, 33F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$350/$700	*** Deductible Waived ***	N/A
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	N/A
Primary Care Office Visit	$30	*** $0 ***	N/A
Specialty Office Visit	$40	*** $0 ***	N/A

Blue Cross and Blue Shield Service Benefit Plan: Basic Option

(FEHB 2024 enrollment codes 111, 112, 113; PSHB 2025 enrollment codes 33A, 33B, 33C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $800 max ***	N/A
Deductible	None	None	N/A
Out-of-Pocket Limit	$7,500/$15,000	$7,500/$15,000	N/A
Primary Care Office Visit	$35	*** $0 ***	N/A
Specialty Office Visit	$50	*** $0 ***	N/A

Blue Cross and Blue Shield Service Benefit Plan: FEP Blue Focus

(FEHB 2024 enrollment codes 131, 132, 133; PSHB 2025 enrollment codes 35A, 35B, 35C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$500/$1,000	$500/$1,000	N/A
Out-of-Pocket Limit	$9,000/$18,000	$9,000/$18,000	N/A
Primary Care Office Visit	$10	*** $0 ***	N/A
Specialty Office Visit	$10	*** $0 ***	N/A

CareFirst Blue Value Plus

(FEHB 2024 enrollment codes B64, B65, B66; PSHB 2025 enrollment codes K4D, K4E, K4F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	None	None	N/A
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	N/A
Primary Care Office Visit	$15	*** $0 ***	N/A
Specialty Office Visit	$50	*** $0 ***	N/A

CareFirst BlueChoice Advantage HDHP

(FEHB 2024 enrollment codes B61, B62, B63; PSHB 2025 enrollment codes K4A, K4B, K4C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$1,650/$3,300	*** Deductible waived ***	N/A
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	N/A
Primary Care Office Visit	$0	$0	N/A
Specialty Office Visit	$35	*** $0 ***	N/A

GEHA Benefit Plan: High Option

(FEHB 2024 enrollment codes 311, 312, 313; PSHB 2025 enrollment codes 37A, 37B, 37C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $1,000 max ***	*** Yes; $1,200 max ***
Deductible	$350/$700	*** Deductible waived ***	*** Deductible waived ***
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	*** $0 ***
Primary Care Office Visit	$20	*** $0 ***	*** $0 ***
Specialty Office Visit	$20	*** $0 ***	*** $0 ***

GEHA Benefit Plan: Standard Option

(FEHB 2024 enrollment codes 314, 315, 316; PSHB 2025 enrollment codes 37D, 37E, 37F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $900 max ***
Deductible	$350/$700	*** Deductible waived ***	*** Deductible waived ***
Out-of-Pocket Limit	$6,500/$13,000	$6,500/$13,000	*** $0 ***
Primary Care Office Visit	$20	*** $0 ***	*** $0 ***
Specialty Office Visit	$35	*** $0 ***	*** $0 ***

GEHA Benefit Plan: HDHP

(FEHB 2024 enrollment codes 341, 342, 343; PSHB 2025 enrollment codes 39A, 39B, 39C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $1,000 max ***	N/A
Deductible	$1,600/$3,200	$1,600/$3,200	N/A
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	N/A
Primary Care Office Visit	5%	5%	N/A
Specialty Office Visit	5%	5%	N/A

GEHA Indemnity Benefit Plan: Elevate Option

(FEHB 2024 enrollment codes 254, 255, 256; PSHB 2025 enrollment codes 58D, 58E, 58F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$500/$1,000	$500/$1,000	N/A
Out-of-Pocket Limit	$8,500/$17,000	$8,500/$17,000	N/A
Primary Care Office Visit	$10	$10	N/A
Specialty Office Visit	$30	$30	N/A

GEHA Indemnity Benefit Plan: Elevate Plus Option

(FEHB 2024 enrollment codes 251, 252, 253; PSHB 2025 enrollment codes 58A, 58B, 58C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$200/$400	*** Deductible waived ***	N/A
Out-of-Pocket Limit	$7,000/$14,000	$7,000/$14,000	N/A
Primary Care Office Visit	$30	*** $0 ***	N/A
Specialty Office Visit	$50	*** $0 ***	N/A

Health Alliance Plan: High Option

(FEHB 2024 enrollment codes 521, 522, 523; PSHB 2025 enrollment codes J5A, J5B, J5C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $800 max ***	*** Yes; $1,800 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$6,350/$12,700	$6,350/$12,700	$6,350/$12,700
Primary Care Office Visit	$20	$20	$20
Specialty Office Visit	$40	$40	$40

Health Alliance Plan: Standard Option

(FEHB 2024 enrollment codes GY4, GY5, GY6; PSHB 2025 enrollment codes J5D, J5E, J5F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $800 max ***	*** Yes; $1,200 max ***
Deductible	$350/$700	$350/$700	$350/$700
Out-of-Pocket Limit	$6,350/$12,700	$6,350/$12,700	$6,350/$12,700
Primary Care Office Visit	$20	$20	$20
Specialty Office Visit	$50	$50	$50

HealthPartners: High Option

(FEHB 2024 enrollment codes V31, V32, V33; PSHB 2025 enrollment codes KGA, KGB, KGC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $1,200 max ***	N/A
Deductible	None	None	N/A
Out-of-Pocket Limit	$6,500/$13,000	$6,500/$13,000	N/A
Primary Care Office Visit	$45	*** $0 ***	N/A
Specialty Office Visit	$45	*** $0 ***	N/A

HealthPartners: Standard Option

(FEHB 2024 enrollment codes V34, V35, V36; PSHB 2025 enrollment codes KGD, KGE, KGF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$750/$1,500	*** Deductible waived ***	N/A
Out-of-Pocket Limit	$7,500/$15,000	$7,500/$15,000	N/A
Primary Care Office Visit	20%	*** $0 ***	N/A
Specialty Office Visit	20%	*** $0 ***	N/A

HMSA Plan: High Option

(FEHB 2024 enrollment codes 871, 872, 873; PSHB 2025 enrollment codes M6A, M6B, M6C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	None	None	N/A
Out-of-Pocket Limit	$3,000/$6,000/$9,000	$3,000/$6,000/$9,000	N/A
Primary Care Office Visit	$15	$15	N/A
Specialty Office Visit	$15	$15	N/A

HMSA Plan: Standard Option

(FEHB 2024 enrollment codes 874, 875, 876; PSHB 2025 enrollment codes M6D, M6E, M6F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$150/$300	$150/$300	N/A
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	N/A
Primary Care Office Visit	$20	$20	N/A
Specialty Office Visit	$20	$20	N/A

Kaiser Permanente – Colorado: High Option

(FEHB 2024 enrollment codes 651, 652, 653; PSHB 2025 enrollment codes M8A, M8B, M8C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $2,400 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$4,000/$8,000	$4,000/$8,000	*** $2,950/$5,900 ***
Primary Care Office Visit	$20	$20	*** $15 ***
Specialty Office Visit	$30	$30	*** $25 ***

Kaiser Permanente – Colorado: Standard Option

(FEHB 2024 enrollment codes 654, 655, 656; PSHB 2025 enrollment codes M8D, M8E, M8F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $2,400 max ***
Deductible	$150/$300	$150/$300	*** Deductible waived ***
Out-of-Pocket Limit	$5,500/$11,000	$5,500/$11,000	*** $3,300/$6,600 ***
Primary Care Office Visit	$30	$30	$30
Specialty Office Visit	$40	$40	$40

Kaiser Permanente – Colorado: Prosper

(FEHB 2024 enrollment codes N41, N42, N43; PSHB 2025 enrollment codes NCA, NCB, NCC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	$300/$600	$300/$600	*** Deductible waived ***
Out-of-Pocket Limit	$7,000/$14,000	$7,000/$14,000	*** $3,600/$7,200 ***
Primary Care Office Visit	$10	$10	$10
Specialty Office Visit	$35	$35	$35

Kaiser Permanente – Fresno California: High Option

(FEHB 2024 enrollment codes NZ1, NZ2, NZ3; PSHB 2025 enrollment codes NNA, NNB, NNC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $3,000 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$2,000/$4,000	$2,000/$4,000	$2,000/$4,000
Primary Care Office Visit	$15	$15	*** $10 ***
Specialty Office Visit	$25	$25	*** $10 ***

Kaiser Permanente – Fresno California: Standard Option

(FEHB 2024 enrollment codes NZ4, NZ5, NZ6; PSHB 2025 enrollment codes NND, NNE, NNF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	None	None	None
Out-of-Pocket Limit	$3,000/$6,000	$3,000/$6,000	*** $2,000/$4,000 ***
Primary Care Office Visit	$30	$30	*** $15 ***
Specialty Office Visit	$40	$40	*** $15 ***

Kaiser Permanente – Hawaii: High Option

(FEHB 2024 enrollment codes 631, 632, 633; PSHB 2025 enrollment codes PKA, PKB, PKC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $2,100 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$3,000/$6,000/$9,000	$3,000/$6,000/$9,000	$3,000/$6,000/$9,000
Primary Care Office Visit	$15	$15	*** $10 ***
Specialty Office Visit	$15	$15	*** $10 ***

Kaiser Permanente – Hawaii: Standard Option

(FEHB 2024 enrollment codes 634, 635, 636; PSHB 2025 enrollment codes PKD, PKE, PKF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	None	None	None
Out-of-Pocket Limit	$3,000/$6,000/$9,000	$3,000/$6,000/$9,000	*** $2,500/$7,500 ***
Primary Care Office Visit	$25	$25	*** $15 ***
Specialty Office Visit	$25	$25	*** $20 ***

Kaiser Permanente – Northern California: High Option

(FEHB 2024 enrollment codes 591, 592, 593; PSHB 2025 enrollment codes TBA, TBB, TBC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $3,000 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$2,000/$4,000	$2,000/$4,000	$2,000/$4,000
Primary Care Office Visit	$15	$15	*** $10 ***
Specialty Office Visit	$25	$25	*** $10 ***

Kaiser Permanente – Northern California: Standard Option

(FEHB 2024 enrollment codes 594, 595, 596; PSHB 2025 enrollment codes TBD, TBE, TBF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $3,000 max ***
Deductible	$100/$200	$100/$200	*** Deductible waived ***
Out-of-Pocket Limit	$3,000/$6,000	$3,000/$6,000	*** $2,000/$4,000 ***
Primary Care Office Visit	$30	$30	*** $25 ***
Specialty Office Visit	$40	$40	*** $25 ***

Kaiser Permanente – Northern California: Prosper

(FEHB 2024 enrollment codes KC1, KC2, KC3; PSHB 2025 enrollment codes UDA, UDB, UDC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	$500/$1,000	$500/$1,000	*** Deductible waived ***
Out-of-Pocket Limit	$5,500/$11,000	$5,500/$11,000	*** $2,000/$4,000 ***
Primary Care Office Visit	$25	$25	$25
Specialty Office Visit	$35	$35	*** $25 ***

Kaiser Permanente – Northwest: High Option

(FEHB 2024 enrollment codes 571, 572, 573; PSHB 2025 enrollment codes UZA, UZB, UZC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $2,400 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	*** $1,000/$2,000 ***
Primary Care Office Visit	$20	$20	*** $15 ***
Specialty Office Visit	$30	$30	*** $15 ***

Kaiser Permanente – Northwest: Standard Option

(FEHB 2024 enrollment codes 574, 575, 576; PSHB 2025 enrollment codes UZD, UZE, UZF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $2,400 max ***
Deductible	$150/$300	$150/$300	*** Deductible waived ***
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	*** $2,000/$4,000 ***
Primary Care Office Visit	$25	$25	*** $20 ***
Specialty Office Visit	$35	$35	*** $20 ***

Kaiser Permanente – Northwest: Prosper

(FEHB 2024 enrollment codes AM1, AM2, AM3; PSHB 2025 enrollment codes YRA, YRB, YRC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	$300/$600	$300/$600	*** Deductible waived ***
Out-of-Pocket Limit	$7,000/$14,000	$7,000/$14,000	*** $3,000/$6,000 ***
Primary Care Office Visit	$10	$10	$10
Specialty Office Visit	$20	$20	$20

Kaiser Permanente – Southern California: High Option

(FEHB 2024 enrollment codes 621, 622, 623; PSHB 2025 enrollment codes Y3A, Y3B, Y3C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $3,000 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$2,000/$4,000	$2,000/$4,000	$2,000/$4,000
Primary Care Office Visit	$15	$15	*** $10 ***
Specialty Office Visit	$25	$25	*** $10 ***

Kaiser Permanente – Southern California: Standard Option

(FEHB 2024 enrollment codes 624, 625, 626; PSHB 2025 enrollment codes Y3D, Y3E, Y3F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $3,000 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$3,000/$6,000	$3,000/$6,000	*** $2,500/$5,000 ***
Primary Care Office Visit	$30	$30	*** $20 ***
Specialty Office Visit	$40	$40	*** $30 ***

Kaiser Permanente – Southern California: Prosper

(FEHB 2024 enrollment codes FL1, FL2, FL3; PSHB 2025 enrollment codes MBA, MBB, MBC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	$100/$200	$100/$200	*** Deductible waived ***
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	*** $3,000/$6,000 ***
Primary Care Office Visit	$30	$30	*** $25 ***
Specialty Office Visit	$40	$40	*** $35 ***

Kaiser Permanente – Washington Core: High Option

(FEHB 2024 enrollment codes 541, 542, 543; PSHB 2025 enrollment codes PRA, PRB, PRC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $600 max ***	*** Yes; $2,100 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$3,000/$6,000	*** $2,000/$4,000 ***	*** $2,000/$4,000 ***
Primary Care Office Visit	$25	*** $15 ***	*** $15 ***
Specialty Office Visit	$25	*** $15 ***	*** $15 ***

Kaiser Permanente – Washington Core: Standard Option

(FEHB 2024 enrollment codes 544, 545, 546; PSHB 2025 enrollment codes PRD, PRE, PRF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $2,100 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$5,000/$5,000	$5,000/$5,000	*** $3,000/$6,000 ***
Primary Care Office Visit	$25	$25	*** $20 ***
Specialty Office Visit	$35	$35	*** $25 ***

Kaiser Permanente – Washington Core: Prosper

(FEHB 2024 enrollment codes PT4, PT5, PT6; PSHB 2025 enrollment codes DWD, DWE, DWF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	$250/$500	$250/$500	*** Deductible waived ***
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	*** $5,000/$10,000 ***
Primary Care Office Visit	$15	$15	*** $10 ***
Specialty Office Visit	$40	$40	*** $35 ***

Kaiser Permanente – Washington Options Federal: Standard Option

(FEHB 2024 enrollment codes L11, L12, L13; PSHB 2025 enrollment codes H9A, H9B, H9C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$350/$700	*** Deductible waived ***	N/A
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	N/A
Primary Care Office Visit	$25	*** $0 ***	N/A
Specialty Office Visit	$35	*** $0 ***	N/A

Kaiser Permanente – Washington Options Federal: HDHP

(FEHB 2024 enrollment codes L14, L15, L16; PSHB 2025 enrollment codes H9D, H9E, H9F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$1,650/$3,300	$1,650/$3,300	N/A
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	N/A
Primary Care Office Visit	20%	20%	N/A
Specialty Office Visit	20%	20%	N/A

Kaiser Permanente – Georgia: High Option

(FEHB 2024 enrollment codes F81, F82, F83; PSHB 2025 enrollment codes PFA, PFB, PFC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $2,400 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$4,000/$8,000	$4,000/$8,000	*** $2,000/$4,000 ***
Primary Care Office Visit	$15	$15	*** $10 ***
Specialty Office Visit	$30	$30	*** $25 ***

Kaiser Permanente – Georgia: Standard Option

(FEHB 2024 enrollment codes F84, F85, F86; PSHB 2025 enrollment codes PFD, PFE, PFF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $2,400 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	*** $2,500/$5,000 ***
Primary Care Office Visit	$20	$20	$20
Specialty Office Visit	$40	$40	*** $30 ***

Kaiser Permanente – Georgia: Prosper

(FEHB 2024 enrollment codes LA1, LA2, LA3; PSHB 2025 enrollment codes QZA, QZB, QZC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	$300/$600	$300/$600	*** Deductible waived ***
Out-of-Pocket Limit	$6,500/$13,000	$6,500/$13,000	*** $3,250/$6,500 ***
Primary Care Office Visit	$20	$20	$20
Specialty Office Visit	$40	$40	*** $30 ***

Kaiser Permanente – Mid-Atlantic States: High Option

(FEHB 2024 enrollment codes E31, E32, E33; PSHB 2025 enrollment codes RAA, RAB, RAC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $2,400 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$2,250/$4,500	$2,250/$4,500	$2,250/$4,500
Primary Care Office Visit	$10	$10	*** $5 ***
Specialty Office Visit	$20	$20	*** $15 ***

Kaiser Permanente – Mid-Atlantic States: Standard Option

(FEHB 2024 enrollment codes E34, E35, E36; PSHB 2025 enrollment codes RAD, RAE, RAF)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $2,400 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$3,500/$7,000	$3,500/$7,000	*** $3,400/$7,000 ***
Primary Care Office Visit	$20	$20	*** $15 ***
Specialty Office Visit	$30	$30	*** $20 ***

Kaiser Permanente – Mid-Atlantic States: Prosper

(FEHB 2024 enrollment codes T71, T72, T73; PSHB 2025 enrollment codes NWA, NWB, NWC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	$100/$200	$100/$200	*** Deductible waived ***
Out-of-Pocket Limit	$4,000/$8,000	$4,000/$8,000	$4,000/$8,000
Primary Care Office Visit	$30	$30	*** $20 ***
Specialty Office Visit	$40	$40	*** $30 ***

Mail Handlers Benefit Plan: Standard Option

(FEHB 2024 enrollment codes 454, 455, 456; PSHB 2025 enrollment codes 73D, 73E, 73F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $900 max ***
Deductible	$350/$700	*** Deductible waived ***	*** Deductible waived ***
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	*** $2,000/$4,000 ***
Primary Care Office Visit	$20	*** $0 ***	*** $0 ***
Specialty Office Visit	$30	*** $0 ***	*** $0 ***

Mail Handlers Benefit Plan: Value Plan

(FEHB 2024 enrollment codes 414, 415, 416; PSHB 2025 enrollment codes 73A, 73B, 73C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$600/$1,200/$1,800	$600/$1,200/$1,800	N/A
Out-of-Pocket Limit	$6,600/$13,200	$6,600/$13,200	N/A
Primary Care Office Visit	$30	$30	N/A
Specialty Office Visit	$50	$50	N/A

Mail Handlers Benefit Plan: Consumer Option

(FEHB 2024 enrollment codes 481, 482, 483; PSHB 2025 enrollment codes 74A, 74B, 74C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$2,000/$4,000	*** Deductible waived ***	N/A
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	N/A
Primary Care Office Visit	$15	*** $0 ***	N/A
Specialty Office Visit	$15	*** $0 ***	N/A

Medical Mutual of Ohio: Standard Option

(FEHB 2024 enrollment codes 644, 645, 646; PSHB 2025 enrollment codes D3D, D3E, D3F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $850 max ***	*** Yes; $850 max ***
Deductible	None	None	None
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	*** $0 ***
Primary Care Office Visit	$25	$25	*** $0 ***
Specialty Office Visit	$45	$45	*** $0 ***

Medical Mutual of Ohio: Basic Option

(FEHB 2024 enrollment codes UX1, UX2, UX3; PSHB 2025 enrollment codes D3A, D3B, D3C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $850 max ***
Deductible	$750/$1,500	$750/$1,500	*** Deductible waived ***
Out-of-Pocket Limit	$6,500/$13,000	$6,500/$13,000	*** $0 ***
Primary Care Office Visit	$30	$30	*** $0 ***
Specialty Office Visit	$60	$60	*** $0 ***

NALC Health Benefit Plan: High Option

(FEHB 2024 enrollment codes 321, 322, 323; PSHB 2025 enrollment codes 77A, 77B, 77C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $900 max ***
Deductible	$300/$600	*** Deductible waived ***	*** Deductible waived ***
Out-of-Pocket Limit	$3,500/$7,000	*** $0 ***	*** $0 ***
Primary Care Office Visit	$25	*** $0 ***	*** $0 ***
Specialty Office Visit	$25	*** $0 ***	*** $0 ***

NALC Health Benefit Plan: CDHP

(FEHB 2024 enrollment codes 324, 325, 326; PSHB 2025 enrollment codes 77D, 77E, 77F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$2,000/$4,000	$2,000/$4,000	N/A
Out-of-Pocket Limit	$6,600/$12,000	$6,600/$12,000	N/A
Primary Care Office Visit	20%	20%	N/A
Specialty Office Visit	20%	20%	N/A

Rural Carrier Benefit Plan: High Option

(FEHB 2024 enrollment codes 381, 382, 383; PSHB 2025 enrollment codes 79A, 79B, 79C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $900 max ***
Deductible	$350/$700	*** Deductible waived ***	*** Deductible waived ***
Out-of-Pocket Limit	$5,000/$10,000	$5,000/$10,000	*** $2,000/$4,000 ***
Primary Care Office Visit	$20	*** $0 ***	*** $0 ***
Specialty Office Visit	$35	*** $0 ***	*** $0 ***

TakeCare Insurance Company: High Option

(FEHB 2024 enrollment codes JK1, JK2, JK3; PSHB 2025 enrollment codes G4A, G4B, G4C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	None	None	N/A
Out-of-Pocket Limit	$2,000/$4,000/$6,000	$2,000/$4,000/$6,000	N/A
Primary Care Office Visit	$20	*** $0 ***	N/A
Specialty Office Visit	$40	*** $0 ***	N/A

TakeCare Insurance Company: Standard Option

(FEHB 2024 enrollment codes JK4, JK5, JK6; PSHB 2025 enrollment codes G4D, G4E, G4F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	None	None	N/A
Out-of-Pocket Limit	$3,000/$6,000	$3,000/$6,000	N/A
Primary Care Office Visit	$25	*** $0 ***	N/A
Specialty Office Visit	$40	*** $0 ***	N/A

TakeCare Insurance Company: HDHP

(FEHB 2024 enrollment codes KX1, KX2, KX3; PSHB 2025 enrollment codes HJA, HJB, HJC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	N/A
Deductible	$2,000/$4,000	$2,000/$4,000	N/A
Out-of-Pocket Limit	$3,000/$6,000	$3,000/$6,000	N/A
Primary Care Office Visit	20%	*** $0 ***	N/A
Specialty Office Visit	20%	*** $0 ***	N/A

Triple-S: High Option

(FEHB 2024 enrollment codes 851, 852, 853 for USVI; 891, 892, 893 for Puerto Rico; PSHB 2025 enrollment codes 14A, 14B, 14C for USVI; 83A, 83B, 83C for Puerto Rico)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	None	None	None
Out-of-Pocket Limit	$6,600/$13,200	$6,600/$13,200	$6,600/$13,200
Primary Care Office Visit	$7.50	*** $0 ***	$7.50
Specialty Office Visit	$7.50	*** $0 ***	$7.50

UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary Postal East: High Option

(FEHB 2024 enrollment codes AS1, AS2, AS3; PSHB 2025 enrollment codes JYA, JYB, JYC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $1,800 max ***
Deductible	$500/$1,000	$500/$1,000	*** Deductible waived ***
Out-of-Pocket Limit	$7,350/$14,700	$7,350/$14,700	*** $0 ***
Primary Care Office Visit	$0	$0	$0
Specialty Office Visit	$60	$60	*** $0 ***

UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary Postal West: High Option

(FEHB 2024 enrollment codes WF1, WF2, WF3; PSHB 2025 enrollment codes KEA, KEB, KEC)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	*** Yes; $1,800 max ***
Deductible	$500/$1,000	$500/$1,000	*** Deductible waived ***
Out-of-Pocket Limit	$7,350/$14,700	$7,350/$14,700	*** $0 ***
Primary Care Office Visit	$0	$0	$0
Specialty Office Visit	$60	$60	*** $0 ***

UPMC Health Plan: Standard Option

(FEHB 2024 enrollment codes UW4, UW5, UW6; PSHB 2025 enrollment codes G9D, G9E, G9F)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	*** Yes; $800 max ***	*** Yes; $800 max ***
Deductible	$850/$1,700	*** $700/$1,400 ***	*** Deductible waived ***
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	*** $3,400/$6,800 ***
Primary Care Office Visit	$20	$20	*** $0 ***
Specialty Office Visit	$50	$50	*** $25 ***

UPMC Health Plan: HDHP

(FEHB 2024 enrollment codes 8W4, 8W5, 8W6; PSHB 2025 enrollment codes G9A, G9B, G9C)

Plan Details	Member Cost-share Without Medicare	With Medicare Part B as Primary	With PSHB Medicare Advantage as Primary
Part B Premium Reimbursement	No	No	No
Deductible	$2,000/$4,000	$2,000/$4,000	$2,000/$4,000
Out-of-Pocket Limit	$6,000/$12,000	$6,000/$12,000	$6,000/$12,000
Primary Care Office Visit	15%	15%	15%
Specialty Office Visit	15%	15%	15%

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