PSHB Medicare Part B: What Former Spouses of Postal Workers Need to Know

If your former spouse worked for the U.S. Postal Service, determine whether your coverage is FEHB Spouse Equity or PSHB coverage as a survivor annuitant. Former spouses eligible under Spouse Equity enroll in FEHB, not PSHB. The PSHB Medicare Part B requirement applies to certain PSHB-eligible postal annuitants and family or survivor annuitants, not to FEHB Spouse Equity coverage.

The PSHB Medicare Rule

Under the Postal Service Health Benefits Program, certain Medicare-eligible postal annuitants and their Medicare-eligible family members must enroll in Medicare Part B to remain in PSHB. A surviving former spouse who is a survivor annuitant may be eligible to continue PSHB coverage. A former spouse enrolled through Spouse Equity is excluded from PSHB and enrolls in a standard FEHB plan; the PSHB Part B requirement does not apply to that FEHB enrollment.

This is a harder requirement than what FEHB imposes. Standard FEHB plans do not require Medicare Part B enrollment, though many federal retirees enroll voluntarily because Medicare becomes their primary payer and reduces their out-of-pocket costs.

Who Is Exempt

For a PSHB enrollee subject to the Part B requirement, exceptions include:

1. The Postal Service annuitant retired on or before January 1, 2025, and was not already enrolled in Medicare Part B. Family members of that annuitant are also exempt.
2. The Postal Service employee was age 64 or older on January 1, 2025. The employee and family members are exempt after the employee retires.
3. You reside outside the United States and its territories (documented international residence).
4. You or the Postal Service annuitant are eligible for or enrolled in specified VA health benefits, or you are eligible for Indian Health Service services. Family members are also exempt when the annuitant qualifies.
5. Uncommon Part A exception. You pay the full premium for Medicare Part A under Social Security Act § 1818 or § 1818A because you do not qualify for premium-free Part A or continue paid Part A after Social Security disability benefits end.

If none of these exceptions apply to the PSHB enrollee, Medicare Part B enrollment is required to maintain PSHB coverage.

The Cost of Part B

The standard Medicare Part B premium in 2026 is $202.90 per month. Income-related monthly adjustment amounts (IRMAA) can increase it. This cost is on top of any PSHB plan premium paid by an enrollee subject to the requirement.

For a PSHB enrollee already paying the plan premium, adding the standard Part B premium creates a significant combined health insurance expense.

FEHB vs. PSHB: Which One Applies to You

Former spouses of postal employees sometimes assume they can choose between FEHB and PSHB. Spouse Equity and survivor coverage follow different rules:

• If you qualify for Spouse Equity after divorce from a postal enrollee, you enroll in standard FEHB, not PSHB. A former spouse who is eligible as a survivor annuitant after the enrollee's death may be eligible to continue PSHB.
• If your former spouse is a non-postal federal employee or annuitant, your Spouse Equity coverage is also under standard FEHB — no PSHB Medicare Part B requirement.

For an active postal employee, apply through the USPS Human Resources Shared Service Center (HRSSC); for a postal retiree, apply through OPM. Spouse Equity enrollment is in FEHB, not a PSHB election. The 60-day Spouse Equity deadline runs from the divorce or OPM's notice of eligibility based on the qualifying court order, whichever is later.

Filing for FEHB Spouse Equity

For a former spouse of a postal enrollee, Spouse Equity coverage is under FEHB, not PSHB. To qualify, you must meet these conditions:

• Court order awarding annuity share or survivor annuity (accepted by OPM as a COAP)
• Covered as a family member under an FEHB or PSHB enrollment at some time during the 18 months before divorce
• Unmarried before age 55

For an active postal employee, submit Form SF 2809 to the USPS Human Resources Shared Service Center (HRSSC); for a postal annuitant, submit it to OPM. Elect an FEHB plan under Spouse Equity; former spouses cannot elect PSHB under Spouse Equity. Postal former spouses who do not qualify for Spouse Equity may be eligible for TCC under PSHB.

The 60-day deadline is the same statutory window that applies to all former spouse health coverage elections. Missing it permanently forfeits your right to Spouse Equity enrollment.

Planning Ahead

If you are a former spouse enrolled in PSHB as a survivor annuitant and are approaching 65, verify your Medicare Part A eligibility and begin the Part B enrollment process during your Initial Enrollment Period (the 7-month window around your 65th birthday). Late enrollment in Part B triggers a permanent premium surcharge of 10% for each full 12-month period you were eligible but not enrolled.

The Former Spouse Federal Benefits Guide includes a health coverage decision worksheet and a postal-specific section covering PSHB enrollment, the Medicare Part B requirement, and exemption verification.

See more United States guides →