PSHB Medicare Part B Net-Cost Calculator
Calculate your required 2026 Medicare Part B cost as a USPS retiree — including IRMAA surcharges, the Part D double IRMAA, your plan's reimbursement offset, and your net annual out-of-pocket.
About This Calculator
USPS retirees who retired on or after January 1, 2025 must enroll in Medicare Part B to keep PSHB coverage — unless an exemption applies. This tool calculates your required annual Medicare cost, including the "double IRMAA" surcharge for higher earners, and offsets it against your plan's Part B reimbursement.
Sources: CMS 2026 Medicare Premiums fact sheet; OPM PSHB Medicare Cost Savings page; 5 CFR 890.1605 (exemptions)
Step 1: Check Your Exemption Status
USPS employees who were age 64 or older on January 1, 2025 are permanently exempt from the Part B mandate, regardless of when they retire. Enter your age on that date.
years old
Step 2: Your Income and Plan
Medicare Part B premiums for 2026 are based on your 2024 MAGI (the 2-year lookback rule). If your income is near a threshold, your actual 2026 premium may differ from prior years. Check your 2024 tax return (Form 1040, line 11 + tax-exempt interest).
Select your current (or planned) PSHB plan. The calculator uses each plan's confirmed 2026 Part B reimbursement to compute your net annual out-of-pocket. Reimbursements are per Medicare-eligible person enrolled.
2026 Part B IRMAA Reference Table
2026 Part B premiums are based on your 2024 MAGI. Higher earners pay surcharges on both Part B and the Part D EGWP — the "double IRMAA."
| 2024 MAGI (Single Filer) | Monthly Part B | Part D IRMAA/mo | Combined Annual (per person) |
|---|---|---|---|
| Up to $109,000 | $202.90 | $0 | $2,434.80 |
| $109,001 – $137,000 | $284.10 | $14.50 | $3,583.20 |
| $137,001 – $171,000 | $405.80 | $37.60~ | $5,320.80 |
| $171,001 – $205,000 | $527.50 | $60.70~ | $7,058.40 |
| $205,001 – $499,999 | $649.20 | $83.80~ | $8,796 |
| $500,000 or more | $689.90 | $91 | $9,370.80 |
Source: CMS 2026 Medicare Parts A & B Premiums and Deductibles fact sheet. ~ denotes approximate Part D IRMAA surcharge; verify against CMS 2026 Part D IRMAA table. Highlighted row = your selected income bracket.
2026 PSHB Plan Part B Reimbursements
Most PSHB plans offset the mandatory Part B premium with a direct reimbursement per Medicare-eligible person enrolled. A couple where both spouses are enrolled receives double the reimbursement.
| Plan | Reimbursement / Person / Year | Net Part B Cost (Standard Tier) |
|---|---|---|
| APWU High Option | $1,200 | $1,234.80 |
| GEHA High Option (PSHB) | $1,200 | $1,234.80 |
| NALC High Option | $900 | $1,534.80 |
| GEHA Standard (PSHB) | $900 | $1,534.80 |
| MHBP Standard | $900 | $1,534.80 |
| BCBS FEP Basic* | $800 | $1,634.80 |
Sources: OPM PSHB Medicare Cost Savings page; Federal News Network October 2025. Net Part B cost shown at 2026 standard premium ($2,434.80/yr). * BCBS Basic amount based on publicly reported figures — verify against the 2026 BCBS PSHB brochure.
Key Facts for USPS Retirees
- • Coverage loss, not a fee. Missing the Part B enrollment period does not trigger a surcharge — it ends your PSHB coverage permanently once the one-time cure window (5 CFR 890.1608(b)) is used or expired.
- • One-time cure window. If you miss your Initial Enrollment Period, OPM gives you one chance to enroll at the next General Enrollment Period (Jan 1 – Mar 31) to keep PSHB. This window can only be used once; the Medicare late penalty still applies.
- • No return to FEHB. USPS employees and annuitants permanently lost FEHB eligibility on December 31, 2024. There is no reversion path.
- • 2-year IRMAA lookback. Your 2026 Part B premium reflects your 2024 income. A high 2024 income year (lump-sum leave payout, final overtime) may push you into an IRMAA tier even if your retirement income is lower. File SSA Form SSA-44 if you had a qualifying life-changing event.
- • Active employees not affected (yet). The Part B mandate activates at retirement, not while employed. Active USPS workers turning 65 do not need to enroll while still on the payroll.
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The PSHB Medicare Part B Mandate — What USPS Retirees Must Know
The Postal Service Reform Act of 2022 (Pub. L. 117-108) created the Postal Service Health Benefits (PSHB) Program, which launched January 1, 2025. A central feature of PSHB is a mandatory Medicare Part B enrollment requirement for most post-2024 retirees. Unlike other federal employees, USPS retirees who retire on or after January 1, 2025, must actively enroll in Medicare Part B to keep their PSHB health coverage.
The word "mandatory" understates the consequence. This is not a financial penalty for skipping Part B. It is a condition of enrollment. A USPS retiree who becomes eligible for Part B and fails to enroll is not charged a higher premium for PSHB — their PSHB coverage is terminated.
Complete Exemption List — 6 Categories (5 CFR 890.1605)
These are the only six exemptions from the Part B requirement. No other reason qualifies. If you do not fall into one of these categories and retire after January 1, 2025, Part B enrollment is required to keep PSHB.
| Category | Who Is Exempt | Family Members Also Exempt? |
|---|---|---|
| Pre-2025 retirees (grandfathered) | Postal annuitants retired on or before January 1, 2025, not already enrolled in Part B | Yes |
| Age-64 transition exemption | Active USPS employees who were age 64 or older on January 1, 2025 (at any point they retire) | Yes |
| VA health care eligible | Annuitants eligible for VA benefits under 38 U.S.C. subchapter II, ch. 17 | Yes — family exempt regardless of own VA eligibility |
| Indian Health Service eligible | Annuitants eligible for IHS coverage | Yes |
| Residing abroad | Annuitants residing outside the U.S. and territories (documentation required) | Yes, per residency documentation |
| Active employees | USPS employees still actively working (any age) | N/A — mandate activates at retirement |
Sources: 5 CFR 890.1605; OPM PSHB Annuitant page; NARFE PSHB FAQ. FedTools 2026 original organizing table — no competitor has published all six categories in a single reference table.
The One-Time Cure Window (Underreported)
The most underreported fact in all competitor coverage: missing the Part B enrollment period does not immediately end PSHB coverage. Under 5 CFR 890.1608(b), an individual who is required to enroll in Part B but has not will receive one opportunity to remain enrolled in PSHB — if they enroll in Part B during their next available enrollment period (typically the Medicare General Enrollment Period, January 1 – March 31 each year, with coverage effective July 1).
Critical Limitations of the Cure Window
- One-time only: The cure window can only be used once per annuitant. There is no second chance.
- The penalty still applies: The one-time cure does not waive the Medicare Part B late enrollment penalty (10% per full 12-month period eligible but not enrolled). You will pay the penalty for life.
- Permanent disenrollment: If you fail to enroll at that next General Enrollment Period, disenrollment from PSHB may follow — and cannot be reversed.
- No FEHB fallback: USPS annuitants permanently lost FEHB eligibility on December 31, 2024.
FedTools 2026 Analysis: Net Annual Medicare Cost by Plan and Income
The table below shows each PSHB plan's net annual Part B cost at the standard (no IRMAA) tier after the plan's per-person reimbursement. Higher earners should use the calculator above to compute their IRMAA-adjusted net cost.
| Plan | 2026 Part B Annual | Plan Reimbursement | Net Annual Cost | Net 15-Year Cost |
|---|---|---|---|---|
| APWU High Option | $2,434.80 | −$1,200 | $1,234.80 | $18,522 |
| GEHA High Option | $2,434.80 | −$1,200 | $1,234.80 | $18,522 |
| NALC High Option | $2,434.80 | −$900 | $1,534.80 | $23,022 |
| GEHA Standard | $2,434.80 | −$900 | $1,534.80 | $23,022 |
| MHBP Standard | $2,434.80 | −$900 | $1,534.80 | $23,022 |
| BCBS FEP Basic* | $2,434.80 | −$800 | $1,634.80 | $24,522 |
FedTools 2026 analysis. Standard Part B premium $202.90/month ($2,434.80/year); no IRMAA. * BCBS Basic reimbursement based on publicly reported figures — verify 2026 brochure. 15-year projection at flat 2026 rates (actual premiums will increase annually). Per-person figures; a couple pays/receives double.
Understand the Full PSHB Medicare Trap
This calculator covers the dollar math. For the complete picture — exemption verification, the cure window, the common misconceptions, and what to do next — read the companion post.