Medicare plays a key role in providing health and financial security to beneficiaries residing in South Carolina. With more than one million South Carolina beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in South Carolina. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in South Carolina?

Medicare covers most South Carolina residents who are 65 or older, and it also covers disabled South Carolina residents. Medicare enrollment in South Carolina works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, 80% of your health care costs will be covered.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

South Carolina Medicare Enrollments

731,277

Original Medicare Plans
(Part A and B)

362,583

Medicare Advantage & Other Health Plans

479,715

Stand-alone Medicare
Part D (Drug plans)

1,093,860

Total Medicare Beneficiaries
in South Carolina

South Carolina Medicare Advantage Plans (Part C)

Nearly 30% of South Carolina Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in South Carolina who already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare.

As of 2020, 92 Medicare Advantage plans are available in South Carolina. The average monthly Medicare Advantage premium changed from $18.15 in 2019 to $15.50 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in South Carolina. Medicare Advantage plans are available in all 46 counties throughout South Carolina. Depending on the county, Medicare Advantage plan availability in South Carolina ranges from six to 41 plans.

According to the Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 362,583 beneficiaries enrolled in Medicare Advantage and other plans in South Carolina. Nearly 30% of South Carolina Medicare beneficiaries were enrolled in a private Medicare Advantage plan in 2019. 100% of people with Medicare have access to a Medicare Advantage plan.

South Carolina Medicare Supplement (Medigap) Insurance Plans

South Carolina’s high-risk pool offers guaranteed-issue Medigap plans to individuals under age 65 who are eligible for Medicare due to a disability.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

There are two initial times to enroll in a Medigap plan before and after you turn 65:

  • 6 months prior to turning 65
  • Once you turn 65, your 6 month period begins the month you enroll in Part B

During this period, an insurance company can’t use medical underwriting. 

As of 2020, there are 57 insurers that offer Medigap plans in South Carolina. Unlike the majority of states that have rules in place to ensure at least some access to private Medigap plans for enrollees who are under the age of 65, South Carolina doesn’t require Medigap insurers to issue coverage to people under 65 years old. Since South Carolina doesn’t require private insurers to offer Medigap plans to people under 65 years old, the state instead maintains its high-risk pool. Through the high-risk pool, Medicare beneficiaries who are under age 65 have access to two guaranteed-issue Medigap plans (Plan A and Plan C). The South Carolina Health Insurance Pool (SCHIP) allows these Medicare beneficiaries to purchase Medigap coverage when they would otherwise be unable to do so. However, these plans are very expensive. In 2019, Plan A was $940.05 per month, and Plan C was $1,194.83 per month.

South Carolina Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of May 2020, There are 479,715 Medicare beneficiaries in South Carolina enrolled in stand-alone Part D prescription drug plans and 337,156 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 28 stand-alone Part D plans available in South Carolina, with premiums ranging from about $14 to $137 per month. About 27% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS). When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in South Carolina

  • South Carolina’s State Health Insurance Assistance Program (SHIP): Also called the Insurance Counseling Assistance and Referrals for Elders (I-Care) program, SHIP helps those applying for Medicare and Medicaid to make the correct choices regarding their insurance. SHIP is a free health benefits counseling service for Medicare beneficiaries and their families or caregivers. SHIP is funded by federal agencies and not associated with any insurance agency.
    Contact: Call 1-800-434-0222 or you can also locate your closest Area Agency on Aging using the search tool on the GetCareSC website.

  • Healthy Connections Prime Ombudsman helps older adults who are enrolled in Healthy Connections Prime address any concerns or conflicts that may interfere with navigating and coordinating their health coverage through Medicare and Medicaid.
    Contact: Call 1-844-477-4632

  • South Carolina Department of Aging – Legal Assistance: Under Title III-B of the Older Americans Act mandates, the South Carolina Department on Aging funds the provision of legal assistance through the various Area Agencies on Aging throughout the state. Legal assistance means legal advice and representation. In South Carolina, that assistance must be provided by an attorney. Legal Assistance can be provided to older individuals (60 years of age and older) within the state who are of greatest economic or social need (with particular attention to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas).
    Contact: Call 1-800-868-9095

  • AccessAbility: Serving Berkeley, Charleston, Dorchester, Orangeburg and Williamsburg counties, AccessAbility is a federally funded nonprofit organization that works to empower people with disabilities. Free services include information and referrals and access to medical equipment through two programs: the Equipment Loan Program and the Fee for Service Program.
    Contact: Call (843) 225-5080

  • Senior Action is a vibrant, growing organization that serves close to 5,000 seniors all over Greenville County. Services have grown from activities and daily meals in each of our nine locations, to also include home-delivered meals, minor home repair, lawn service, and medical transportation.
    Contact: Call (864) 467-3660

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of South Carolina. Our process makes it easier for you to access your Medicare eligibility in South Carolina so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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