Medicare Plan Options
As you consider your Medicare choices, think about your current state of health. If you’re healthy, Original Medicare may provide you with what you need. If you desire that extra little bit of protection, consider adding a Medicare Supplemental Insurance Plan to Original Medicare. If you’re concerned about vision or dental issues, a Medicare Advantage Plan is a good choice. Taking a lot of medication? You’ll want to investigate a Medicare Part D plan.
Original Medicare is the basic Medicare plan: Part A looks after hospitalization, nursing care, hospice, and home health care; Part B covers doctor’s visits, mental health care, durable medical equipment, and ambulance services. Part A can cost as much as $471 a month, but that cost depends on how much you’ve paid in Medicare taxes in the past. You are responsible for the Part B premium of $148.50 per month, normally deducted from your Social Security payment. After you’ve paid your deductibles, you’re responsible for 20% of any Medicare-approved medical procedures you need. There are no out-of-pocket limits on Original Medicare.
Medicare Advantage Plans
All Medicare Advantage Plans must provide Original Medicare’s Parts A and B. In addition, Medicare Advantage Plans provide dental, hearing, and vision coverage. Some plans will also include fitness programs, and many provide prescription drug coverage. There are four kinds of Medicare Advantage Plans: HMOs, PPOs, Private Fee-For-Service Plans (PFFS), and Special Needs Plans (SNP). The key thing to know about a Medicare Advantage Plan is that although there are 59 in South Carolina, you can only select a plan that’s available in the county in which you live.
Medicare Prescription Drug Coverage Plans
Medicare Part D provides for prescription drug coverage. If you select Original Medicare, you’ll need to purchase a Medicare Part D plan separately. This cost is affected by several factors, including your pharmacy, if the drug company that provides the medication also offers financial assistance to purchase it, and the drug’s tier. Many Medicare Advantage Plans offer prescription drug coverage, although not all of them do. During your initial enrollment, if you decide not to select a Part D plan or a Medicare Advantage Plan that offers prescription drug coverage, you can sign up for a plan later although you may have to pay a penalty.
Medicare Supplement Insurance Plans
A Medicare Supplemental Insurance Plan, also known as Medigap, helps you plug holes in your Original Medicare coverage. It helps with co-pays, deductibles, and coinsurance. A Medicare Supplemental Insurance Plan will not cover vision, dental, hearing, long-term care, or your Medicare Part D premium of $148.50 a month. Supplemental Insurance Plans are helpful if you need to travel outside the country and you want medical coverage. However, if you get your Medicare through a Medicare Advantage Plan, you cannot purchase a Medigap plan.
Medicare in South Carolina by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|733,031||Plan A: $0 to $471 per month*
Plan B: $148.50 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Resources in South Carolina
The first time you navigate your way through these Medicare options, it can seem a little overwhelming. If you select Original Medicare, does it provide you with enough coverage? If you know you’ll be traveling overseas, should you purchase a Medicare Supplemental Insurance Plan? Is there a good Medicare Advantage Plan available in your county? Fortunately, South Carolina offers everyone in the state who is eligible for Medicare access to counseling that’s free, unbiased, and confidential. Here are some organizations that can help you make good choices:
Area Agencies on Aging (AAA)
South Carolina has 10 Area Agencies on Aging that provide information and services for seniors across the state. AAA organizations assist seniors in several important ways. They provide nutritious meals to seniors who are needy or homebound, arrange congregate meal sites where mobile seniors can enjoy a healthy meal and associate with other seniors, help seniors and their families find appropriate assisted-living communities, provide transportation to medical appointments, offer respite care to family members of seniors with memory care issues, and offer guidance and counseling on issues like Medicare, Medicaid, and long-term insurance.
Contact Information: Website | 800-868-9095
South Carolina Department on Aging – GetCareSC
One of the most important resources offered by the South Carolina Department on Aging is GetCareSC. It’s an online hub that provides information on assisted living (including a directory of all assisted-living facilities in the state), insurance counseling, transportation if needed, and volunteer opportunities for those who want to assist seniors to live healthy and independent lifestyles. Seniors, their families, or their caregivers will find answers to many of their questions at GetCareSC.
Contact Information: Website | 803-734-9900
Insurance Counseling (Medicare/Medicaid) – SHIP
South Carolina’s State Health Insurance Assistance Program (SHIP), also known as the Insurance Counseling Assistance and Referral for Elders (I-Care) program, provides free, unbiased, and confidential counseling for anyone eligible for Medicare in the state. This program is funded by the federal government and is not associated with any private insurance company, so none of the trained SHIP volunteers will try to sell you a plan. Since Medicare plans and costs can change from year to year, SHIP provides an invaluable resource to seniors, their families, or their caregivers looking for the best Medicare options.
Contact Information: Website | 800-868-9095
Learn More from Our Sources
- Medicare | What Part A covers | Last accessed June 2021
- Medicare | What Part B covers | Last accessed June 2021
- Medicare | Part D | Last accessed June 2021
- Medicare | Health Maintenance Organizations (HMO) | Last accessed June 2021
- Medicare | Preferred Provider Organizations (PPO) | Last accessed June 2021
- Medicare | Private Fee-for-Service Plans (PFFS) | Last accessed June 2021
- Medicare | Special Needs Plans (SNP) | Last accessed June 2021
- Medicare | What’s Medicare Supplemental Insurance Plan? | Last accessed June 2021
- Medicare | Medigap and travel | Last accessed June 2021
- Medicare | How to Get Prescription Drug Coverage | Last accessed June 2021
- Patient Advocate Foundation | Understanding Drug Tiers | Last accessed June 2021