Understand Medicare in South Carolina
Medicare, the United States federal medical insurance program, provides coverage for about 1.1 million people in South Carolina who qualify for Medicare. You can get Medicare if you’re 65 or older or have a qualifying disability.
Your disability typically qualifies if you’ve received at least 24 Social Security or Railroad Retirement Board (RRB) disability insurance payments. You can also enroll in Medicare Advantage Plans if you have End-Stage Renal Disease (ESRD) or amyotrophic lateral sclerosis (ALS).
Most people have premium-free Part A but, if you have to buy it, the cost can reach up to $506 per month in 2023. Part B costs $164.90 per month but can be more if you have higher income. There are 97 Medicare Advantage Plans in the state that are an alternative to Original Medicare. Learn more about your Medicare options in South Carolina.
Medicare Plans in South Carolina
|Compare ratings of South Carolina’s Medicare plan providers:|
|Insurance company||Medicare rating||A.M. Best rating||BBB rating||J.D. Power ranking|
|Aetna||4 stars||A+||A+||6th out of 9|
|Blue Cross Blue Shield||4 to 4.5 stars||A+||A+||5th out of 9|
|Cigna||4 stars||A-||Not rated||8th out of 9|
|Humana||4 stars||A-||A+||2nd out of 9|
|UnitedHealthcare||3.5 stars||A-||A-||4th out of 9|
Medicare Plan Options in South Carolina
Residents of South Carolina have multiple Medicare plans to choose from. Many are tiered to help South Carolinians find the plan that is best suited to your lifestyle and medical needs. For example, seniors and individuals with disabilities who don’t need much coverage can apply for Original Medicare. South Carolina’s Medicare Advantage program might be a better option if you need more comprehensive insurance. Some Medicare policies offer additional prescription drug add-ons or supplementary coverage.
|Original Medicare (Parts A and B)||Original Medicare is the basic Medicare plan, which is a fee-for-service form of insurance. It has two parts: Part A hospital insurance and Part B medical insurance. Part A covers hospital stays and periods spent at skilled nursing facilities, lab tests an individual has performed, and hospice care. Part B covers doctor’s office visits and home health care services. It may also cover some preventive care, such as screenings for cancers and mental illnesses, including depression. With Original Medicare, you’ll pay a deductible along with your share of the fees incurred during an inpatient or outpatient visit:
|Medicare Advantage Plans (Part C)||Medicare Advantage plans, also known as Part C, are an alternative to Original Medicare offered by private insurance companies. These plans include both Part A and Part B coverage, except for hospice care. Most services are provided by network providers, and you may need primary care physicians, referrals for specialists, and prior authorizations for treatment and medications. Medicare Advantage offers additional coverage for essential needs, such as prescription drugs, dental and vision care. Some Medicare Advantage Plans also cover gym memberships and transportation to and from medical appointments. Part C may also pay for adult day care services:
|Medicare Prescription Drug Coverage Plans (Part D)||Many Medicare Advantage policies add Part D drug coverage automatically to their package, but you can also add Medicare prescription drug coverage to Original Medicare. Medicare prescription drug coverage is offered to all Medicare enrollees, but you may have to pay a penalty if you wait to enroll after being initially eligible. Medicare Part D plans may not all cover the same drugs or have the same costs as Medicare Advantage policies. Standalone Part D coverage is provided by Medicare-approved private insurers. Most plans require a deductible and a copay for each prescription drug:
|Medicare Supplement Insurance Plans (Medigap)||Some South Carolina seniors purchase a Medicare Supplement Insurance policy, also known as Medigap. These plans are intended to fill in the gaps Original Medicare doesn’t cover. Some of these gaps include medical coverage while overseas, Part A and Part B copays, and excess Part B charges. Medigap doesn’t pay for anything related to Medicare Advantage. You cannot have a Medigap plan and a Medicare Advantage Plan at the same time.
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|
|737,889||Part A: $0 to $506 per month*
Part B: $164.90 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
Making Medicare decisions can be challenging to some seniors, which is why South Carolina has resources to help enrollees find the right plans for them. South Carolina also provides support via local nonprofits and public health agencies, and Area Agencies on Aging (AAAs). Here are some resources that can help.
South Carolina Department on Aging
The South Carolina Department on Aging is dedicated to improving the quality of life for older residents in the state. It also provides other services including family caregiver support programs, an Alzheimer’s Resource Coordination Center, etc.
Contact information: Website | (803) 734-9900
GetCareSC is run by the South Carolina Department on Aging. It serves as a resource for seniors who would like to be matched with the appropriate service providers who can help them maintain good health and independence for as long as possible.
Contact information: Website | (800) 868-9095
Mayor’s Office on Aging (Charleston)
Charleston senior residents have a true advocate in their corner with this office. Its main mission is to ensure that aging residents can enjoy the best quality of life possible. The office also provides educational workshops on age-related topics including health coverage, scams to avoid, and more.
Contact information: Website | (843) 724-7311
Learn More from Our Sources
- Medicare | How do Medicare Advantage plans work? | Last accessed September 2023
- Medicare | How to get prescription drug coverage | Last accessed September 2023
- Medicare | Medicare Advantage Plans cover all Medicare services | Last accessed September 2023
- Medicare | What Medicare covers | Last accessed September 2023
- Medicare | What’s Medicare Supplement Insurance (Medigap)? | Last accessed September 2023