Medicare Advantage Plans in South Carolina

Private insurance companies offer Medicare Advantage plans in South Carolina but adhere to rules set forth by Medicare. The insurance company provides a separate insurance card to each beneficiary, but the red, white, and blue Original Medicare card is kept for future use.

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Top-rated Medicare Advantage Providers in South Carolina

Here are some of the private insurance companies offering Medicare Advantage plans for 2022:

Popular Medicare Advantage Plan Types in South Carolina

Best for network freedom: Medicare Advantage PPO

  • PPO plans often have wider networks than HMO plans, giving beneficiaries more excellent choices when selecting healthcare providers.
  • Some PPO policies allow beneficiaries to seek care from out-of-network providers.
  • $0 premium PPO plans are available, but rates may go up to $100 monthly.

Best for lowest out-of-pocket: Medicare Advantage HMO Plan

  • Most HMO plans have no monthly premium, which reduces out-of-pocket costs.
  • HMO costs are reduced by limiting services to in-network providers willing to abide by plan payment policies.

Best for low income or health conditions: Medicare Advantage D-SNIP

  • SNP insurance plans are reserved for low-income beneficiaries or those with chronic health conditions.
  • Each special needs plan focuses on specific health conditions. Low-income plans are limited to beneficiaries meeting income qualifications.
  • A South Carolina Medicare Advantage plan is often combined with Medicaid to minimize out-of-pocket costs.

South Carolina Enrollment Facts:

  • The five largest counties in South Carolina are Greenville, Richland, Charleston, Spartanburg, and Horry.
  • 1,051,955 Medicare beneficiaries were enrolled in Medicare Part A and B (or just one of the two) in South Carolina in 2018.
  • 265,865 Medicare beneficiaries in South Carolina enrolled in Medicare Advantage in 2018.

How much does Medicare Advantage in South Carolina cost?

The average monthly premium for a South Carolina Medicare Advantage plan was $15.02 in 2021. Most service areas have at least one $0 premium HMO plan. PPO plans are trending away from $0 premiums, but some are still available in select counties.

How much do Advantage Plans cost in South Carolina?

PPO Plan $0.00 to $15.02

HMO Plan $0.00

When can I enroll in a Medicare Advantage plan?

Initial Enrollment Period

  • All beneficiaries have seven months to enroll in Medicare Part A and Part B and select an Advantage, Part D, and/or Medigap plan.
  • Starts three months before the beneficiary’s 65th birthday month. It begins on the first day of the month.
  • Ends three months after the beneficiary’s 65th birthday months.

Open Enrollment Period – AKA Annual Election Period

  • October 15 – December 7 every year
  • Switch between Advantage plans, go back to Original Medicare, or select a Medicare Part D plan
  • Takes effect on January 1 of the following year

Medicare Advantage Open Enrollment Period

  • January 1 – March 31 every year
  • Limited to beneficiaries already enrolled in a Part C plan
  • Switch to a new Advantage plan or go back to Original Medicare

Special Enrollment Periods – Special Circumstances

  • Occur at unique times for each eligible beneficiary
  • Allows late enrollment in Original Medicare or Advantage plans due to exceptional circumstances
  • Everyday Qualifying Events: losing health care coverage from an employer and moving to a new service area

5-star Special Enrollment Period

  • November 30 – December 8 every year
  • Switch to a 5-star Advantage plan

Special Enrollment Periods if you get “Extra Help.”

  • Changes are permitted during three annual periods: January – March, April – June, and July – September.
  • Beneficiaries eligible for Medicaid and Medicare can change Advantage or Part D plans.
  • Beneficiaries receiving Extra Help to pay for prescription drug coverage may change Plan D policies.

Medicare Advantage Highlights:

Consider some additional facts about the Medicare Advantage health plans in South Carolina:

  • Medigap plans may eliminate more out-of-pocket costs like copayments, coinsurance, and deductibles, but Advantage plans offer lower monthly premiums.
  • Medicare Advantage plans often include additional Medicare coverage, like benefits for dental, vision, and hearing services. Medicare Supplement plans do not offer that coverage.
  • Medicare Advantage Prescription Drug plans, also known as MAPD, include prescription drug coverage. Beneficiaries don’t need to pay for a Part D plan separately.
  • Many Medicare Advantage plans require beneficiaries to select a primary care physician and see network providers in agreement with the plan’s payment terms.
  • An insurance agent can help beneficiaries select a Medicare Part C plan.

Ready to Learn More?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Call us today, or request a quote online to learn more about plan options.

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