Medicare Advantage Plans in South Carolina

Medicare Advantage plans in South Carolina combine the coverage included in Original Medicare plus additional services. Extras included in MA plans range from prescription medications to wellness care. Plans vary based on the services provided, how much they cost, and where each plan is offered.

Medicare Advantage is available to anyone who qualifies for Original Medicare and must cover at least what Original Medicare — made up of Medicare Parts A and B — covers. In 2022, there are 96 Medicare Advantage plans available in South Carolina. Still, not every plan is available in every part of the state.

Availability depends on the insurance company offering the plan and where you live.

Medicare Part A covers services you receive in the hospital or nursing home, also known as inpatient care. Medicare Part B covers outpatient care, including wellness visits, examinations in your doctor’s office, or therapy sessions.

While Medicare Parts A and B cover these general areas of care, a Medicare prescription medication plan — Part D — is an optional add-on. Some Medicare Advantage plans may include Part D coverage and other services, including:

• dental care
• hearing aids
• medical transportation
• lab testing
• home medical equipment and supplies
• over-the-counter medications
• fitness classes
• care in foreign countries

The Centers for Medicare & Medicaid Services (CMS) set rules on who is eligible and what Medicare Advantage plans include. Still, different states may have additional restrictions, too. South Carolina generally follows the federal requirements for Medicare Advantage plans. Still, it does have special considerations for Medigap plans.

The cost of Medicare Advantage plans in SC will vary based on where you live and what coverage you want to have included in your plan. You can find plans in your area by entering your zip code at Medicare.gov, or you can contact a licensed insurance agent like those at GoHealth to help you find the right plan for your needs.

The average cost of a Medicare Advantage plan in 2022 is $11.66 per month. Some people may also qualify for a $0 per month premium. In South Carolina, 100% of people with Medicare are eligible for these plans.

Your costs also will depend on rules set by your individual plan. Many Medicare Advantage plans require you to receive care within a specific provider network to receive the maximum coverage for your healthcare services.

Will a Medicare Advantage plan save me money?

You will likely pay more up front for a Medicare Advantage plan compared to Original Medicare, but you could save money in the long run when it comes to out-of-pocket costs. Be sure to consider your individual needs when choosing a plan.

The federal government sets Medicare Advantage eligibility since Medicare is a federal public health insurance program.

Medicare is available to:

• people who are over age 65.
• people with end-stage renal disease.
• people with Amyotrophic Lateral Sclerosis.
• people with disabilities who qualify for Social Security.

In addition to specific eligibility rules, Medicare also has set periods for when you can enroll. You can sign up for Medicare in the three months before or after your 65th birthday or after you have been receiving disability benefits from the Social Security Administration for at least 24 months.

Suppose you are interested in enrolling in a Medicare Advantage plan. In that case, it may be best to consider this option when you first enroll in Medicare. Whether you choose Original Medicare or Medicare Advantage, you have options for Part D coverage when you enroll.

Suppose you wait to sign up for a Part D plan. In that case, a late enrollment penalty will be added to your Medicare premium for the rest of your life. This penalty is based on how long you were eligible for a prescription plan but chose not to enroll.

Some important dates to remember when enrolling in a Medicare Advantage plan include:

• Medicare Open Enrollment Period for all Medicare plans: Oct. 15 to Dec. 7.
• Medicare Advantage Open Enrollment: Jan. 1 to March 31.

In certain circumstances, you may be eligible for a Special Enrollment Period. These circumstances can include, but are not limited to, a new disability, changes to your eligibility, or moving to an area that doesn’t offer your current plan.

Whether or not you include prescription drug coverage in your Medicare Advantage plan is up to you. Most offer options with and without drug coverage. Without a Part D plan added to your Medicare Advantage coverage, you should expect to pay the entire cost of your outpatient prescription medications. You may add Part D coverage at any time. If you neglect to enroll in Part D at the same time as your Medicare, a penalty will be added to your Part D premium for the rest of your life.