Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). pays 80% of most covered healthcare services. You pay the remaining 20%.
Medicare Supplement Plans can cover your coinsurance and copayments to lower your out-of-pocket costs.
There are 12 Medigap plans available in South Carolina, each with different cost and coverage options.
Medigap plans do not cover any Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). costs. Medicare Supplement Plans only cover out-of-pocket costs for Original Medicare.
Original Medicare in South Carolina offers Medicare Part A and Part B coverage. This includes hospital care, medical care and preventative services. But Medicare coverage doesn’t pay the entire cost of covered services. When you access care, Original Medicare pays for 80% of the covered service, and you pay the remaining 20% coinsurance. Some services include a fixed-rate payment, and this is called your copayment.
Original Medicare costs include:
- Medicare Part A premium: Most people qualify for premium-free Part A, but if you need to buy Part A your monthly premium is $499 in 2022.
- Part A deductible: Before your coverage begins, you’ll need to reach your $1,556 yearly deductible in 2022.
- Part B premium: The monthly Part B premium starts at $170.10 per month.
- Part B deductible: Before your Part B coverage starts, you’ll need to pay your $233 yearly deductible.
- Coinsurance and copayments: Each time you access care you’ll pay your portion of the covered service.
- Part B excess charges: If your provider charges more than the Medicare-approved amount, you will pay the difference.
Find a local Medicare plan that fits your needs
Medicare Supplement Plans in South Carolina can help you fill in the cost gaps in Original Medicare. These plans can lower your out-of-pocket costs by covering your coinsurance, copayments or even deductibles.
There are 12 Medigap plans available in South Carolina, including Medigap Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan K, Plan L, Plan M and Plan N. Medigap Plan F and Plan G also offer high-deductible plans to give you even more cost and coverage options.
All Medicare Supplement Plans in SC must offer a few key benefits:
- Part A coinsurance for hospital and hospice care
- Part B coinsurance and copayments
- Blood (first 3 pints) needed during a medical procedure
Some South Carolina Medigap plans may also offer:
- Part A coinsurance for skilled nursing facility care
- Part A yearly deductible
- Part B yearly deductible
- Part B excess charges
- Foreign travel medical emergency coverage
Plans are offered by private insurance companies, but coverage options are standardized. This means that regardless of the provider, each plan will offer the same coverage. Check out this side-by-side comparison chart to see exactly what’s covered by each plan.
While coverage options are standardized, the costs of Medigap plans in SC are set by each insurance company. Medigap plan premiums in SC range from $26 to $940 in 2022 depending on the plan and the provider. Other factors that may impact the cost include where you live, your age, your health status and when you purchase the plan.
Insurance companies use three formulas to determine the cost of Medicare Supplement Plans:
- Community-rated: Everyone in the community pays the same price for each Medigap plan.
- Issue-age-rated: Your age will determine how much you pay for the plan. Prices are usually higher for older adults.
- Attained-age-rated: Your current age will determine how much your plan costs. This plan may be very affordable when you first enroll, but the cost increases every year.
Are you eligible for cost-saving Medicare subsidies?
The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period. This six-month period starts the first day your Medicare Part B coverage begins. During the Open Enrollment Period you’ll have guaranteed issue rights and plan providers must sell you a plan. They can’t use medical underwriting to deny coverage or increase your premiums. Just remember that your guaranteed issue rights end when your Medigap Open Enrollment Period ends.
Medigap plans do not include prescription drug coverage.These plans only cover Original Medicare costs and do not include medication coverage.
You can get prescription drug coverage by enrolling in a Medicare Part D plan. Part D plans work alongside Original Medicare to cover your medications. However, Medigap plans will not cover any Part D out-of-pocket costs or help with prescription drug costs.
What extra benefits and savings do you qualify for?
Medicare Advantage plans and Medigap plans don’t work together. Medicare Advantage plans are an alternative to Original Medicare, and they bundle all your benefits into one standalone plan. You’ll get all the same coverage as Original Medicare, and most plans include additional benefits such as prescription drug coverage, dental coverage and more.
Medigap plans only work with Original Medicare. A Medigap plan covers Original Medicare coinsurance, copayments and deductibles to lower your out-of-pocket costs. Medigap plans do not cover Medicare Advantage plan costs and you can’t have both plans at the same time.
Medigap plans are sometimes updated or discontinued. For example, Medigap Plans E, H, I and J are no longer available. Medigap Plan C and Plan F are also being discontinued. If you’re a new Medicare beneficiary, you’re not eligible for Plan C or Plan F. However, if you became eligible for Medicare before January 1, 2020, you can still enroll in Medigap Plan C or Medigap Plan F.
If you’re enrolled in Original Medicare, you can buy a Medigap plan even if you’re under 65. However, adults under 65 may not qualify for all Medigap plans. In South Carolina, Medicare beneficiaries under 65 have guaranteed issue rights for Medicare Plan A and Plan C. Plan providers must offer these plans, but you may not qualify for another Medigap plan.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement