Medicare in South Carolina
Written by: Aaron Garcia
Reviewed by: Shikita Nunnery, Licensed Insurance Agent
Key Takeaways
Who can enroll in Medicare in South Carolina? All legal U.S. citizens, or legal residents of five years, who are 65 and older. Some younger than 65 may also be eligible based on certain health conditions.
You can choose between Original Medicare and Medicare Advantage in South Carolina.
Original Medicare helps cover hospital and medical costs, but other services need to be added separately. Medicare Advantage often bundles these services together.
You may know that Medicare is health insurance for Americans aged 65 and older. But do you know what the different Medicare plans in South Carolina are? Do you know how to enroll or how it works? Have you ever thought about Medicare Advantage options in South Carolina?
If you or a loved one have questions like these, here is GoHealth’s guide to Medicare in South Carolina.
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Call TodayWho Qualifies for Medicare in SC?
You qualify for Medicare in South Carolina if you’re 65 or older and either a legal U.S. citizen, or have been a legal resident for at least five years. There are also cases when people younger than 65 qualify for Medicare, including:
- You’re living with:
- End-stage renal disease (ESRD)
- Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s Disease.
- You have received disability-based Social Security benefits, or Railroad Retirement Board (RRB) benefits for 24 or more months.
How Do I Apply for Medicare in South Carolina?
There are several ways to sign up for Medicare in South Carolina. If you’re approaching your Initial Enrollment Period, you’ll need to enroll through the Social Security Administration. Here’s how:
- Visit your local SSA office.
- Call the SSA at 1-800-772-1213.
- Apply online through the SSA website.
- Call GoHealth at 1-855-792-0088 TTY: 771. Our licensed insurance agents will guide you through the process and answer your questions as you go.
If you worked for a railroad, you might need to enroll in Medicare in South Carolina through the Railroad Retirement Board (RRB). For more information, call the RRB at 1-877-772-5772.
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Get Help NowWhat Is the Income Limit for SC Medicaid?
Medicaid is not Medicare. It’s a state and federal program that helps low-income seniors, adults, families, and children receive healthcare. To see if you’re eligible for assistance, visit Health Connections, South Carolina’s Medicaid program.
Do You Have to Get Medicare at Age 65?
If you’re working at 65 and receiving group coverage from an employer with 20 or more employees, you don’t need to enroll in Medicare right away. Instead, your private coverage will serve as your primary policy. When you lose that coverage, a special enrollment period will open up for you to enroll in Medicare in South Carolina without a late enrollment penalty.
If your employer has fewer than 20 employees, you’ll need to enroll as your Medicare will become your primary coverage.
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Call TodayWhat Are the Different Parts of Medicare?
You can receive Medicare in two ways: Original Medicare (Parts A and B) and Medicare Advantage (Part C). There are some key differences you’ll need to know. Here’s an overview of the types of Medicare plans in South Carolina.
Original Medicare (Parts A and B)
Provides coverage for hospital care and for medical and preventive services. You can see any doctor that accepts Medicare, but out-of-pocket costs can be high. Original Medicare doesn’t include Medicare Part D for prescription drugs or cover dental, vision, or hearing, so you’ll need additional coverage.
Medicare Advantage (Part C)
Medicare Advantage (Part C) substitutes for Original Medicare (Part A & B), offering the same Part A and B benefits. Medicare Part C usually bundles additional services like dental, hearing, vision, and prescription drug coverage.
Medicare Part D and Medigap
Since Original Medicare is limited to Parts A and B, enrollees often also purchase a Medicare Prescription Drug Plan (Part D) and Supplement Insurance (Medigap) to boost their coverage and control costs. Here’s how they work:
Medicare Prescription Drug Plan (Part D)
Part D covers prescription drugs. Private insurance companies provide part D plans, and their costs are separate from Original Medicare. Medicare Advantage in South Carolina, on the other hand, often includes Part D coverage.
Medicare Supplement Insurance (Medigap)
To help cover the high out-of-pocket costs that come with Parts A and B, South Carolinians often purchase Medigap. These are a group of plans you can add to Parts A and B that cover costs like premiums, copays and deductibles. Medigap plans are sold by private insurance companies and have their own premiums.
Medicare in South Carolina: Costs and When to Enroll
There’s still plenty more to learn about the different Medicare plans in South Carolina, including how much you can expect to pay and the various enrollment periods. GoHealth has the resources you need to make sense of the process. Of course, you can always give us a call at 1-855-792-0088 TTY: 771. You’ll connect with a licensed insurance agent that can explain your options and answer questions when you have them.
Can I bundle multiple benefits into one plan?
See My OptionsHow Do I Choose the Righ Medicare Advantage Plan?
You can compare how different Medicare Advantage plans work to find the choice that best fits your healthcare needs and financial situation:
- Health Maintenance Organization (HMO): HMOs use primary care physicians to manage your health and refer you to other providers within your network.
- Preferred Provider Organization (PPO): PPOs typically allow you to see out-of-network providers but still use a primary care physician.
- Private Fee-for-Service (FFS): PFFS plans pay your providers each time you receive a service.
- Special Needs Plans (SNPs): SNPs are specialized plans for patients living with certain health conditions or diseases. [i] D-SNP assists dual eligible individuals, and C-SNP is for people with chronic diseases.
What are the Disadvantages of Medicare Advantage Plans?
There are advantages and disadvantages to both Medicare Advantage and Original Medicare, and you’ll want to know the pros and cons of each. Here is a high-level comparison:
- Original Medicare allows you to see any doctor that accepts Medicare but can have high out-of-pocket costs. You may also need to add other policies like Part D and Medigap.
- Medicare Advantage typically has lower costs and usually bundles other services like Part D, but Part C plans limit which doctors you can see using provider networks.
If you need help figuring out what these advantages and disadvantages mean for you, give GoHealth a call. We’ll discuss your needs and see how your options line up.
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Call TodayMedicare in South Carolina by the Numbers
Medicare
South Carolina
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Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
South Carolina Medicare Resources & Contacts
To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which South Carolina-based resources, like these, may be able to help:
Nationwide Resources
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Medicare guide
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare guide
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare guide
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Medicare guide
Low Income and Medicare Guide
For individuals with a qualifying income status
Medicare guide
A Caregiver’s Guide
For individuals with a qualifying income status