The top Medicare Advantage plans in South Carolina provide optional health insurance to Medicare beneficiaries already enrolled in Original Medicare. The policies offer extended coverage that doesn’t come with Medicare Part A and Medicare Part B. Medicare Advantage best suits beneficiaries who want to combine prescription drug coverage and wellness benefits with enhanced medical coverage.
All beneficiaries should understand the following facts about Medicare Part C:
- All plans are issued by and administered by a private insurance company rather than the Centers for Medicare and Medicaid Services.
- Medicare Advantage health plans may include wellness benefits like Silver Sneakers memberships and added health benefits like coverage for dental, hearing, and vision services.
- Medicare Advantage Prescription Drug plans, also known as MAPD, include prescription drug and medical coverage in one plan.
- An insurance agent can sign up beneficiaries for Part C plans once enrolled in Original Medicare.
Best Medicare Advantage plan types in South Carolina
Best for network freedom: Medicare Advantage PPO
- More extensive provider networks allow greater freedom when selecting healthcare providers.
- Some plans may allow out-of-network providers with higher out-of-pocket costs.
- Premiums range from $0 to $100 per month.
Best for lowest out-of-pocket: Medicare Advantage HMO Plan
- Most Medicare beneficiaries have access to $0 premium HMO plans.
- Narrow networks allow for lower monthly premiums.
- Beneficiaries have fewer options when selecting medical providers.
Best for low income or health conditions: Medicare Advantage D-SNIP
- Select South Carolina insurance plans are reserved for beneficiaries with specific chronic health conditions or income limitations.
- Additional coverage is offered to help beneficiaries manage their chronic health conditions.
- Medicaid is often combined with Medicare coverage to minimize out-of-pocket expenses for low-income beneficiaries.
The following statistics show that many South Carolina beneficiaries do find Advantage plans valuable:
- In 2021, 42% of Medicare beneficiaries nationwide enrolled in Medicare Advantage plans.
- While Original Medicare experienced a significant decline in 2021, the Medicare Advantage program grew with more than two million new enrollees.
- South Carolina’s Advantage program grew by 15% from 2020 to 2021.
- Experts predict that about half of all Medicare beneficiaries will enroll in Advantage plans by 2025.
How much does Medicare Advantage cost in 2022?
In 2020, the average monthly premium for a South Carolina Medicare Advantage plan with a Part D plan was just over $15. 41, and the percentage of MAPD plans had a star rating of 4 or 5. With average premiums going over $70 a month in some states, South Carolina is one of the more affordable states for Part C plans.
In addition to the monthly premium, beneficiaries must pay the following out-of-pocket costs when enrolled in an Advantage plan:
When can you enroll in a Medicare Advantage plan in South Carolina?
Initial Enrollment Period
South Carolina beneficiaries enrolling in Medicare at age 65 have an initial enrollment period that lasts seven months. It includes the 65th birthday month plus the three months before and after the birthday month.
This is the best time to enroll in a Medicare Advantage plan because there are no penalties for late enrollment, and beneficiaries can select from Medicare Supplement plans, Advantage plans, and Original Medicare with Medicare Part D.
Open Enrollment Period – AKA Annual Election Period
From October 15 to December 7 each year, Medicare beneficiaries have the chance to switch to a new plan. That includes going from an Advantage plan to Original Medicare or vice versa. Beneficiaries may also change or pick up prescription drug plans if they aren’t satisfied with their current plans or didn’t enroll in Part D.
Medicare Advantage Open Enrollment Period
Medicare Advantage plans have their own open enrollment period from January 1 to March 31 each year. Only beneficiaries already enrolled in a Part C plan can make a change at this time unless they qualify for a special enrollment period.
Special Enrollment Periods – Special Circumstances
Some special circumstances allow select beneficiaries to enroll in Medicare Advantage plans outside the initial enrollment period and the two open enrollment periods. These periods are personalized to the beneficiary and can occur at any time in the year.
Some of the most common reasons for special enrollment include:
- Moving outside of the service area for the current plan
- Losing private medical coverage from an employer or another reputable source
5-star Special Enrollment Period
From November 30 to December 8 each year, beneficiaries enrolled in an Advantage plan can switch to a 5-star plan in their service area. That allows beneficiaries to enroll in the best plan for their needs even as new plans are started in each county.
Special Enrollment Periods if you get “Extra Help”
Medicare beneficiaries who receive Extra Help and qualify for Medicare and Medicaid can join, drop, or switch an Advantage plan during each of the following periods:
- January – March
- April – June
- July – September
Beneficiaries aren’t allowed to change Medigap plans during these periods. In addition, the extra help enrollment periods are open only to those with an Advantage plan or Part D prescription drug plan.
When can I make changes to my Medicare Advantage plan?
The best time to make changes to a Medicare Advantage plan in South Carolina is during the annual Open Enrollment Period. It takes place from October 15 to December 7, and new coverage starts on July 1.
The following options are available during the Advantage Open Enrollment Period:
- Switch to a new South Carolina Medicare Advantage plan
- Switch back to Original Medicare with or without a Part D prescription drug plan
Special circumstances can unlock eligibility for Advantage plan enrollment outside of the annual election period. However, most beneficiaries are locked into their plan choices until the next open enrollment period.
South Carolina Medicare Resources
South Carolina Medicare Resources
- South Carolina Medicare Extra Help
- South Carolina Office of Aging
- CMS: Centers for Medicare and Medicaid Services
South Carolina Medicare Plan Statistics:
These enrollment statistics are for South Carolina Medicare Advantage plans:
- Enrolled in a Medicare Advantage plan in South Carolina: 243,000
- Percent of South Carolina Medicare recipients: 2%
These are the most populated counties in South Carolina:
- Greenville County, South Carolina: 506,837
- Richland County, South Carolina: 411,592
- Charleston County, South Carolina: 401,438
- Horry County, South Carolina: 333,268
- Spartanburg County, South Carolina: 306,854
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Medicare can be very confusing; if you need help with plan selection or getting more detailed information, please reach out to us for additional assistance; we are here to guide you!