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Medicare in South Carolina

As a South Carolina Medicare beneficiary, you’re eligible for a number of important health benefits under Original Medicare, Part A and Part B, including medical insurance and hospital insurance. In addition, in South Carolina, as in other U.S. states, Medicare beneficiaries may enroll in a private health insurance plan of their choosing under Medicare Advantage (Medicare Part C) and may receive prescription drug coverage through a private company under Medicare Part D. Medicare Advantage is required by law to offer at least the same benefits as Original Medicare. Like residents of other states, South Carolina residents enrolled in Medicare Advantage are covered through their individual health plan and not through Original Medicare.

Original Medicare for South Carolina beneficiaries

Original Medicare consists of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). To qualify for Original Medicare, you must be a citizen of the United States and be 65 years or older. Some people under 65 may also qualify for Medicare if they have certain disabilities.

In South Carolina, as in other states, you can sign up for Original Medicare during the seven-month period that begins three months before the month you turn 65, including the month you turn 65, and ending three months after the month you turn 65. This is the seven-month Medicare Initial Enrollment Period (IEP). If you don’t sign for up Original Medicare during your IEP, you can still join during the General Enrollment Period, which runs from January 1 to March 31 each year, but you may have to pay a late-enrollment penalty in the form of higher premiums.

In general, enrollment in Medicare Part A is free for qualifying people who worked at least 10 years (40 quarters) and paid Medicare taxes during that time (or whose spouses did), but others may have to pay a premium. As a South Carolina Medicare beneficiary, you’re eligible for the following benefits under Medicare Part A:

  • Hospital care
  • Skilled nursing facility (SNF) care
  • Nursing home care
  • Hospice care
  • Home health services

Medicare Part B is medical insurance, and most people have to pay a monthly premium upon enrollment. You may also have to pay an income-related monthly adjustment fee if your income is higher than a certain limit set by Medicare. South Carolina Medicare beneficiaries, like Medicare beneficiaries in other states, receive the following benefits under Medicare Part B:

  • Clinical research
  • Ambulance services
  • Durable medical equipment
  • Mental health (inpatient, outpatient, and partial hospitalization)
  • A second opinion before surgery
  • Limited outpatient prescription drugs

Medicare private insurance in South Carolina

South Carolina Medicare beneficiaries can sign up for Medicare Advantage plans as an alternative to their Original Medicare coverage. Medicare Advantage plans are offered by private insurance companies in South Carolina, and they cover the same hospitalization and medical benefits offered by Original Medicare. In addition, South Carolina Medicare Advantage plans can offer benefits such as vision, hearing, and dental coverage.

Many South Carolina Medicare Advantage plans also include prescription drug coverage. These plans, known as Medicare Advantage Prescription Drug plans (MA-PDs), combine health and prescription drug coverage into one private insurance plan.

As a South Carolina state resident, you also have the option to sign up for a Medicare Supplement plan (also known as Medigap plan). Medigap plans are available through private insurance companies, and they’re designed to help pay for costs you incur under Original Medicare, like copayments, coinsurance, and deductibles, but do not include drug coverage.

If you’re seeking a standalone prescription drug plan, you may want to consider a Medicare Prescription Drug Plan, which is private health insurance designed to help Medicare beneficiaries cover prescription drug costs. Costs for each Medicare Prescription Drug Plan in South Carolina vary, but most require you to a pay a monthly premium, annual deductible, and copayment or coinsurance.

A resident of Columbia in Richland County may have different Medicare plan offerings than a resident of Charleston in Berkeley County. It’s important for South Carolina Medicare beneficiaries to not only customize their search for Medicare plans based on their individual health and prescription needs, but to also take into consideration the county in which they reside.

South Carolina resources for Medicare beneficiaries

There are a number of resources designed to help South Carolina Medicare beneficiaries with Medicare-related issues and concerns. Here are some resources that may be helpful:

  • State Department of Insurance, 1-803-737-6160, representatives are available Monday through Friday, 8:30 AM to 5:00 PM ET, website.
  • State Health Departments, 1-888-549-0820, website.
  • State Health Insurance Assistance Program (SHIP), 1-800-868-9095, website.
  • State Hospice Organization, 1-803-791-4220, website.

Learn more about how Medicare plans work in South Carolina including: