If you live in South Carolina, you won’t have to look too hard to find a great Medicare Advantage plan. Read on to discover the top-rated plans your state has to offer.

If you’re searching for a Medicare Advantage plan in South Carolina, you’ll be pleased to learn there are nearly 100 plans to choose from. While it’s a natural reaction to initially feel overwhelmed by so many options, having online tools and resources at your fingertips makes it easy to take charge of your healthcare decisions. More choices can simply mean more opportunities to find a Medicare Advantage plan that’s the perfect match for you. 

Saving money on Medicare is easy. Just use the Insurify Medicare comparison tool to find the right Advantage plan for you. Uncover options in your area at no cost to you. Try it today!

 

 

What Are the Best Medicare Advantage Plans in South Carolina?

Just like any other healthcare decision, finding the right Medicare Advantage plan is a highly personal one. Because each person’s priorities and wants will differ from the next, it’s difficult to say which health insurance plan is “the best.”

The best plan for you may not be the best plan for your friend or neighbor—so it’s highly recommended to create a personal list of benefits you need covered, your top healthcare priorities, your budget, and your preferences. Once you have a clear idea of must-haves, it becomes easier to find which healthcare plan is the best match for you.

It’s also helpful to learn which plans are the top-rated in the state. Here, we’ll review the top eight highest-rated plans in South Carolina based on the Medicare star rating system. This system takes into consideration factors like monthly premiums, deductibles, out-of-pocket costs, and customer services. Even if these plans aren’t your ideal match, it’s beneficial to know what types of plan coverage are generally available in your area. 

#1 Aetna Medicare Elite Plan H5521-253 (PPO)

    • Monthly Premium: $0
    • Deductible: $1,000
    • Prescription Drug Plan Deductible: $0
    • Out-of-Pocket Maximum: $7,500
    • Counties Covered: Jasper, Hampton, Beaufort

Rated four out of five stars, this health plan offers low co-pays for doctor’s visits—even for out-of-network providers. The co-pay is $0 in-network and just $10 for out-of-network primary care physicians. For specialists, co-payments are $20 in-network and just $30 out-of-network. This plan also has excellent coverage for preventive dental, comprehensive dental, and vision, with most services covered with a $0 co-pay. You’ll also receive coverage for hearing, mental health, rehabilitation, and podiatry services with this plan.

#2 Aetna Medicare Premier Plan H5521-140 (PPO)

    • Monthly Premium: $0
    • Deductible: $0
    • Prescription Drug Plan Deductible: $150
    • Out-of-Pocket Maximum: $7,500
    • Counties Covered: Pickens, Laurens, Spartanburg, Oconee, Cherokee, Anderson, Greenville, York

This four-star plan is offered in eight South Carolina counties and offers an affordable prescription drug plan. The deductible is fairly low, at $150, and co-payments for Tier 1 and Tier 2 generic drugs are as low as $0. With this plan, you’ll get dental, vision, mental health, rehabilitation, and podiatry services covered. A hearing exam and evaluation are also covered, but you won’t receive coverage for hearing aids. Overall, this is a solid Advantage plan option with its $0 monthly premium and breadth of benefits. 

#3 Aetna Medicare Premier Plus Plan H5521-319 (PPO)

    • Monthly Premium: $0
    • Deductible: $0
    • Prescription Drug Plan Deductible: $0
    • Out-of-Pocket Maximum: $7,500
    • Counties Covered: Laurens, Greenville, Cherokee, Anderson, Spartanburg

This four-star plan has an attractive $0 monthly premium and $0 deductible. With this plan, you’ll enjoy low co-payments on generic prescription drugs and in-network doctor visits. While co-pays are on the higher side for out-of-network providers (in the $55–$60 range), it is still fairly affordable in lieu of coinsurance coverage. You’ll also receive great hearing, dental, vision, mental health, skilled nursing home, rehabilitation, and podiatry services. Wellness programs, like fitness incentives and nursing hotlines, are also included.

#4 Aetna Medicare Value Plan H5521-251 (PPO)

    • Monthly Premium: $16
    • Deductible: $0
    • Prescription Drug Plan Deductible: $150
    • Out-of-Pocket Maximum: $6,700
    • Counties Covered: Darlington, Orangeburg, Richland, Colleton, Calhoun, Clarendon, Chesterfield, Chester, Charleston, Chester, Marlboro, Marion, Newberry, Lexington, Greenwood, Dillon, Georgetown, Dorchester, Florence, Fairfield, Lancaster, Lee, Kershaw, Horry, Williamsburg, Union, Berkeley, Saluda, Sumter

Available in nearly 30 South Carolina counties, this Medicare Advantage plan has great service area coverage. Low co-pays for in-network and out-of-network doctor visits and for generic drugs back up this plan’s four-star rating. Plan beneficiaries also receive great coverage for hearing, vision, dental, mental health, skilled nursing home, rehabilitation, and podiatry services. 

#5 Cigna Preferred Medicare H7020-004 (HMO)

    • Monthly Premium: $0
    • Deductible: $0
    • Prescription Drug Plan Deductible: $0
    • Out-of-Pocket Maximum: $5,900
    • Counties Covered: Anderson, Cherokee, Chester, Chester, Greenville, Lancaster, Pickens, Spartanburg, Union, York

With this HMO plan, beneficiaries can only receive coverage for in-network healthcare providers—though the coverage offered for in-network providers is excellent. Co-payments for doctor visits and generic prescription drugs are low, and there are $0 co-pays across the board for hearing, dental, and vision services. You’ll also receive great coverage for mental health, skilled nursing, rehabilitation, and podiatry services with this plan.

#6 Cigna Preferred Plus Medicare H7020-006 (HMO)

    • Monthly Premium: $29
    • Deductible: $0
    • Prescription Drug Plan Deductible: $0
    • Out-of-Pocket Maximum: $4,900
    • Counties Covered: Anderson, Cherokee, Chester, Chester, Greenville, Lancaster, Pickens, Spartanburg, Union, York

Rated four out of five stars, this healthcare plan has an affordable monthly premium and attractive $0 deductibles. With this plan, you’ll receive great coverage on hearing, dental, vision, mental health, skilled nursing, rehabilitation, and podiatry services. You’ll also be able to take advantage of extra nice-to-haves, like wellness programs.

#7 Cigna Preferred Savings Medicare H7020-007 (HMO)

    • Monthly Premium: $0
    • Deductible: $0
    • Prescription Drug Plan Deductible: $0
    • Out-of-Pocket Maximum: $6,950
    • Counties Covered: Greenville, Spartanburg, York

Although this plan offers limited coverage for hearing and no vision benefits, beneficiaries will find great coverage in other areas. Doctor visits have a $0 co-pay, and seeing a specialist involves just a $30 co-pay. You’ll also receive coverage for mental health, skilled nursing, rehabilitation, and some podiatry services. Wellness programs are also included in this healthcare plan as an added bonus.

#8 HumanaChoice H5216-075 (PPO)

    • Monthly Premium: $70
    • Deductible: $500
    • Prescription Drug Plan Deductible: $340
    • Out-of-Pocket Maximum: $7,550
    • Counties Covered: Charleston, Berkeley, Colleton, Dorchester

This healthcare plan offers affordable co-pays for in-network doctor and specialist visits and a 50 percent coinsurance for out-of-network providers. While hearing, dental, and vision aren’t covered in this plan, you’ll receive coverage for a variety of other benefits, like mental health services, skilled nursing facilities, and rehabilitation services. Wellness programs are also included. 

Ready to shop plans now? Use the Insurify Medicare comparison tool to find the right Medicare Advantage plan for you. All you need is your ZIP code to start. Try it today!

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How Much Do South Carolina Medicare Advantage Plans Cost?

The cost of Medicare Advantage isn’t quite as straightforward as evaluating the cost of Original Medicare. Original Medicare, which is Medicare Part A and Part B, is a healthcare plan offered by the government. While Medicare Advantage (Medicare Part C) is regulated by the government, the plans are offered by private insurance companies. Depending on the insurance company‘s terms with their healthcare provider network, the type of coverage you receive and its costs will vary. 

Generally, the monthly premium you can expect to pay for Medicare Advantage in South Carolina will be lower than the national average—so that’s good news. But remember to keep in mind that you will need to consider more than just the monthly premium when comparing the cost of Medicare Advantage plans. There are also deductibles, co-pays, coinsurance, and out-of-pocket costs to consider. Your total cost for Medicare Advantage will depend entirely on the specific plan you buy, what healthcare services you decide to use, and the providers you see. 

This is why it’s critical to compare healthcare plans and prices before making a decision. In the past, this task could turn into a burden that involved finding a licensed insurance agent, setting up phone appointments, and more. Now, with online comparison tools available, health insurance comparison shopping is much easier to do on your own time and on your terms. 

What Types of Medicare Advantage Plans Are Available in South Carolina?

    • Health Maintenance Organization (HMO): These plans cover healthcare services through a limited network of healthcare providers. This means if you want coverage, you’ll have to stick to the plan’s network. You’ll also need to have a designed primary care provider who you visit for referrals to specialists. 
    • Preferred Provider Organization (PPO): PPO plans offer more flexibility by offering some coverage for healthcare providers outside the plan’s network. You’ll get the best coverage for in-network providers. Even though you receive coverage for out-of-network providers, you will typically have to pay more. For example, you might have a $0 co-pay for in-network providers and a $100 co-pay for out-of-network providers. With a PPO plan, you can also see a specialist directly with no need for a referral.
    • Special Needs Plan (SNP): These health insurance plans are designed to meet the needs of people with specific health conditions or other criteria. This includes people who are diagnosed with a chronic illness and those who live in a nursing home or other facility.
    • Private Fee-for-Service (PFFS): These types of plans are not as common. PFFS plans are designed to allow more flexibility and freedom, letting you visit a doctor or facility of your choice and then submitting a claim to your insurer. The caveat is that not all providers will accept your plan, so you will need to check whether they accept the terms of your plan with every visit.
    • Medical Savings Accounts (MSA): Another rare plan, MSAs combine a high-deductible health plan with a bank account that Medicare deposits money into. As the name suggests, this account is for medical savings, and you can use those funds to pay for healthcare services throughout the year.

Who Is Eligible for Medicare Advantage in South Carolina?

Medicare is a federal program, meaning that it’s available to U.S. citizens and permanent residents nationwide. As you approach 65, you will become eligible for Medicare and can enroll in Medicare benefits during your Initial Enrollment Period. This begins three months before your 65th birthday and ends three months afterward. During this period, you should enroll in Original Medicare (Medicare Part A and Medicare Part B). This is a necessary step before you can enroll in a Medicare Advantage plan.

There are also special circumstances where you may be eligible for Medicare even if you are under the age of 65, such as:

  • Being diagnosed with end-stage renal disease (ESRD)
  • Having received Social Security Disability Insurance (SSDI) for at least 24 consecutive months

If you’re unsure about your eligibility for Medicare services, you can always visit Medicare.gov or call 1 (800) 633-4227 for more details. TTY users can call 1 (877) 486-2048.

What Is the Medicare Advantage Enrollment Process in South Carolina?

As mentioned, the first step to enrolling in Medicare Advantage is to sign up for Original Medicare. Once enrolled, Medicare beneficiaries can choose to switch to a Medicare Advantage plan during two enrollment periods.

There’s the Open Enrollment Period that occurs every year from October 15 to December 7, and the Medicare Advantage Open Enrollment Period that takes place from January 1 to March 31 every year.

 

 

FAQ: South Carolina Medicare Advantage

Can I have a Medicare Advantage plan and Medicare Supplement Insurance (Medigap) at the same time?

Nope. Medigap plans were designed to help cover the gaps in Original Medicare coverage. If you enroll in Medicare Advantage, which typically fulfills that purpose, then you can't have Medigap coverage at the same time.  

Can I have Medicare and Medicaid at the same time? 

Yes. If you are eligible for Medicaid services, you can continue receiving those benefits while enrolled in a Medicare Advantage or Original Medicare plan. If you have any questions about your dual-eligible status, you can visit the Centers for Medicare & Medicaid Services at CMS.gov.

Do all Medicare Advantage plans come with prescription drug coverage?

While many Advantage plans include a prescription drug plan, not all do. Make sure to read your plan's coverage details if Medicare Part D prescription drug coverage is important to you. 

Conclusion: Comparing Plans Online Is Safe and Simple, and It Saves You More Money

Traditionally, finding the best health insurance plan involved contacting an insurance agent, which can be a very tedious task. Although there have been many advancements in Medicare, it has still been viewed as a confusing world to navigate.

Fortunately, there are many online resources that make navigating your Medicare options easy. By understanding what your options look like and taking the time to create a prioritized list of needs and preferences, you’re well on your way to finding the best Medicare Advantage plan for you.

Did you know that you can use the Insurify free Medicare comparison tool to find the right Medicare plan for you? Shop Medicare Advantage plans as low as $0/month—all you need is your ZIP code to get started. Try now!

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Updated April 14, 2021

Emily Vasquez is a content marketing writer based in Tampa, Florida. A graduate from the University of South Florida, Emily has worked as a copywriter, communications lead, and content strategist for high-growth start-ups and global brands and retailers. You can learn more at www.emvwrites.com