Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – September 17, 2022

The original Medicare program was designed as a federally operated health insurance system for U.S. citizens and lawful immigrants aged 65 and older as well as younger citizens who have qualifying medical conditions.

Medicare Advantage combines all the benefits of Medicare Parts A and B, also called Original Medicare, into a single plan provided by a private insurer. It’s also known as Medicare Part C. All Medicare Advantage plans must provide the same coverage as Original Medicare as a baseline, but plan providers can also choose to offer additional coverage benefits. Many Medicare Advantage plans include dental, vision and wellness program benefits, as well as prescription drug coverage, none of which are included under Original Medicare. 

Beneficiaries are responsible for paying their Medicare Part B premium and the premium of their Advantage plan unless they choose a zero-premium plan. The federal government administers the original Medicare, but not Medicare Advantage, so plan providers can set their own policies around eligibility, cost and physician networks.

Medicare Advantage plans are increasingly popular across the United States. In South Carolina, 35% of Medicare beneficiaries are enrolled in Medicare Advantage plans, based on data from 2021. This is below the national average of 42%.

This guide is designed to help South Carolina residents understand what Medicare Advantage plans are available in their state, as well as how much each plan costs and what it covers. 

The Top 10 Medicare Advantage Plans in South Carolina

The table below lists the Top 10 most popular Medicare Advantage Plans in South Carolina. Total enrollment numbers are included for each plan to help seniors better understand how many beneficiaries are enrolled. Additional cost info and star ratings provide further context to help differentiate plans from one another. Because many plan providers offer multiple Medicare Advantage plans, costs are displayed as a range rather than a set median number. 

All plan information in the table below is accurate as of April 2022. South Carolina residents can go to Medicare.gov to find the most up-to-date information about Medicare Advantage plans in their area. Residents need to note that plan availability can depend on whether they live within the plan’s service area. 

Name

Total Enrollment

Star Rating

Min Cost

Max Cost

Plan Types

Humana

161,042

4

$0

$111

HMO, PPO, PFFS

UnitedHealthcare

153,401

3.5

$0

$49

HMO, PPO

Aetna Medicare

59,972

4

$16

$28

HMO, PPO

Wellcare

38,864

3.5

$0

$44

HMO, PPO

Blue Cross Blue Shield of South Carolina

16,720

3.5

$10

$25

HMO, PPO

Cigna

6,367

3.5

$0

$24

HMO, PPO

Wellcare by Allwell

3,106

3

$0

$0

HMO

Molina Healthcare of South Carolina

1,616

3

$0

$0

HMO

Clover Health

1,223

3.5

$31

$31

PPO

Blue Cross Blue Shield of Michigan

1,216

0

$0

$0

PPO

How Medicare Advantage Plans Work in South Carolina

South Carolina’s eligible Medicare beneficiaries have the ability to choose between various different Medicare Advantage plans. There are four main types of Medicare Advantage plans in South Carolina: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS) and Special Needs Plan (SNP). Plan providers often offer more than one plan type. The table below contains information about each of the four most popular plan types. 

What Medicare Advantage Plans Cover in South Carolina

Medicare Advantage plans cover all of the same services as Medicare Part A, such as hospital care and nursing home stays, and Medicare Part B, which includes services like preventative screenings and durable medical equipment. The only exception is hospice care, which is covered under Medicare Part A but not under Medicare Advantage.

Medicare Advantage plans also offer additional coverage for things like vision screenings, dental cleanings, hearing aids and prescription drugs. These extra coverage offerings vary depending on the plan. 

The table below includes several common medical services and explains if they’re covered under Original Medicare or Medicare Advantage. 



Coverage Available With Medicare Parts A & B?

Coverage Available With Medicare Advantage?

Preventive Screenings

Yes

Yes

Hospital Care

Yes

Yes

Durable Medical Equipment

Yes

Yes

Prescription Drugs

No

Yes**

Vision Care

No

Yes*

Dental Care

No

Yes*

Hearing Aids

No

Yes*

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in South Carolina

All South Carolina residents aged 65 or older (or younger if they have a qualifying disability) who are U.S. citizens or lawful immigrants are eligible for Medicare Advantage. However, they must enroll in Original Medicare before applying for Medicare Advantage. 

Some Medicare Advantage plans have additional eligibility requirements established by the plan provider. For example, Medicare Special Needs Plans (SNP) are only available to individuals living with specific diseases or chronic conditions. 

Medicare Advantage enrollment is only available during specific periods throughout the year. Once the enrollment periods are over, there’s no way to sign up for a plan or change coverage, except in rare situations. Medicare Advantage enrollment periods include:

  • Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
  • Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
  • Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Start Date

End Date

Initial Coverage Election
Period

3 Months Before One’s
65th Birth Month

3 Months After One’s
65th Birth Month

Annual Election Period
(AEP)

October 15th

December 7th

Medicare Advantage Open
Enrollment Period

January 1st

March 31st

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in South Carolina

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.




State-Wide Medicare Advantage Resources

State Health Insurance Assistance Program (SHIP) 

Also called the Insurance Counseling Assistance and Referrals for Elders, or I-CARE program, South Carolina’s State Health Insurance Assistance Program provides free health benefits counseling for Medicare beneficiaries. Families and caregivers of Medicare-eligible seniors can also utilize SHIP services.  SHIP is funded solely through federal agencies, and the program is not affiliated with any insurance companies, plans or service providers. Services include assistance with Medicare enrollment for parts A, B, C and D. I-CARE counselors also explain Medicare benefits to seniors, offer Medicaid fraud prevention education and facilitate benefit coordination between various providers.  I-CARE counselors also help seniors compare plans during Medicare Open Enrollment and assist clients with applications for cost-saving programs, including the Low Income Subsidy (LIS). 

Contact Info

South Carolina’s SHIP/I-CARE program is administered through the statewide network of Area Agencies on Aging. You can find your local Area Agency on Aging by calling the South Carolina Department on Aging at 1-800-434-0222. You can also locate your closest Area Agency on Aging using the search tool on the GetCareSC website

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Healthy Connections Prime Ombudsman

Seniors enrolled in South Carolina’s Healthy Connections Prime program, an enhanced health care plan that combines benefits of Medicare and Healthy Connections Medicaid, can contact the Healthy Connections Prime Ombudsman for help with Medicare. Because the coordination of benefits between Medicaid and Medicare can be somewhat confusing and fragmented, some Prime members struggle with inconsistent care and overuse of emergency room services.  The Ombudsman’s office assists Prime members with appeals and grievances, Medicare eligibility and continuity of care issues. The Ombudsman also provides ongoing member education, particularly with regard to member rights and the benefits Healthy Connections Prime members are entitled to. Successful resolutions achieved through the Healthy Connections Prime Ombudsman’s office include prevention of inappropriate discharge from inpatient facilities, assisted members with the Medicaid recertification process and settlement of overdue claims. 

Contact Info

To connect with the Healthy Connections Prime Ombudsman’s office, call the South Carolina Department on Aging at 1-844-477-4632. 

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South Carolina Department of Aging – Legal Assistance

South Carolina seniors age 60 and older can access no-cost legal assistance through Area Agencies on Aging Statewide. Funding for these services is provided through the South Carolina Department on Aging, in accordance with Title III-B of the Older Americans Act.  The Department on Aging has long-standing partnerships with various legal groups and agencies that provide legal advocacy for seniors, including assistance with Medicare and health care services. Seniors can connect with state-sponsored legal services in their region by contacting the local Area Agency on Aging or by calling the South Carolina Department on Aging at 1-800-868-9095.

Contact Info

The Department on Aging has long-standing partnerships with various legal groups and agencies that provide legal advocacy for seniors, including assistance with Medicare and health care services. Seniors can connect with state-sponsored legal services in their region by contacting the local Area Agency on Aging or by calling the South Carolina Department on Aging at 1-800-868-9095.

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Local Medicare Advantage Resources

AccessAbility 

Serving Berkeley, Charleston, Dorchester, Orangeburg and Williamsburg counties, AccessAbility is a federally funded nonprofit organization that works to empower people with disabilities.  Free services include information and referrals and access to medical equipment through two programs: the Equipment Loan Program and the Fee for Service Program.  Seniors who have experienced changes to their mobility can borrow durable medical devices through the Equipment Loan Program. The service can help seniors who are evaluating their future medical needs decide if they need a Medicare Advantage plan that includes coverage for mobility aids and accessibility accommodations.  

Contact Info

Seniors can contact AccessAbility by calling (843) 225-5080. 

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Senior Action

Based in Greenville, Senior Action is a nonprofit organization that provides a variety of services throughout the City of Greenville, Greenville County and the City of Greer.  The organization operates a number of activity centers where seniors can participate in wellness, social and recreational classes. Senior Action also hosts a number of financial planning programs and workshops that can help seniors decide if Medicare Advantage enrollment is right for their particular financial situation.  Senior action offers free tax preparation assistance, insurance seminars, budgeting seminars and one-on-one insurance counseling and multiple locations. 

Contact Info

Seniors can learn more about services and programs offered by Senior Action by calling (864) 467-3660 or by downloading the current activity calendar for the nearest program site.

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