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 – December 23, 2023

Seniors and adults with certain disabilities have access to affordable health coverage through the national Medicare program. These benefits are broadly divided into two categories, Original Medicare and Medicare Advantage. Original Medicare is administered directly by the federal government and delivers care in three parts, the hospital inpatient benefit (Part A), outpatient services (Part B) and the prescription drug benefit (Part D). Medicare Advantage (sometimes called Part C) combines the benefits of Parts A and B under a single monthly premium and delivers services via private insurance companies licensed to operate in South Carolina.

Part C plans are available at many different coverage levels and plan configurations, including HMO and PPO options. Most include some prescription drug benefits, as well as several services not traditionally covered by Original Medicare, such as dental and vision benefits, hearing aids and advanced health planning services. With all these benefits, it’s not surprising that 43% of eligible Medicare enrollees in South Carolina choose to get their benefits this way. From 2022 to 2023 alone, Medicare Advantage enrollment went up in the Palmetto State by 8.58%, while the national increase in participation was 6.9%.

In 2023, over 500,000 seniors in South Carolina enrolled in one of the state’s 96 Medicare Advantage Plans. Nationwide, nearly 31 million out of the 65 million Medicare beneficiaries enrolled in a Medicare Advantage Plan. These rates have been rising for many years since Medicare Advantage was first rolled out in 2003, and they’re expected to continue going up as the senior population continues to rise through 2030.

This guide is a resource aimed at helping seniors and their families find a great Medicare Advantage Plan in South Carolina. It goes over the top Medicare Advantage providers in the state, along with price data and customer reviews. Enrollment figures are included, along with information about plan types that should help seniors research the best plans for them.

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

Since 2021, South Carolina has recognized 96 Medicare Advantage Plans that are offered through a number of state-licensed providers. Private insurers operate HMO, PPO and specialty plan options to tailor their coverage as closely as possible to seniors’ health care needs. Eight top providers in South Carolina are listed in the table below, along with the aggregate enrollment, average monthly premiums across providers and consumer ratings to give readers an idea how popular each option is with the people who use it. All of the data here is accurate as of July 2023, though readers can learn more by visiting Medicare.gov.

Name

Enrollment

Medicare Star Rating

Monthly Cost Range

Plan Types

Humana

202515

3.5

$0 – $103

PPO, HMO, PFFS

UnitedHealthcare

116458

2.5

$0 – $49

PPO, HMO

Aetna Medicare

62156

3.5

$0 – $16

PPO

Wellcare

29361

2.5

$0 – $16

PPO, HMO

Cigna

5668

3

$0 – $22

PPO, HMO

Highmark Inc.

4071

4

$0 – $22

HMO

Devoted Health

1776

N/A

$0 – $0

PPO, HMO

Clover Health

1108

3.5

$0 – $38

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. 

Medicare Advantage Plan Types Graphic

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.

Choose a Medicare Advantage Plan



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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