Introduction to Medicare Part C in South Carolina (Medicare Advantage)

Do the gaps in Medicare Parts A and B have you worried about out-of-pocket medical expenses down the road? Well, you don’t need to worry, because there are easily affordable Medicare supplement insurance policies out there which can protect you. The trick is to find the one which gives you the coverage you need for the right price. One solution you might be considering is a Medicare Advantage (or “Medicare replacement”) plan. We’ll explain Advantage plans in detail, as well as give you all of the advantages and disadvantages of such a policy.

Federal Regulations for Medicare Advantage

The reason that Advantage plans are sometimes referred to as “Medicare replacement” is because, essentially, that is what they do. With Medicare Advantage, you are purchasing a private health insurance policy from a private company which provides exactly the same or better coverage than Traditional Medicare. That company then becomes responsible for paying out your Medicare-related health claims. The government no longer covers you.

Medicare Advantage Enrollment In South Carolina

Medicare Advantage is fairly popular in South Carolina, but not overly so. Around 22% of Medicare-qualified seniors have signed up for Medicare Advantage. Of course, there are many different types of Advantage plans available for purchase. Some of them are more popular than others, as the chart below explains:

Plan Type Enrollment Percentage
HMO Plans 59%
Local PPO Plans 13%
Special Needs Plans 11%
Regional PPO Plans 9%
Private Fee-For-Service Plans 5%
Other (Cost Plans, MSA’s, etc.) 3%

Plan Coverage & Cost

In this section, you can get a look at estimated rates for Advantage policies available near you. Keep in mind, however, that these are estimates. You will need to talk to a local insurance agent near you for accurate quotes, which are based on your own personal circumstances.

Most Popular Medicare Advantage Plans in South Carolina

As you may have noticed by now, HMO plans are significantly more popular than almost any other type of plan. This is due to the fact that HMO plans are considerably more affordable than the other available types. The reason for this is directly connected to each plan’s provider network. The smaller the network, like with an HMO, the less you will have to pay for care. However, there are downsides to this.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

Your provider network will play an important part in your decision to obtain an Advantage plan, as well as which plan is right for you. Some networks are more exclusive than others, significantly limiting the doctors and facilities where you can get medical care. Other networks are larger with fewer restrictions – sadly, they are also more expensive. Additionally, the doctors and hospitals which are part of your network can change at any time, forcing you to switch doctors without much warning.

Doctor/Providers List

Drug, Vision and Dental Coverage

One convenient aspect of a Medicare Advantage plan is the ability to add all of the medical coverage you need – including dental, vision, and even prescription drugs – to the same policy. Original Medicare and other Medicare supplements don’t provide this option. Outside of a Medicare Advantage policy, you would need to purchase multiple different insurance policies in order to get the same coverage.

Enrollment Options & Best Time To Enroll

The best time to enroll is during your Early Enrollment Period, within your first six months of turning 65. However, you can enroll later with little hassle if you happen to qualify for a Special Enrollment Period. If you wait to enroll, or if you are trying to get covered with a pre-existing medical condition such as End Stage Renal Disease, getting approved will be much more challenging. However, you have options. Your state department of insurance will have more information on getting covered with a pre-existing condition, as well as your local insurance agent. You may also want to take a look at our Medicare Advantage Enrollment Options page.

  • Initial Enrollment Period: For best results, try to enroll in a Medicare Advantage plan within your first 6 months of Medicare enrollment.
  • Annual Enrollment Period (AEP): You have the option of changing or cancelling your Medicare Advantage and Part D drug plan between October 15th and December 7th every year.
  • Special Enrollment Period (SEP): If you lose your employer plan coverage, move out of your coverage area, or lose coverage from your provider, you could qualify for an SEP.

What Medicare Advantage Plan Is Best For Me?

Compare Medigap Plans Online