Medicare Advantage in South Carolina

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South Carolina state

Information about Medicare Advantage Plans in South Carolina

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28 percent of Medicare beneficiaries in South Carolina were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.1

There are 49 different South Carolina Medicare Advantage plans in 2019.1 Not every plan is available in each South Carolina county.

A licensed insurance agent can help you compare the availability, benefits and costs of Medicare Advantage plans in your area of South Carolina. Read below to learn more about Medicare in your state.

You may be able to find other additional types of Medicare Health insurance plans in South Carolina:

Average costs of Medicare Advantage in South Carolina

The average 2019 Medicare Advantage plan premiums in South Carolina were among the lowest in the nation, at $1 per month.

That average was affected by the 27 available plans that feature $0 monthly premiums.

  • Average monthly premium cost in 2019 (weighted): $1
  • Average in-network out-of-pocket spending limit: $6,436
  • Average deductible in 2019 (weighted): $6.191

The plan premiums, deductibles and out-of-pocket costs for plans may vary greatly based on where you live and the plan you have.

The 2019 average South Carolina Medicare Advantage plan premiums by county are listed below in this guide.

Learn more about your Medicare Advantage plan options and compare costs for plans that are available in your area.

Compare South Carolina Medicare Advantage plan costs

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

In order to enroll in a South Carolina Medicare Advantage plan, you must sign up for Medicare Part A and Part B, often referred to as Original Medicare.

In order to be eligible for Original Medicare at age 65, you must meet the following requirements:

  • You must be a United States citizen (or a permanent legal resident who has lived in the U.S. for five continuous years).

  • You or your spouse must be eligible for Social Security or Railroad Retirement benefits.

  • You or your spouse must be government employees who have paid Medicare payroll taxes, whether or not you paid into Social Security.

You may also be eligible for Medicare benefits before you reach age 65 if:

  • You receive Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.

  • You have ALS (amyotrophic lateral sclerosis, also called Lou Gehrig's disease).

  • You have End-Stage Renal Disease (ESRD) and you or your spouse have paid Social Security taxes for a certain length of time.

If you have ESRD, you may not qualify for most Medicare Advantage plans, but you may be able to enroll in a South Carolina Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to enroll in a Medicare Advantage Plan in South Carolina

The first time you may be able to sign up for a South Carolina Medicare Part C plan is during your Medicare Initial Enrollment Period (IEP).

Medicare Initial Enrollment Period graphic

Each Medicare beneficiary is given a seven-month Initial Enrollment Period when they first become eligible for Medicare.

Your IEP begins three months before your 65th birthday, includes the month of your birthday and continues for three more months after your birth month.

Your IEP is your first opportunity to sign up for Medicare coverage, including a Medicare Advantage plan.

If you do not enroll during your IEP, you will have to wait for one of the following:

Medicare Advantage Open Enrollment Period graphic

Medicare Advantage Open Enrollment Period: January 1 – March 31

If you are already enrolled in a Medicare Advantage plan, you may switch to a new Medicare Advantage plan or disenroll from your plan and return to Original Medicare during the Medicare Advantage Open Enrollment Period.

This period lasts from January 1 to March 31 each year.

If you return to Original Medicare during this period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare AEP graphic

Medicare Annual Enrollment Period (AEP): October 15 – December 7

From October 15 to December 7 every year, you can typically enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another.

You may also drop your current Medicare Advantage plan and return to Medicare Part A and/or Part B.

During AEP, you may also join, switch or drop a Medicare Part D prescription drug plan. 

Medicare Special Enrollment Periods (SEP)

Depending on your situation, you could potentially be granted a Medicare Special Enrollment Period (SEP). You may qualify for a Medicare SEP at any time throughout the year if you have a qualifying circumstance.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Find a South Carolina Medicare Advantage plan

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in South Carolina 2019

The Centers for Medicare & Medicaid Services (CMS) issues star ratings every year for all Medicare Advantage plans using a system of one to five stars.2

If a Medicare Advantage plan earns four or more stars out of five stars, it can be designated as a top-rated Medicare Advantage plan.

There are 17 top-rated 2019 Medicare Advantage plans in South Carolina that are rated four stars or higher.

Medicare Star Ratings
Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

Medicare Advantage plans are rated based on the five categories listed below:

  • Preventive care and health maintenance (screenings, tests, vaccines, etc.)
  • Management of chronic conditions
  • Member experiences and ratings of the plan
  • Member complaints, problems receiving services and member retention
  • Customer service

The information for the star ratings is gathered from information that is submitted to Medicare, Medicare’s regular monitoring activities and member surveys.

List of Medicare Advantage Plans Available in South Carolina in 2019

You can use our plan comparison tool to view a list of plans offered in your area within South Carolina.

Find a South Carolina Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in South Carolina

There may be multiple insurance carriers who offer Medicare Advantage plans in South Carolina, depending on the area you live in.

Private insurance companies and the Medicare Advantage plans that they offer may be unique to the program area that they service.

Call to speak with a licensed insurance agent to learn more about Medicare Advantage plans and to compare the options that may be available from carriers in your area of South Carolina.

When shopping for a Medicare Advantage plan in South Carolina, some of the following information might be helpful sources of more information about available plans and the carriers that provide them:

  • Annual Medicare Star Ratings can help you understand the overall quality of plans available in your area.

  • Agencies such as A.M. Best, Moody’s and Standard & Poor’s provide information about the credit ratings and financial standings of various insurance companies. This information can be helpful as you compare Medicare Advantage insurance companies in South Carolina.

  • The Better Business Bureau and Consumer Reports publish information about different insurance carriers that you might find helpful.

  • You can read through Medicare Advantage plan reviews and testimonials from customers

South Carolina Medicare Advantage plans by county

You can use the chart below to learn more about 2019 South Carolina Medicare Advantage plans in each county.1

  • Greenville County the most 2019 MA plans available, and there were 5 different $0 premium plans in Greenville County in 2019.

  • Berkeley County had the highest number of top-rated Medicare Advantage plans in 2019, with 4 plans that were rated 4 stars or higher by the CMS.
2019 SC Medicare Advantage by County
County Total of County MA Enrollees % of Medicare Beneficiaries Enrolled in MA Average Monthly Premium Number of Plans Available Number of $0 Premium Plans Available % Enrolled in a $0 Premium Plan
Abbeville 2364 36% $1 5 2 98%
Aiken 10504 26% $24 4 2 45%
Allendale 915 42% $3 1 0 94%
Anderson 16770 36% $4 2 1 92%
Bamberg 1258 35% $3 1 0 95%
Barnwell 1479 31% $3 0 0 93%
Beaufort 11065 20% $2 5 2 95%
Berkeley 9594 25% $2 5 3 97%
Calhoun 1289 33% $4 1 0 89%
Charleston 17387 22% $1 5 4 99%
Cherokee 5047 39% $1 3 2 98%
Chester 2471 31% $4 0 0 92%
Chesterfield 2531 25% $1 1 1 97%
Clarendon 2801 30% $1 1 0 96%
Colleton 3240 31% $2 0 0 95%
Darlington 3500 22% $34 0 0 33%
Dillon 1958 29% $1 0 0 97%
Dorchester 6874 23% $25 0 0 56%
Edgefield 1735 29% $8 0 0 84%
Fairfield 1991 34% $3 0 0 91%
Florence 6275 20% $1 0 0 99%
Georgetown 5416 26% $1 1 0 97%
Greenville 35262 35% $0 6 5 100%
Greenwood 4894 30% $0 0 0 100%
Hampton 1433 31% $3 0 0 94%
Horry 23486 23% $18 0 0 55%
Jasper 2018 31% $5 0 0 90%
Kershaw 3713 24% $2 0 0 95%
Lancaster 5313 23% $20 1 0 55%
Laurens 5956 35% $1 0 0 97%
Lee 1318 30% $4 0 0 92%
Lexington 13240 23% $14 1 1 60%
Marion 2087 26% $1 0 0 98%
Marlboro 1986 30% $2 0 0 96%
McCormick 1395 35% $1 0 0 98%
Newberry 2753 29% $1 0 0 99%
Oconee 6631 29% $25 0 0 50%
Orangeburg 7849 37% $1 0 0 98%
Pickens 10037 37% $0 0 0 99%
Richland 16684 24% $1 4 2 96%
Saluda 1365 29% $1 0 0 95%
Spartanburg 26898 40% $0 1 1 100%
Sumter 5282 23% $24 0 0 33%
Union 3167 41% $0 1 1 99%
Williamsburg 3131 37% $1 0 0 98%
York 13881 28% $23 0 0 50%

SC Medicare Advantage enrollees by plan type

Here’s how 2019 Medicare Advantage enrollment in South Carolina is broken down by plan type.1

Plan type Percentage of South Carolina enrollees (2019)
HMO 96.9%
Local PPO 1.8%
Regional PPO 1.2%
PPFS <1%

The primary types of Medicare Advantage plans include:

  • HMO
    Medicare Health Maintenance Organization (HMO) plan typically requires beneficiaries to visit certain health care providers and pharmacies that are part of the plan’s network (except in the case of emergencies). If you have a Medicare HMO, you are also typically required to get a referral from a primary care doctor in order to see a specialist.

  • PPO
    Medicare Advantage beneficiaries in a Preferred Provider Organization (PPO) can typically see providers outside of their plan’s network, though it will most likely cost more money to get out-of-network services.

    PPO beneficiaries will typically pay less out of pocket if they visit providers and hospitals within their plan’s network.

    With a PPO plan, you are usually not required to get a referral before visiting a specialist.

  • PFFS
    A Private Fee-For-Service (PFFS) plan determines how much you pay for services at the point when you receive care.

    With a PFFS plan, you can typically visit any doctor, hospital or health care provider that accepts Medicare and your plan’s terms.

  • SNP
    A Medicare Advantage Special Needs Plan (SNP) can be designed to fit the needs of people with certain chronic conditions and other specific characteristics.

    Except for in cases when you need emergency or urgent care and when someone who has End-Stage Renal Disease (ESRD) needs out-of-area kidney dialysis, you must typically visit providers in your SNP network.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 South Carolina Medicare Advantage plans that are available where you live.

Local health insurance resources in South Carolina

  • The Insurance Counseling Assistance and Referrals for Elders program is a network of volunteers who offer free health benefits counseling to South Carolina seniors who are eligible for or enrolled in Medicare, Medicaid and related programs. The program may be reached at 800-868-9095.    

  • You can also explore more information about the insurance industry in South Carolina by visiting the state’s Department of Insurance website.

  • South Carolina Prescription Drug Assistance Programs
    The state of South Carolina has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 MedicareAdvantage.com's internal analysis of CMS Medicare Advantage landscape source files, accessed May 2019. Data retrieved from www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.

Includes 2019 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown.

2 Every year, Medicare evaluates plans based on a 5-star rating system.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC is a licensed and certified representative of A Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any plan depends on contract renewal.

TZ Insurance Solutions LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult www.medicare.gov.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year.

Medicare has neither reviewed nor endorsed this information.

Last Updated: 6/24/2019