If you are 65 or older or under 65 with qualifying disabilities, you may be eligible for Medicare benefits. Those with end-stage renal disease can also qualify for Medicare at any age. When you receive Medicare, it comes in two parts, Part A and Part B.
Medicare Part A is for hospital inpatient costs, and Part B is for doctor's costs. In most cases, Medicare pays 80 percent of your medical bills after your deductible. You will still have to pay for any expenses not covered by your plan, including prescriptions, dental, and vision.
Medicare is a federal program so it’s available in every state, including South Carolina, and you can use it to cover many of your medical expenses. You can also choose a Medicare Advantage plan, which is an alternative to Original Medicare offered by private insurance companies. Medicare Advantage may offer additional benefits such as prescription drug coverage, and vision and dental coverage.
Over eight million people are enrolled in Medicare in South Carolina, including:
You can apply for Medicare Part A and Part B three months prior to your 65th birthday. Medicare actually recommends that you apply early because of the amount of time it takes to process applications. Apply through the Social Security or Railroad Retirement Board office, whichever is applicable.
Medicare pays for skilled nursing facilities but not for custodial or long-term care. Medicare has "benefit periods." Each benefit period starts from the time you go into a hospital or skilled nursing care facility and ends when you leave. You can have multiple benefit periods in one year.
Part A pays for all of the costs you incur during the first 60 days, with the exception of your deductible, which is $1,484.00 in 2021, and your coinsurance portion. For the first 60 days, your cost over and above your deductible and coinsurance is $0. From Day 61 through Day 90, you pay $371.00 per day, and from Day 91 to Day 150, $742.00 per day.
If you are in the facility for over 150 days, you are responsible for all costs. For skilled nursing facilities, you pay a coinsurance of $185.50 for Day 21 through Day 100 and all costs after Day 100.
A Medicare Advantage plan is offered through private insurance companies. It includes Medicare Parts A and B, plus other coverage that might include prescriptions, dental, and vision, depending on the plan. Medicare Advantage plans are often referred to as Part C or MA plans. If you have an advantage plan, Medicare pays the insurance company to cover Medicare benefits.
The plans available depend on your location in South Carolina. The best plan for you will depend on many individual factors including premiums, copays, and out of pocket costs. You can search plans online by entering your zip code and filter by benefits.
Yes, Medigap is available in South Carolina. Medigap is a supplemental insurance plan that covers some or all of the coinsurance that Medicare does not pay. Any doctor that accepts Medicare should accept Medigap plans. Your Medigap plan coverage depends on the plan you choose. Medigap plans will only pay for services that Medicare deems necessary.
Medicare Select is a Medigap policy – as with the standard Medigap policies, you pick from one of the supplement plans labeled A through N. However, Medicare Select usually does not allow out-of-network providers. You can use them, but you will be charged more for the costs you incur. In many cases, the premiums are lower if you choose to use a Medicare Select policy. If you choose Medicare Select, you can switch to a regular Medigap policy at any time, as long as the company you have for Medicare Select offers the Medigap plan you want. You cannot switch to a different Medigap policy – it has to be the same or have less coverage than the Medicare Select policy you originally chose.
Understanding Medicare and its various parts can be confusing, but we’re here to help and answer your Medicare questions. Search for a Medicare plan near you or contact a licensed agent to help you choose the right plan for your needs. Visit our website to [find Medicare and Medicare Advantage plans in South Carolina](https://medicare.healthinsurance.com].
Short Term Medical Insurance
Limited Fixed Indemnity Plans