South Carolina Medicare plans present individuals with two separate and distinct options for coverage in addition to Medicare. This article will discuss the differences in the two plan options, as well as some general pros and cons of both. Before discussing the two options, the most important thing to know is that, to be eligible for either South Carolina Medicare Supplements or South Carolina Medicare Advantage plans, you must have both Medicare Parts A & B.
Part A is the part of Medicare that is generally obtained by working in the United States and paying into the Social Security system. There is no cost for this coverage. Part B is a part of Medicare that you generally pay a monthly premium to have. This is usually deducted monthly from your Social Security check. Once you have both Part A and Part B, you are eligible to consider and sign-up for one of the two options listed below.
The first option for coverage is a Medicare Supplement plan. These are sometimes called Medigap plans. These plans are designed to fill in the “gaps” in Medicare so that you have very few, or in many cases, no out of pocket costs. These plans are standardized from company to company – that is, each company is required to offer the exact same coverage. The biggest difference in plans is in monthly premium costs. There is no network restrictions with the standardized Medigap plans.
The second option is Medicare Advantage plans. With this type of coverage, the private company provides all of your health insurance benefits. Rather than “supplementing” it, these plans take over for Medicare to manage your insurance benefits. Generally, these plans have more cost-sharing (co-pays and deductibles) but lower monthly premiums than South Carolina Medicare Supplements. Some of these plans have network and non-network coverage that must be considered. Also, some plans include prescription drug coverage, which can be a nice asset. These plans are not standardized in any way by the Federal Government, like Medicare Supplements are, so you must examine and consider each plan carefully to see what the specific benefits are.
There are also a couple of other factors to keep in mind when considering these two options. The first factor is that, with South Carolina Advantage plans, you can only enroll during the once-a-year enrollment period, unless you are in a special enrollment period allowing you to enroll at other points in the year. With South Carolina Supplement plans, you can enroll or disenroll at any time. The second additional factor to keep in mind is that the Advantage plans have the ability to change (decrease or increase) coverage every calendar year. You do, however, have the option of exploring other plans rather than accepting the changes to your plan. The coverage on existing South Carolina Medigap plans does not generally change.