Medicare Made Simple: Your South Carolina Answers Hub

Explore fast, clear answers to your Medicare questions—tailored just for South Carolinians! Our FAQ delivers local insight and practical tips, so you can make confident coverage choices with Mauldin Insurance Group.

 

1. Who qualifies for Medicare in South Carolina?

Anyone 65 or older who is a U.S. citizen or permanent resident of at least five years qualifies for Medicare. People under 65 can also qualify through disability, ALS, or End-Stage Renal Disease.

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2. When can South Carolinians enroll in Medicare?

Most people enroll during their Initial Enrollment Period around age 65, but others can join during the Annual Election Period (Oct 15–Dec 7) or Medicare Advantage Open Enrollment (Jan 1–Mar 31).​

3. What is the most popular Medicare option in South Carolina?

Nearly half of South Carolina Medicare beneficiaries use Medicare Advantage plans, which often include prescription, dental, and vision coverage.​

4. How many Medicare Advantage plans are available in South Carolina for 2025?

Every county in South Carolina offers between 29 and 50 Medicare Advantage plan options.​

5. Do all doctors in South Carolina accept Medicare?

Most providers accept Medicare, but networks vary by plan. Always confirm that your preferred doctor participates before enrolling in a specific plan.​

6. Are dental services covered under Original Medicare in South Carolina?

No, Original Medicare does not cover dental care, but Medicaid ABD or certain Medicare Advantage plans can offer limited dental benefits, up to $750 annually.​

7. What are the income limits for Medicaid assistance with Medicare in South Carolina?

For 2025, the monthly income limit is about $1,215 for singles and $1,643 for couples to qualify for Medicaid ABD or Medicare Savings Programs.​

8. Can working South Carolinians delay Medicare at 65?

Yes, if your employer has 20 or more employees, you can keep group coverage and delay Medicare without penalty.​

9. What is the penalty for delaying Medicare without creditable coverage in South Carolina?

Without qualified coverage after age 65, you’ll face a 10% higher Part B premium for each year you delayed enrollment.​

10. Does South Carolina offer Medigap (Supplement) plans?

Yes, private companies in South Carolina offer standardized Medigap plans to cover out-of-pocket costs from Original Medicare.​

11. Are prescription drugs covered under Original Medicare in South Carolina?

No, you’ll need a separate Part D plan or a Medicare Advantage plan with drug coverage.​

12. How many Part D plans are available in South Carolina in 2025?

There are 15 stand-alone Part D prescription drug plans, with premiums as low as $0 per month.​

13. Can you have both Medicare and Medicaid in South Carolina?

Yes, dual-eligible individuals can receive both—Medicare as primary and Medicaid as secondary—to help pay for premiums and cost-sharing.​

14. Does Medicare cover nursing home care in South Carolina?

Medicare only covers short-term skilled nursing care following a hospital stay. Long-term custodial care is generally not covered.​

15. Are Medicare Advantage plans county-specific in South Carolina?

Yes, plan availability and benefits differ by county, so options in Lexington might not match those in Greenville or Charleston.​

16. What is the Extra Help program in South Carolina?

Extra Help lowers prescription drug costs for Medicare beneficiaries with limited income and resources.​

17. Do Medicare Advantage plans in South Carolina include vision benefits?

Many plans include routine eye exams and eyewear allowances, unlike Original Medicare, which does not cover vision care.​

18. Can South Carolina residents change Medicare Advantage plans mid-year?

Yes, during the Medicare Advantage Open Enrollment (Jan 1–Mar 31), beneficiaries can switch to another Advantage plan or return to Original Medicare.​

19. What agency provides Medicare guidance in South Carolina?

The South Carolina Department of Insurance and SHIP (State Health Insurance Assistance Program) offer free Medicare counseling.​

20. Can low-income Medicare beneficiaries in South Carolina get dental coverage?

Yes, Medicaid ABD provides limited dental care, including cleanings, fillings, and extractions, up to $750 per year.​

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