South Carolina's largest private employer sends more people into retirement every year than almost any company in the state. Here are the five questions that decide whether your Medicare handoff is smooth or expensive.

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Prisma Health is the biggest private employer in South Carolina — roughly 30,000 people across the Midlands and Upstate, from Prisma Health Richland and Baptist in Columbia to the Greenville hospitals and hundreds of practices in between. Statistically, some of the state's largest annual waves of new Medicare beneficiaries walk out of Prisma's doors.

Rather than the full textbook, let's do this one as the five questions we'd ask you across the desk — because your answers decide everything.

1. Are you actually retiring, or just stepping back?

Healthcare careers end gradually — PRN, part-time, seasonal returns. Medicare doesn't care about your badge; it cares about whether you're covered by the group plan as an active employee. The day you lose benefits eligibility — even if you're still working shifts — your 8-month Part B enrollment window starts. If your plan is full-time → PRN → done, your Medicare calendar is set by the first step. Answer this question before you request the status change, not after.

2. What does your exit paperwork actually offer?

Three things to pin down with HR before you commit to a date: whether any retiree medical benefit, subsidy, or HRA exists for your hire date and role; what the COBRA offer costs and — more important — what it doesn't do (it isn't active coverage, it doesn't pause your Part B clock, and after 65 it pays second to Medicare whether you enrolled or not); and what happens to your employer life insurance, which usually shrinks or vanishes at retirement right when replacing it gets expensive.

3. Who else is on your plan?

A spouse under 65 loses coverage when you leave the group plan, and they can't follow you onto Medicare early. Their bridge — marketplace coverage, their own employer's plan, or something else — needs to be priced and arranged before your last day. This is the most commonly forgotten piece of the whole transition, and the most stressful to fix late.

4. Which doctors do you refuse to give up?

Prisma people retire loyal to Prisma doctors — you've worked beside them for years. So your plan choice has to be run against the actual network: some Medicare Advantage plans work beautifully with Prisma facilities, others don't, and Original Medicare plus a supplement sidesteps network questions entirely at a higher monthly premium. There's no universal answer; there's an answer for your doctors, your prescriptions, and your budget. (And your first 6 months on Part B are the only time SC Medigap carriers must take you without health questions — decades of hospital work on your body make that window worth protecting.)

5. What's your income doing in your final year?

Big last-year numbers — payouts, PTO cashouts, retirement plan moves — can trigger IRMAA, Medicare's income-based premium surcharge, two years later. If your income drops after retirement, you can appeal it with Social Security's life-changing-event form. Almost nobody knows this; it's real money.

Where we come in

Five questions, one sit-down:

• We sequence your status change and Medicare dates so nothing starts late and nothing overlaps.
• We translate the exit paperwork into dollar comparisons — retiree benefit vs. open market, COBRA vs. clean handoff.
• We run every major SC carrier against your Prisma doctors and your prescriptions — independently, because we're paid the same regardless of what you pick.
• We solve the under-65 spouse bridge and check the IRMAA angle while we're at it.
• No cost, no obligation. If the answer is simple, you'll hear that it's simple.

The bottom line

Prisma Health runs on people who spent careers making complicated things work for others. Your own handoff deserves the same competence. If you or your spouse works anywhere in the Prisma system — Columbia, Greenville, or anywhere between — bring us your five answers, or come get help finding them. The review is free, and it's a lot cheaper than learning question #1 the hard way.

Mauldin Insurance Group is an independent insurance agency in Lexington, SC. We are not affiliated with or endorsed by Prisma Health, Medicare, or any government agency. Benefits vary by employee; consult your official plan documents for details about your specific coverage.