Best Medicaid Plans In South Carolina


Ambetter From Absolute Total Care

Democratic lawmakers push to expand Medicaid in South Carolina

Ambetter from Absolute Total Care is Centenes Health Insurance Marketplace product in South Carolina. Ambetter exists to improve the health of its beneficiaries through focused, compassionate and coordinated care. Our approach is based on the core belief that quality healthcare is best delivered locally.

Top Medicare Supplement Carriers In South Carolina

There are several top Medigap plan carriers in the state. The following quotes are for a South Carolina female aged 65.

SBLI USA is the most affordable Medigap plan carrier in South Carolina, while Royal Arcanum offers the highest prices for Plan F, Plan G, and Plan N. Medico offers a plan similarly priced to SBLI USAs offerings, with just $77 for Plan N.


South Carolina Dental And Vision Plans

Dental and vision insurance plans, underwritten by Golden Rule Insurance Company, have no age limit restrictions.4 They offer coverage for the dental and vision services many medical insurance plans dont include.

From Columbia to Charleston, Greenville to Myrtle Beach, explore these South Carolina health insurance options and more that may be available now.

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Medicare Plan Options In South Carolina

Residents of South Carolina have multiple Medicare plans to choose from. Many are tiered to help South Carolinians find the plan that is best suited to your lifestyle and medical needs. For example, seniors and individuals with disabilities who dont need much coverage can apply for Original Medicare. South Carolinas Medicare Advantage program might be a better option if you need more comprehensive insurance. Some Medicare policies offer additional prescription drug add-ons or supplementary coverage.

About Medicare Advantage Plans In South Carolina

SC Medicaid: Healthy Connections South Carolina Medicaid Program

There are a few types of Medicare Advantage plans in South Carolina, including

  • Health Maintenance Organization plans
  • Preferred Provider Organization plans
  • Private Fee-for-Service plans

There are 96 different Medicare Advantage plans available in South Carolina, some rated 3.5 or higher by the National Committee for Quality Assurance .

Number of Medicare Advantage Plans available Medicare Advantage Plan types available Medicare Advantage Plans rated 3.5 or higher by NCQA
  • Sierra Health Life Insurance Co.
  • United HealthCare Insurance Co.

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South Carolina Medicaid Eligibility Requirements

Medicaid eligibility is not always black and white. The Healthy Connections program includes several categories of eligibility: Aged and blind or disabled, breast and cervical cancer, disabled children, family planning, former foster care, nursing home residents, medically needy, parents and caretaker relatives, partners for healthy children, pregnant women and infants, qualifying Medicare beneficiaries, and working disabled people. The chart below can help you determine whether or not you qualify:

South Carolina Plans Tailored Medicaid

In June, the state of South Carolina requested permission from the U.S.

In June, the state of South Carolina requested permission from the U.S. Centers for Medicare and Medicaid Services to restructure the state’s Medicaid program from an open-ended entitlement into a defined contribution system similar to health plans in the private market. South Carolina Gov. Mark Sanford planned and submitted the proposal , and the governor’s office expects a response in the coming months, most likely in 2006.

To pay health insurance premiums or purchase care directly, most of the state’s 850,000 Medicaid recipients would have access to a personal health account similar to the new Health Savings Accounts that became available to workers with private health coverage in 2004. So-called “dual-eligibles,” who qualify for both Medicaid and Medicare coverage, and foster care children would not receive personal health accounts.

Benefits Would Remain Same

Under Sanford’s plan, the amount the state would contribute toward each enrollee’s care would vary according to the beneficiary’s age, sex, and physical condition, but on average would be about what the state now pays under fee-for-service plans. Enrollees would receive sufficient funds to purchase approved health plans equivalent to their current coverage.

Plan Offers Choice, Competition

Counselors Will Guide Enrollees

Under the proposal, called Healthy Connections, beneficiaries will have four options from which to choose:

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Unitedhealthcare Connected For Mycare Ohio

UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.

Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays, and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

When Can I Make Changes To My Medicare Advantage Plan

Democrats push for Medicaid expansion

The best time to make changes to a Medicare Advantage plan in South Carolina is during the annual Open Enrollment Period. It takes place from , and new coverage starts on July 1.

The following options are available during the Advantage Open Enrollment Period:

  • Switch to a new South Carolina Medicare Advantage plan
  • Switch back to Original Medicare with or without a Part D prescription drug plan

There are special circumstances that can unlock eligibility for Advantage plan enrollment outside of the annual election period. Most beneficiaries are locked into their plan choices until the next open enrollment period.

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Finding Your Best Health Insurance Coverage In South Carolina

The best health insurance plans in South Carolina vary by county. For example, the cheapest Silver plan for a 40-year-old in Abbeville is $317 per month, whereas the cheapest Silver plan for a 40-year-old in Oconee is $514 per month. No matter where you live, you can choose a plan that offers coverage to fit your lifestyle.

Higher metal tier health plans, like Gold policies, have monthly premiums that are typically more expensive than Silver policies but offer significantly lower out-of-pocket expenses, like deductibles, copays and coinsurance. This means if you have high recurring medical costs or you think you may become sick, a higher metal tier plan may be the best option.

On the other hand, if you are young, healthy and have no expected medical costs â and would prefer a lower monthly premium â a lower metal tier policy may be the best choice.

Gold plans: Best for high expected medical costs

If you use or expect to use your insurance often, Gold plans typically come with the lowest costs because they offer lower deductibles and copays. However, the monthly premium you can expect to pay for a Gold plan will generally be higher. Ultimately, these health plans are best if you have high expected medical costs or don’t want to pay out of pocket for an unexpected condition.

The cheapest Gold plan in South Carolina is the Ambetter Secure Care 5. Compare all tiers in South Carolina above.

Silver plans: Best for those with low income or average medical costs

Find And View Providers And Health Plans

This website has tools to help you find and view primary care providers and health plans.

Medicaid and NC Health Choice Provider and Health Plan Lookup ToolYou can use the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool to find a PCP. Our provider search will help you find the best PCP for you and your family.

To search for a provider, go to Find a provider.

Health Care Option GuideYou can use the Health Care Option Guide to view health plans. It will help you choose the best health plan to meet your health care needs.

To view health plans, go to View health plans.

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Best Medicare Advantage Plan In South Carolina Without Drug Coverage

You can look into other plans if you dont need Part D coverage for prescription drugs.

MoneyGeek found that the Aetna Medicares Premier Plan is the best plan in South Carolina if you want a Medicare Advantage Plan that may or may not include drug coverage, offers the six core benefits and has a good rating from CMS.

Aetna Medicare

If youre not particularly interested in drug coverage, the Aetna Medicare Premier Plan PPO might be your best option in South Carolina. This plan does include drug coverage.

The following features are included in the plan:

  • No monthly premium
  • An in-network max-out-of-pocket limit of $6,100
  • A rating of 4.5 out of 5 stars by CMS

All the six common additional benefits, like dental, fitness, hearing, vision, worldwide emergency and telehealth coverage are included in the Aetna Medicare Premier Plan. CMS also awarded it a good rating.

Sc Healthy Connections Dental Program & Vision Coverage

SC did not expand Medicaid under Obamacare, but cost and enrollment are ...

Adults in the SC Healthy Connections Dental Program can receive preventative services of up to $750 in value per year. This includes annual cleanings and exams, x-rays, extractions, and fillings. Most people will pay a $3.40 copayment. Kids also get six-month fluoride treatments, one sealant every three years, and one space maintainer. These services are provided through Dentaquest, so you can find a provider at the SC Dentaquest website.

Vision coverage is also much more comprehensive for kids than it is for adults. While kids can get coverage for both exams and glasses, adults can only receive medically necessary exams, like for those pertaining to eye diseases like glaucoma.

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Compare Medicare Supplement Options

Plan M Plan N
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up Yes
Part B coinsurance or copayment Yes
Part A hospice care coinsurance or copayment Yes
Skilled nursing facility care coinsurance No
Foreign travel exchange No

* Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs up to the deductible amount of$2,490 in 2022 before your policy pays anything.

** For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.

*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that dont result in inpatient admission.

What Are Medigap Plans

Medigap plans are Medicare Supplement Insurance offered by Medicare-approved private insurance companies to help cover cost sharing requirements of Original Medicare Parts A and B.

While Medicare pays for a large percentage of the health care services and supplies you may need, you are still responsible for a portion of the costs in the form of deductibles, copays, and coinsurance. Medigap policies help with these costs and sometimes offer more coverage for excess charges and foreign travel health emergencies.

Medigap plans are standardized by Medicare and regulated by state laws and insurance commissioners. You pay a monthly premium for Medigap. Costs and availability of Medigap plans vary depending on several factors including your age and gender, the insurer, and your state of residence. Learn about Medigap in South Carolina so you can determine which plan best meets your needs.

  • In 2019, there were over 280,000 Medicare Supplement enrollees in South Carolina.
  • Plans F and G are the most popular and comprehensive Medigap plan types in South Carolina. Plan F is no longer available to people who are eligible for Medicare after December 31, 2019.
  • Monthly premiums for Plan G for a 65 year old female who doesnt use tobacco range from $84 to $361.
  • South Carolina does not require Medigap insurers to offer plans to disabled Medicare beneficiaries under age 65, however one South Carolina agency, United American Insurance, does offer plans to people under the age of 65.

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Tailored Plans Will Start December 1 2022

On December 1, 2022, NC Medicaid will have a new type of health plan. It is called the Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan . People who need certain services to address a mental health disorder, substance use disorder, intellectual/developmental disability or traumatic brain injury may qualify for the Tailored Plan that serves their county.To learn more, go to Tailored Plan services.

Meetings and events

You can schedule rides to medical appointments. Learn more about transportation services.

Get the free mobile app

To get the app, search for NC Medicaid Managed Care on or the App Store.

Use the app to find and view primary care providers and health plans for you and your family. Learn more about the free mobile app at .

Understand Medicare In South Carolina

NC Medicaid change results in delayed payments for some small healthcare providers

Medicare, the United States federal medical insurance program, provides coverage for about 700,000 people in South Carolina who qualify for Medicare. You can get Medicare if youre 65 or older or have a qualifying disability.

Your disability typically qualifies if youve received at least 24 Social Security or Railroad Retirement Board disability insurance payments. You can also enroll in Medicare Advantage Plans if you have End-Stage Renal Disease or amyotrophic lateral sclerosis .

Most people have premium-free Part A but, if you have to buy it, the cost can reach up to $499 per month in 2022. Part B costs $170.10 per month but can be more if you have higher income. There are 73 Medicare Advantage Plans in the state that are an alternative to Original Medicare. Learn more about your Medicare options in South Carolina.

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Using The Sc Medicaid Portal

While all options are viable, applying online certainly has unique perks. By using the SC Medicaid Portal, youll be able to see all of your free and affordable health coverage options, plus you can save your work and return to it later. This is important because the application requires a lot of paperwork and documentation that you may not have in front of you all at once. Plus, it takes a while to complete the application properly. It may be easier for you to spend a few minutes at a time working on it.

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Best For Low Income Or Health Conditions: Medicare Advantage D

  • Select South Carolina insurance plans are reserved for beneficiaries with specific chronic health conditions or income limitations.
  • Additional coverage is offered to help beneficiaries manage their chronic health conditions.
  • Medicaid is often combined with Medicare coverage to minimize out of pocket expenses for low-income beneficiaries.

The following statistics show that many South Carolina beneficiaries do find Advantage plans valuable:

  • In 2021, 42% of Medicare beneficiaries nationwide enrolled in Medicare Advantage plans.
  • While Original Medicare experienced a significant decline in 2021, the Medicare Advantage program grew with more than two million new enrollees.
  • In South Carolina, the Advantage program grew by 15% from 2020 to 2021.
  • Experts predict that about half of all Medicare beneficiaries will enroll in Advantage plans by 2025.

You Have More Insurance Options For Your Health Than You Think South Carolina

North Carolina and the ACAâs Medicaid expansion

If youre self-employed or without insurance from your employer in other words, youre looking for individual or family health insurance in South Carolina you might be looking for Affordable Care Act insurance, what’s often called Obamacare. However, we want to make you aware of the whole range of individual and family insurance products we have available in your state.

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Best Cheap Health Insurance In South Carolina 2022

Find Cheap Health Insurance Quotes in South Carolina

South Carolinians can go to their state exchange to find affordable health insurance, but the best plans available depend on the coverage you choose to fit your budget and needs.

We analyzed all health insurance plans in South Carolina and found Ambetter Balanced Care 30 was the cheapest Silver health insurance policy in most counties.

For a 40-year-old, the average cost of health insurance in South Carolina is $436 per month for a Silver plan.

What Is Medicare Advantage Also Known As Medicare Part C

Medicare Advantage is a type of health insurance provided by private insurance companies to U.S. adults ages 65 and over, as well as younger individuals with certain disabilities and health conditions. The federal government pays a flat fee per enrollee to the insurance companies, which then provide the core benefits of Original Medicare, payment to care providers and oftentimes additional benefits.

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When Can I Enroll In Medicare South Carolina Plans

Many people are automatically enrolled in original Medicare South Carolina when they turn age 65. If you havent been automatically enrolled, or you want to enroll in Part D coverage or a Medicare Advantage plan, there are two set periods per year when you can enroll in Medicare or switch between carriers or plans.

  • Initial enrollment. You can also sign up for the first time during your initial enrollment period if you are turning age 65. All Americans can enroll in a Medicare plan during an initial enrollment period which starts 3 months prior to your 65th birthday and extends 3 months after your birthday.
  • Open enrollment period . you can easily enroll in Medicare or switch plans during this period.
  • Annual enrollment period. This is the second period to reevaluate your coverage and switch or enroll in a Medicare plan.
  • Special enrollment. You may qualify to change your Medicare South Carolina plan or enroll if your job status has recently changed, you no longer have employer insurance, you have moved to a new coverage area, or you have a chronic illness or disability.


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