South Carolina Medicare questions, answered plainly

Nothing. Independent Medicare agents are paid by the insurance carriers when you enroll, so comparing plans, answering questions and reviewing your coverage each year is free to you. Your premium is the same whether you enroll through us, another agent or the carrier directly.

No. Your six-month Medigap open enrollment at 65 is the guaranteed window, plus guaranteed-issue events such as a plan leaving your county or you moving out of an Advantage plan’s service area. Outside those, South Carolina insurers can use medical underwriting.

Original Medicare comes with you unchanged. An Advantage or Part D plan is tied to your old county, so a permanent move gives you a Special Enrollment Period to pick a plan sold here. Leaving an Advantage plan because you moved out of its service area also gives you a guaranteed-issue right to certain Medigap plans, generally for 63 days. A Medigap policy from another state keeps working; the premium may be re-rated.

Maybe. Because South Carolina has no birthday rule, switching outside a guaranteed-issue window means answering health questions, and a carrier can decline. We compare current premiums and each company’s filed rate history with you before you cancel anything; the filings are public on our research site, MyMedigapRate.

State law does not require insurers to sell to you, but some carriers do, and South Carolina’s high-risk pool has offered guaranteed-issue Medigap options for people under 65 on Medicare, generally at higher premiums. I-CARE (800-868-9095) and the Department of Insurance shopper’s guide list what is currently sold. You get a fresh open enrollment for every plan at 65.

Each accepts Original Medicare and therefore every Medigap policy. Each contracts with some Medicare Advantage plans and not others, and the list changes yearly — the same is true of Roper St. Francis, Spartanburg Regional, McLeod, Lexington Medical Center and the rest. If a specific system is your care, we confirm the plan’s status before you enroll.

South Carolina’s Medicare-Medicaid plan for people 65 and over ended on December 31, 2025. Members were encouraged to choose a Dual Special Needs Plan, and some were moved automatically to a D-SNP from their Prime plan’s company. If you have not reviewed the new plan, do it during the Annual Election Period.

Usually neither. TFL pays secondary to Medicare and its pharmacy is creditable drug coverage. An MA-only Advantage plan can add dental or vision without duplicating the drug benefit. Our Joint Base Charleston, Shaw and Fort Jackson pages walk through it.

In most cases, yes. VA medical care is not creditable coverage for Part B, so delaying it triggers a permanent penalty and leaves you without coverage at a non-VA hospital. VA pharmacy is creditable for Part D.

If your county was under a FEMA emergency or major disaster declaration during the election period, or you relied on someone who lived in one, Medicare gives you a Special Enrollment Period to make the election you missed. Call your plan, 1-800-MEDICARE or us and name the storm and the county.

Your Initial Enrollment Period is the seven months around your 65th birthday. The Annual Election Period runs October 15 to December 7; Medicare Advantage Open Enrollment runs January 1 to March 31. Moving, losing a plan, qualifying for Medicaid, or a FEMA disaster declaration opens a Special Enrollment Period.

Part B premium $202.90 a month, Part B deductible $283, Part A hospital deductible $1,736 per benefit period, Part D out-of-pocket cap $2,100. Higher earners pay IRMAA surcharges above $109,000 (single) or $218,000 (joint) of 2024 income. Our costs page has the full chart and calculators.

Possibly. The Medicare Savings Programs (QMB, SLMB, QI), run by SCDHHS through Healthy Connections, pay the Part B premium for people with limited income and resources, and QMB also covers Medicare’s deductibles and copays. Apply at apply.scdhhs.gov, or call I-CARE at 800-868-9095.

I-CARE, Insurance Counseling Assistance and Referrals for Elders, is South Carolina’s State Health Insurance Assistance Program, run by the Department on Aging through your regional Area Agency on Aging: 800-868-9095. You can also call 1-800-MEDICARE or use Medicare.gov. We are an independent agency, not a government program, and we say so on every page.

No. We represent a number of insurance organizations and products in South Carolina, not all of them, and we will always say so. For the complete list, use Medicare.gov, 1-800-MEDICARE or I-CARE. For help choosing among the plans we do offer, call (702) 706-6564.

Darin Weidauer holds South Carolina insurance license #18580338 (NPN 18580338). You can verify it through the South Carolina Department of Insurance individual licensee search or through the NIPR.

We work with South Carolinians statewide by phone and video, which is how most people prefer it from the Upstate to the coast. Our sister agency has walk-in offices in Mesa and Sun City, Arizona.