A Medicare Advantage (MA) Plan is a type of health insurance offered by private insurance companies that are bound by Medicare rules and provide Medicare Part A and B coverage and, frequently, Part D drug coverage. They often offer additional benefits such as routine hearing, vision, dental exams, and fitness club memberships.
Plan availability varies by zip code and county. Discover the best Medicare Advantage Plans in South Carolina in 2023 and learn about their coverage, average costs, and ratings. In this article, we rank our top-rated MA plans in South Carolina.
Best Medicare Advantage Plans in South Carolina in 2023: shortlist
- Humana – highest quality and customer service ratings, largest service area, outstanding unique benefits
- Aetna – $0 premiums, focus on total health, ER/urgent care coverage worldwide
- UnitedHealthCare – $0 options for plan costs, nationwide provider network, robust additional benefits
Best Medicare Advantage Plans in South Carolina: our top picks
These are our top three picks for the best Medicare Advantage Plans in South Carolina (SC) in 2023. Our search included plans with good CMS Star ratings, broad service areas, and the best overall value for the member. However, you might value lower costs, greater access to care, or additional perks and benefits.
You are unique, and so are Medicare Advantage Plans. Read more on these top picks and learn about other search tools to find the best fit for your individual health needs.
1. Humana — high quality customer service and benefits
Humana is noteworthy for its high quality and customer service ratings, large service area, and outstanding unique benefits. Some unique benefits include Part B Premium giveback, SilverSneakers fitness memberships, and a spending allowance. The availability of benefits for individual plans may vary.
Humana has an extensive healthcare provider network covering all 46 South Carolina counties and 596 contract options available. Humana provides a wide range of prescription drug coverage.
2. Aetna — great focus of total health
Aetna is known for its focus on total health, ER/urgent care coverage worldwide, and $0 monthly premium options. Some unique benefits Aetna offers are Resources for Living, a 24-hour nurse line, prescription delivery, SilverSneakers fitness membership, OTC benefits, and meals-at-home post-hospitalization.
Aetna offers 228 contracts throughout 46 counties in South Carolina. Aetna is accredited by the National Committee for Quality Assurance and scored 4 out of 5 for overall MA Plan quality.
3. UnitedHealthcare — provider network available nationwide
UnitedHealthcare (UHC) is a cost-effective, high-quality plan offering extensive service in South Carolina and a robust option of additional benefits. UHC offers some plans with $0 options for monthly premiums and annual drug deductibles, making it affordable for most people.
Some additional benefits are fitness, dental, and hearing. They also have an eyewear allowance and 24/7 telephonic access to a nurse.
Comparing the top 3 Medicare Advantage plans in South Carolina
This chart provides an at-a-glance view of the evaluation criteria utilized in our article. We reviewed MA Plan costs, availability, quality, and customer satisfaction ratings.
|Avg. Monthly Premiums (excluding $0)||$57.19||$19.73||$34.00|
|Avg. in-network Max out-of-pocket||$6,466.18||$6,709.12||$6,100.00|
|Avg. Annual Drug Deductible||$346.37||$145.00||$228.33|
|Number of Counties serviced||46||46||46|
|Types of Plans Available||Local HMO and PPO; Regional PPO; PFFS||Local HMO and PPO||Local HMO and PPO; Regional PPO|
|Number of Contracts Available||596||228||369|
|Extra Benefits||Part B premium giveback, SilverSneakers, spending allowance; user-friendly website||Fitness, dental, hearing, meal delivery, OTC allowance, Prescription home delivery||Fitness, dental, hearing, Part B premium reductions, eyewear allowance, Prescription drug home delivery, Housecalls, fitbit, Virtual Visits|
|Avg. CMS Star Rating||4.3||3.6||3.4|
|NCQA: based on quality and member experience||Not Accredited 3/5||Accredited 4/5||Accredited 3/5|
|J.D. Powers (Overall Customer Satisfaction Index Ranking 2022)||2nd||6th||4th|
You can compare plans specific to your zip code on Medicare’s plan finding tool.
How we ranked the best South Carolina Medicare Advantage plans
To rank the best South Carolina Medicare Advantage Plans, we evaluated cost, availability, quality ratings, and customer satisfaction ratings.
- Cost. We utilized the Centers for Medicare and Medicaid Services (CMS) 2023 data to evaluate plan costs such as monthly premiums, annual prescription drug coverage, and in-network max-out-of-pocket limits.
- Availability. Service areas for MA Plans are based on South Carolina county and zip code. We used CMS 2023 data to tally the number of providers and contracts provided per county.
- Quality ratings. The quality of service that MA Plans provide to their members can make or break your Medicare Advantage experience. CMS provides a public transparency tool to rate every plan called the 5-Star Rating system based on five categories and 38 quality measures. We used CMS Star Ratings from CMS.gov and the National Committee for Quality Assurance (NCQA) Report Card data. The NCQA is a non-profit organization that is the leader in healthcare accreditation.
- Customer satisfaction. We considered J.D. Powers' overall customer satisfaction index ranking from 2022 for each MA Plan. This J.D. Power analysis considered six factors: Coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment.
Medicare Advantage in South Carolina: things to know
Medicare Advantage Plans provide everything covered by your Medicare Part A and B services as well as Part D and additional benefits. You may select an MA plan regardless of your preexisting health conditions. You may need to choose a new health provider if your provider joins or leaves your MA plan, which can happen anytime during the year. By using your in-network health services, you can save costs.
- MA Plan service area is based on your South Carolina county and zip code
- Average consolidated monthly premium of South Carolina MA Plans (excluding $0 premiums): $33.48
- Average Annual Drug Deductible of South Carolina MA Plans: $254
- Average In-Network max out-of-pocket amount: $6,469
- Medicare mandates that the max OOP amount for MA Plans is $8,300 although most plans have lower amounts
- Average Overall Star Rating: 3.64
What providers offer Medicare Advantage plans in South Carolina
Various health insurance models may be offered by Medicare Advantage plans in South Carolina, such as HMO, PPO, PFFS, MSA, and SNP. To learn more about each model of MA Plan, read Best Medicare Advantage Plans. HMO and PPO plans are the most commonly offered.
These are the 12 providers offering MA plans in South Carolina in 2023 listed alphabetically along with the number of contracts each provider offers:
|Provider||No. of available contracts|
|Blue Cross Blue Shield of South Carolina||83|
|Clear Spring Health||22|
|Molina Healthcare of South Carolina||45|
The Centers for Medicare and Medicaid Services (CMS) rates Medicare Advantage plans with prescription drug coverage on a Star Rating System based on five main categories comprising 38 quality measures. These ratings are reviewed annually and updated on CMS.gov. Each category is rated on a scale of 1–5 stars, with one being the worst and five being the best.
Nationwide, about 78% of MA Plan beneficiaries were enrolled in a plan rated four or more stars in 2023. MA plans rated 4 or 5 are considered “excellent.”
The CMS rating categories include:
- Staying healthy: screenings, tests, and vaccines
- Managing chronic (long-term) conditions
- Member experience with health plan
- Member complaints and changes in the health plan’s performance
- Health plan customer service
Unfortunately, at this time, there are no CMS 5-star Medicare Advantage providers in South Carolina. However, Humana, a 4.5-star MA provider in South Carolina, offers the following plans.
- Humana Honor PPO
- HumanaChoice H5216 (8 options) PPO
Medicare Advantage plans in South Carolina: comparing different counties
South Carolina contains 46 counties with more than 5.2 million residents. The chart below shows cost averages and the number of plans available for the four counties with the highest percentage of population aged 65 or older.
|McCormick County||Georgetown County||Beaufort County||Horry County|
|Pop. aged 65+||38.8%||31%||28.9%||26.6%|
|Avg. Monthly Premium (excluding $0 premiums)||$36.90||$34.84||$35.71||$33.01|
|No. of MA Plan Providers||7||8||9||8|
|No. of contracts available||38||41||41||40|
|Main MA Plan Providers||Aetna, Clover Health, Humana, United Healthcare, Wellcare||Aetna, BlueCross Blue Shield of South Carolina, Humana, United Healthcare, Wellcare||Humana, Lasso Healthcare, Molina Healthcare of South Carolina, United Healthcare, Wellcare||Aetna, BlueCross Blue Shield of South Carolina, Clover Health, Humana, Lasso Healthcare|
|Avg. max in-network-out-of-pocket||$6,488.89||$6,567.95||$6,547.44||$6,564.47|
|Avg. Annual drug deductible||$267.50||$242.50||$248.13||$239.41|
What are the eligibility requirements for a Medicare Advantage plan in South Carolina?
To be eligible to enroll in a Medicare Advantage Plan in South Carolina, you must be a Medicare beneficiary with Part A and B coverage, not enrolled in Medigap, and live within the service area of your chosen MA plan. You are not required to answer any health questions before enrollment unless you have end-stage renal disease, and you cannot be denied coverage based on a preexisting health condition.
To be a Medicare beneficiary, you must:
- Qualify to receive Social Security (or Rail Road Retirement) benefits by having worked for at least ten years while paying Medicare and Social Security taxes.
- Be at least 65 years old or have a qualifying disease or disability for earlier enrollment.
You may sign up for, switch, or drop an MA plan during set enrollment periods. These include:
- Initial Enrollment Period when you turn 65.
- Medicare Advantage Open Enrollment Period.
- Special Enrollment Period.
Choosing the best Medicare Advantage plan in South Carolina
When choosing the best MA Plan, consider these questions to help you obtain the coverage that’s right for you. If your needs change, you have the option to change MA plans or switch to Original Medicare at set times throughout the year.
- Plan Network. Are your doctors and specialists in-network?
- Cost. What will the plan cost? Consider the monthly premium, drug cost, deductibles, co-pays/coinsurance, and max out-of-pocket costs.
- Benefits. What are the additional perks and benefits?
- Medications. Are my prescription medications covered?
- Utilization. How often do you plan to use your benefits?
- Coverage area. Will you be traveling often?
Medicare.gov offers a plan comparison tool that many people find useful: Medicare’s plan finding tool.
These free South Carolina State programs also provide assistance in choosing the right health coverage.
South Carolina State Health Insurance Assistance Program (SHIP) offers free local health insurance counseling to people with Medicare coverage. These programs are paid for with federal government money and are independent of any insurance company. Visit SHIP or call 1-800-868-9095.
The South Carolina Department on Aging provides free counseling services regarding insurance benefits. They also offer programs such as adult advocacy, assisted living and nursing homes, caregiver support, emergency financial assistance, food and nutrition, in-home care, and transportation. Contact your local South Carolina county agency for more information.
Medicare Advantage Plans in other states
What is the best Medicare Advantage plan in South Carolina?
The best MA plan in South Carolina is Humana, considering its CMS star ratings, J.D. Power customer satisfaction ratings, and service area coverage. Humana offers robust unique benefits such as Part B Premium giveback, SilverSneakers fitness memberships, and a spending allowance. However, Humana plan costs can be higher than others, so finding a plan that best suits your needs is essential.
Does Blue Cross Blue Shield offer Medicare Advantage plans in South Carolina?
Yes, BCBS offers MA Plans in South Carolina. They offer BlueCross Blue Basic, BlueCross Total, BlueCross Total Value, and BlueCross Secure. These are PPO and HMO plans with an average monthly premium of $17.61 and have a 3-star rating from CMS.
Why should I switch to a Medicare Advantage plan?
Switching to a Medicare Advantage plan makes sense if you seek a consolidated way to receive your Medicare benefits and need prescription drug coverage. Many MA plans also offer unique benefits not included in your original Medicare benefits, such as fitness memberships, meal deliveries post hospitalization, prescription home delivery, and eyewear or hearing aid allowances.