Speak to a Licensed Sales Agent
Call Now 1-888-992-0738 TTY: 711
M-F 9am-8pm EST
Customer ID

South Carolina State FlagMedicare Part D Plans in South Carolina

President Johnson signed Original Medicare into law in 1965, with the goal of helping retired seniors pay their healthcare costs. But Medicare coverage did not include prescription medications until 2003, when Congress passed the Medicare Modernization Act (MMA). The passage of MMA increased beneficiaries' Medicare plan options and introduced both Part C (Medicare Advantage) and Part D (prescription drug coverage). This page explains Medicare Part D in South Carolina.

How Do You Get Medicare Part D in South Carolina?

There are two ways to get Medicare Part D in South Carolina:

  • A standalone Medicare Part D plan
  • A Medicare Advantage Prescription Drug plan (MA-PD)

Original Medicare includes Part A, hospital insurance, and Part B, medical insurance. Medicare Advantage (MA) plans provide the same benefits you get with Original Medicare. Most also offer additional coverage, including fitness programs,  routine vision and dental care, and prescription drugs.

You may pair a standalone Part D prescription drug plan to either Original Medicare or an MA plan that does not include prescription drug coverage. (Approximately 10 percent of Advantage plans don't cover prescriptions.)

Medicare Advantage Prescription Drug plans are sometimes referred to as all-in-one plans because they combine your Original Medicare and Part D benefits into a single policy.

You cannot pair a standalone Part D plan with an MA-PD plan.

Who Is Eligible for Medicare Part D in South Carolina?

Once you sign up for Medicare Part A and/or Part B, you're eligible for Part D in South Carolina. You must also live in the plan's service area.

If you are a U.S. citizen or permanent legal resident, you will become eligible for Medicare when you turn 65. Enrollment won't be automatic, however, unless you start receiving Social Security benefits at least 4 months before your 65th birthday. Everyone else must sign up for Medicare through Social Security.

You qualify for Medicare before you turn 65 if you collect Social Security disability benefits for 24 months. Enrollment in  both Parts A and B occurs automatically in month 25.

Medicare Part D enrollment is never automatic, even if you were automatically enrolled in Parts A and B. You always have to opt in to Part D.

When Can You Enroll in a Prescription Drug Plan in South Carolina?

Medicare Part D enrollment in South Carolina in limited to certain time periods.

  • Initial Enrollment Period: Your IEP lasts for a full 7 months. It begins 3 months before the month you become eligible for Medicare. So, if your 65th birthday or 25th month of collecting disability benefits occurs in January, your IEP begins on October 1 and ends on April 30. Once you apply for Part A and/or Part B, you may then choose a prescription drug plan.
  • General Enrollment Period: If you missed your IEP and do not qualify for a Special Enrollment Period (SEP), you can sign up for Medicare Part A and/or Part B during General Enrollment from January 1 through March 31. You can then join a prescription drug plan from April 1 through June 30.
  • Medicare Annual Enrollment Period: Current Medicare beneficiaries can change their Medicare coverage during AEP from October 15 through December 7. This includes joining a Part D or MA-PD plan.
  • Medicare Advantage Open Enrollment Period: From January 1 through March 31, Medicare Advantage enrollees may either join a new Advantage plan or return to Original Medicare. You may also sign up for a standalone Part D plan if making that change leads to you losing your prescription drug coverage.
  • Special Enrollment Periods: You may qualify for a Special Enrollment Period if you experience certain life changes, such as moving to a new address or losing your current coverage. Medicare.gov provides the full list of qualifying special circumstances here.

How to Compare Medicare Part D Plans in South Carolina

Medicare contracts with private insurance to provide prescription drug plans in South Carolina, which is why coverage and costs can vary widely. To get the best plan for your unique needs and budget, you should compare your Part D options carefully.

Start by reviewing the plan's drug formulary, which is the list of medications it covers. If the formulary don't include one or more of your medications, it probably isn't the right plan for you.

Next is the plan's drug tiers, which indicate your costs for a particular medication. Drugs on lower tiers have a lower copayment than medications on the top tier.

In addition to copayments, out-of-pocket costs for Medicare Part D may include the annual deductible and monthly premium. Review all three metrics to understand the full cost of a plan.

Medicare beneficiaries who have limited income and resources may qualify for Extra Help. Medicare or Social Security should notify you by mail if you qualify for Extra Help in South Carolina. If you think you meet the requirements but did not receive this notification, call your plan provider.

Please note that all communication from both Medicare and Social Security are via U.S. mail. Nobody will ever call you unless you requested a phone call. If someone calls claiming to be from Medicare or Social Security, hang up. Then, call the appropriate program (1-800-MEDICARE or 1-800-772-1213) and explain what happened.

Do You Have to Have Medicare Part D in South Carolina?

No, no part of Medicare is mandatory in South Carolina, including Part D. Medicare encourages enrollment by charging late fees to people who delay Medicare enrollment AND who do not have creditable coverage elsewhere. To be considered creditable, a plan's benefits must be comparable to what you'd get with Medicare Part D and at a similar price. If you go 63 days or more without prescription drug coverage, you face lifelong late penalties when you do finally join a Part D plan.

Find a Plan today!
Call a Licensed Sales Agent

1-888-992-0738 TTY User: 711

M-F 9am-8pm EST