South Carolina Medicare Plans

The team at David A. Crotts & Associates is here for medicare plan enrollment assistance, as well as help with Medicare Supplement Plans like Medicare Advantage (Medicare Part C) and Medicare Part D. 

If you are enrolling in Medicare or are looking to change plans, you may wonder which plan is best for you. Medicare does not offer a one-size-fits-all plan therefore select the plan that best meets your healthcare needs. When deciding which plan to enroll in, you must first choose between a Medicare Advantage plan and a Medicare Supplement plan. 

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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Medicare Advantage Plan (Medicare Part C)

A Medicare Advantage Plan is a health plan offered by a private insurance company that works directly with Medicare to provide you with all their traditional Part A and Part B benefits. It is structured to be an all-in-one option with low monthly premiums.

Medicare Advantage Plans Include:

• Health Maintenance Organizations (HMO) Plans
• Preferred Provider Organizations (PPO) Plans
• Private Fee-For-Service (PFFS) Plans
• Special Needs Plans (SNP) Plans

Medicare Supplement (Medigap) Plans

Medicare Supplement Plans, also known as Medigap, serve to bridge the gaps between traditional Medicare (Part A & B) coverage and out-of-pocket expenses. Medicare Supplement Insurance (Medigap) policies sold by private companies can help pay for some of the remaining health care costs for covered services and supplies, like copayments, coinsurance, and deductibles.

All plans are standardized by the government and must follow federal and state laws designed to protect you. However, while the benefits are the same from one company to the next, there are still many options to choose from, and premiums and extra costs may vary significantly. It is important to be well-versed in those options before sitting down to make a decision.

Medicare Part D Prescription Drug Plan

For Medicare recipients with high prescription drug costs, Medicare Part D offers viable solutions. Medicare Part D, also known as Medicare Prescription Drug Plan (PDP), is optional insurance coverage that helps you pay for prescription drugs. Medicare Part D can be purchased as a stand-alone plan or as part of an MA-PD (Medicare Advantage Prescription Drug).

There are two ways to get Medicare drug coverage (Part D):

• Medicare drug plans. These plans add Medicare drug coverage (Part D) to Original Medicare, some Medicare Cost Plans, some Medicare Advantage Private Fee-for-Service plans, and Medicare Advantage Medical Savings Account plans. You must have Part A and/or Part B to join a separate Medicare drug plan.
• Medicare Advantage Plans or other Medicare health plans with drug coverage. You get your Part A, Part B, and Medicare drug coverage (Part D) through these plans. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all Medicare Advantage Plans offer drug coverage. 

There are no physical exams required and applicants cannot be declined due to medical history or history of prescription drugs. While plans may vary, there are several mandatory standards set by the federal government. Medicare can be a daunting program, but at David A. Crotts & Associates, we can assist in guiding you through all the details and help you decide which plans are best for you.

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Things to Keep in Mind when Selecting a Medicare Advantage Plan:

• You’re still in the Original Medicare Program and have all Medicare rights and protections.
• You still get complete Part A and Part B coverage through the plan.
• You are only enrolled in a plan for 1 year and you can only join a plan at certain times during the year.
• You can join a Medicare Advantage Plan even if you have a pre-existing condition.
• The only exception is End-stage Renal Disease (ESRD).
• You must follow the rules of the plan. The plans come with a regional network of doctors and hospitals, meaning coverage from the plan will not travel with you. Additionally, your current doctor may not accept the plan as coverage. *Always verify coverage with your plan before you receive any service or schedule an appointment with a referred specialist to make sure they are covered by the plan’s network.*
• A number of Medicare Advantage plans are all-inclusive plans meaning, they also include prescription drug coverage. *To ensure it is the right plan for you always review the drug formulary.
• Medicare Advantage Plans can’t charge more than Original Medicare for certain services like chemotherapy, dialysis, or skilled nursing facility care.
• Medicare Advantage Plans offer an annual cap on how much you pay for Part A and Part B services during the year. This annual maximum out-of-pocket amount can be different between advantage plans. 
• If the plan decides to stop participating in Medicare, you will have to join another Medicare Health Plan or return to your Original Medicare.