South Carolina Medicare insurance is a federally-sponsored health insurance program for those older than 65 as well as workers with certain disabilities. South Carolina also has programs that offer several types of assistance for Medicare beneficiaries in the state.
The main benefits of Medicare come from Original Medicare, which has coverage for two sets of healthcare service with Part A and Part B. Part A covers hospital insurance including inpatient care. Part B covers outpatient services, including preventive services and durable medical supplies.
Part A rarely requires a premium, but premiums are typical for Medicare Part B starting at $134 a month. Both aspects of Original Medicare also include deductibles, copays, and coinsurance costs which beneficiaries will cover out-of-pocket.
As some Medicare beneficiaries believe that there are gaps to Original Medicare coverage, they can obtain supplemental Medicare coverage from Medicare-approved private carriers in South Carolina. These plans will require a premium separate from the premium required by Medicare Part B.
With one of these plans, beneficiaries can obtain coverage for Medicare prescription drugs. This coverage is known as Medicare part D. Other plans can cover extra healthcare services that Original Medicare doesn’t cover, and it can also help pay for the deductibles, copays, and coinsurance for Part A and Part B.
This Part C refers to the Medicare Advantage Plan that may also be purchased from Medicare-approved private health insurance carriers. This type of plan combines the coverage of Original Medicare with the benefits that may be available from supplemental plans. Thus, it can provide Medicare Part D coverage and coverage for additional healthcare services.
Some residents of South Carolina have some difficulties in affording the costs of Medicare coverage. To help in these matters, the state of South Carolina offers several Medicare Savings Programs (MSP) for certain Medicare beneficiaries. To qualify for any of these programs, beneficiaries must be eligible for Medicare Part A and comply with income and resource limitations. The benefits that the beneficiaries will receive will depend on the particular MSP.
The Qualified Medicare Beneficiary (QMB) program offers the greatest level of assistance, as it pays for virtually every expense connected with Medicare. It pays for the premiums of both Medicare Part A and Part B. It also covers the deductibles, coinsurance, and copayments. An individual can qualify for the QMB program with an income of no more than $1,032 a month. Married couples are limited to a combined monthly income of $1,392 at the most.
The Specified Low-Income Medicare Beneficiary (SLMB) covers only the premium for Medicare Part B. Those individuals who qualify for the SLMB program must have an income of no more than $1,234 a month. For married couples, the income limit is $1,666 a month.
The Qualified Individual (QI) program also pays for the Part B premium, but the funding can be limited. Applications are therefore only granted on a “first come, first serve” basis. Individuals can be eligible with an income of $1,386 a month, while for married couples the limit is $1,872 a month.
All three of these programs also have a limit on the current resources of beneficiaries, which factor in the savings and checking accounts and the values of their stocks and bonds. The limit for assets is $7,560 for an individual and $11,340 for married couples.
These programs also automatically qualify the beneficiaries for the “Extra Help” or Low-Income Subsidy (LIS) program, which pays for all or part of Medicare Part D depending on the income and assets of the beneficiaries.
Another MSP is for the Qualified Working and Disabled Individuals who may have lost their premium-free Medicare Part B when they went back to work. The program can then pay for their Medicare Part A premium. The income limits are far more generous, as an individual’s income can be as much as $4,132 a month. For a married couple, the combined monthly income cannot exceed $5,572.
The QDWI program also has an asset limit. It’s $4,000 for individuals and $6,000 for married couples.
Each state is required to provide free and also unbiased counselling for Medicare beneficiaries who require assistance and answer regarding Medicare matters. In South Carolina, this is called the Insurance Counseling Assistance and Referrals for Elders program (I-CARE). The contact numbers are 800-868-9095 and 803-734-9900.
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