If your Medicare comes from SSDI, Part A is usually $0 and the main cost is Part B at $202.90 a month in 2026, plus a $283 annual deductible and generally 20% of each service with no yearly cap. In South Carolina, the lack of an under-65 Medicare Supplement requirement makes that uncapped 20% a more significant consideration than it is in neighboring states.

What Medicare costs apply if I qualify through SSDI?

Medicare based on Social Security Disability Insurance uses the same basic Medicare cost structure as Medicare at 65. The disability path changes how you qualify, not the standard Part A and Part B cost sharing. You can review the federal cost categories on Medicare.gov and the disability benefit path through Social Security.

  • Part A premium: Usually $0 when your Medicare is based on SSDI.
  • Part A hospital deductible: $1,736 for each benefit period.
  • Hospital days 61 to 90: $434 a day.
  • Lifetime reserve days 91 to 150: $868 a day.
  • Part B standard premium: $202.90 a month in 2026.
  • Part B income-adjusted premium: If your income is higher, your Part B premium can be higher, with the 2026 income-adjusted Part B range running from $284.10 to $689.90.
  • Part B annual deductible: $283 in 2026.
  • Part B coinsurance: Generally 20% of each Medicare-approved service after the deductible.

The over-65 figures are the same, and our guide to how much Medicare costs walks through each one and how income affects the Part B premium.

Why is the 20% coinsurance such a big issue in South Carolina?

Original Medicare alone does not have a yearly out-of-pocket maximum for Part A and Part B services. That means the 20% Part B coinsurance does not stop at a set point during the year. If you need frequent specialist visits, outpatient surgery, dialysis, durable medical equipment, infusions, imaging, or ongoing therapy, that open-ended percentage can matter more than the monthly premium.

This is the part that catches many people who are under 65 on disability. A predictable Part B premium is only one part of the budget. The larger risk is what happens after the deductible if you have repeated covered services and no secondary coverage to limit your share.

In South Carolina, you should not assume you can buy the same Medicare Supplement choices under 65 that people commonly review at 65. Federal Medigap rules do not create the same under-65 access in each state, and South Carolina does not function like states that require broader under-65 Medicare Supplement availability. Because rules and availability can change, confirm current options with the South Carolina Department of Insurance or with a licensed agency before you make a decision.

What choices can put a ceiling on Medicare costs under 65?

There are two main ways people try to reduce the risk of Original Medicare’s uncapped 20% coinsurance: add a Medicare Supplement if one is available and affordable, or enroll in a Medicare Advantage plan that has a yearly maximum out-of-pocket limit for in-network care. Neither route is automatically right. The right comparison depends on your doctors, hospitals, prescriptions, health conditions, income, and willingness to use a plan network.

A Medicare Supplement works with Original Medicare and can cover some or much of the cost sharing that Original Medicare leaves to you. In South Carolina under 65, availability is the question to ask first. How Supplements work here, including at 65, is covered in Medicare Supplement plans in South Carolina.

A Medicare Advantage plan is different. You receive your Part A and Part B benefits through the plan, usually with a provider network, plan rules, and a yearly maximum out-of-pocket amount for covered in-network medical care. That cap is the reason Medicare Advantage often becomes part of the South Carolina conversation for people under 65 on disability. See Medicare Advantage under 65 on disability in South Carolina for how that route works here.

Use this checklist before comparing plans:

  1. Confirm your Medicare status. Check your Part A and Part B start dates, your Part B premium, and whether any income-related premium applies.
  2. List your doctors and facilities. Include specialists, clinics, preferred hospitals, therapy providers, and medical equipment suppliers.
  3. List your prescriptions. Use exact drug names, dosage, frequency, and pharmacy preferences.
  4. Ask about Medicare Supplement availability under 65. Do not assume a plan is available just because you see it advertised for people turning 65.
  5. Compare Medicare Advantage medical exposure. Look at the in-network maximum out-of-pocket amount, copays for your most likely services, referral rules, prior authorization rules, and whether your doctors participate.
  6. Review what happens when you turn 65. Your choices may look different at that point, so plan to review again before then.

Full detail on the South Carolina under-65 disability decision is in Medicare before 65 on disability in South Carolina.

How much should I expect prescription drug coverage to cost?

Prescription costs depend on your medications, pharmacy, plan formulary, deductible, and whether you qualify for Extra Help. The important 2026 Part D figures are that a Part D plan cannot have a deductible above $615, and once your out-of-pocket spending on covered Part D drugs reaches $2,100, you pay nothing more for covered drugs for the rest of that year. The Part D coverage gap, often called the donut hole, was eliminated in 2025.

The deductible does not always apply to each medication the same way. Some drugs may have copays before the deductible, while others may require you to meet the deductible first. A person taking only common generics may have a very different annual drug cost than someone taking brand-name drugs, specialty medications, or insulin. The practical step is to run your exact drug list through plan comparisons, not to rely on the premium alone.

If you choose Original Medicare, you usually need a separate Part D plan for outpatient prescriptions. If you choose Medicare Advantage, drug coverage may be included in the medical plan, but you still need to check the formulary, pharmacy network, deductible, and cost tiers. Changes can be made during the Medicare Annual Enrollment Period, October 15 to December 7, and some qualifying life events may create a Special Enrollment Period of 60 days.

What help is available if money is tight?

If the Part B premium, deductibles, coinsurance, or prescriptions are hard to manage, look into assistance before you drop coverage or skip care. Medicare Savings Programs can help pay the Part B premium for people who qualify, and in some cases may help with other Medicare costs. Extra Help can reduce Part D prescription costs and is handled through Social Security, with information at SSA.gov.

South Carolina Medicaid, also called Healthy Connections, may also be part of the review for people with limited income and resources. Start with South Carolina Healthy Connections Medicaid if you need the state application and eligibility information. Medicaid rules are separate from Medicare rules, so eligibility for SSDI or Medicare does not automatically mean you qualify for Medicaid.

For a South Carolina-specific overview, see help paying for Medicare in South Carolina for the 2026 limits. When reviewing assistance, ask whether help can pay your Part B premium, whether it changes your drug costs, whether you need to renew, and whether it affects the plans available to you.

How The Jordan Insurance Agency can help

The Jordan Insurance Agency is an independent agency founded in 2006 by Billy Jordan Jr., who is licensed in 23 states, including South Carolina, North Carolina, and Tennessee. We can compare your Original Medicare, Medicare Advantage, Part D, and Medicare Supplement options, check your doctors and prescriptions, and help you ask the right questions about Medicaid, Extra Help, and enrollment timing. Schedule Your Consultation to review your options.

Licensing: Billy Jordan Jr. is licensed in 23 states, including North Carolina, South Carolina and Tennessee. See Licensing & Credentials.

Office: South Carolina clients are served by the Charlotte office, 3540 Toringdon Way, Suite 200, Charlotte, NC 28277, (704) 926-7565.

Medicare disclaimer: We do not offer every plan available in your area. Currently we represent 7 organizations which offer 70 products in your area (South Carolina). Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Read the full Medicare disclaimer.