Medicare itself is a federal programme, so the rules are the same in South Carolina as anywhere else. What is local is which specific plans are sold where you live — Medicare Advantage and Part D availability can vary by county and ZIP code, so a plan a friend in another part of the state recommends may not be offered at your address.

The four structures

1. Original Medicare alone. Parts A and B. You pay roughly 20% of most Part B services with no annual cap, and no prescription coverage.

2. Original Medicare plus a Part D drug plan. Adds prescription coverage. The 20% is still uncapped.

3. Original Medicare plus a Medicare Supplement plus a drug plan. The Supplement covers much of that 20%. Supplements are standardised by letter, so the basic benefits of a given letter are the same between insurers — premiums, underwriting and service differ.

4. A Medicare Advantage plan. Another way to receive your Medicare-covered benefits, usually through a network, and required to set a yearly maximum out-of-pocket for in-network care. Many include drug coverage.

None of these is universally better. The right one depends on your doctors, your prescriptions, how much you travel and how you want costs to feel across a year.

Two things specific to South Carolina

Medicare Supplements under 65. Federal law does not require insurers to sell a Supplement to people under 65, and South Carolina does not require it either — access runs through the state pool. This is a real difference from North Carolina and Tennessee, and it matters if your Medicare comes from a disability. See Medicare before 65 on disability in South Carolina.

Dual eligible plans. South Carolina has four Dual Eligible Special Needs Plans on the CMS 2026 list, for people who have both Medicare and Medicaid. See dual eligible in South Carolina.

What it costs

In 2026 the standard Part B premium is $202.90 a month with a $283 annual deductible. Part A is usually $0 if you or your spouse paid Medicare taxes for about ten years. If money is tight, help paying for Medicare in South Carolina covers the programmes that can pay that premium.

Where to start

With the doctors you intend to keep and your prescription list with doses — not with a plan name. Whether a given plan includes your doctors is checked one at a time against your actual address.