SC STATE Retiree Insurance
The Individual Marketplace
South Carolina Employee Benefits Authority | SC PEBA
2023 Retiree Insurance "Medicare Supplemental" Plan Funding Rates
Funding Status can only be determined by SC PEBA. Contact info above. Or Call Medicare Savings 1-888-608-0654 if you are a Retiree that is "Non-Funded" or "Partially-Funded" status for affordable individual marketplace Medicare Supplement Insurance Plans. SC PEBA 2021 & 2022 Premiums(Active Employees and Retirees)
How do I and/or my spouse or family members qualify for Retiree Insurance with SC PEBA?
Next, What is the "Medicare Supplemental Plan" from SC PEBA? Carve-Out Plan?
What is the individual marketplace for Medicare Supplement(Medigap) Insurance?
2021 Guide to choosing a Medigap Policy booklet by CMS
Why compare SC PEBA Retiree Insurance vs The Individual Marketplace?
Next, What else do me and/or spouse or family need to consider about Retirement?
Where are the Big Differences in Premiums? How does that affect Retiree Insurance Participation? ***PROOF***
What situation would be a good deal me, my spouse and family members with SC PEBA?
There are a few different situations where SC PEBA "Medicare Supplemental Plan" could cover 'Full-Family', Retiree and Child or provide coverage to survivors. Some of these options could be affordable for these situation. Especially, if no one within your family is eligible for a group health plan. These situations offer coverage under one premium which could be a good benefit for SC STATE families needing coverage.
According SC PEBA handbook, a family member must be under 26 years of age to be considered a "Child". The individual health insurance marketplace at Healthcare.gov for major medical health insurance offers higher deductibles for individuals then the SC PEBA Retiree Insurance. Unless others family members are employed and covered under another group health insurance plan.
Call SC PEBA at 803.737.6800 to determine if you and your family members qualify for Retiree Insurance. The "Medicare Supplemental Plan" from SC State Retiree is a set group/member rate.
Real Example of Medical University of South Carolina Retiree and Spouse eligible for Non-Funded Status. Retiree was Newly-Eligible for Medicare due to age.
Real Example of Retired School Teacher & Husband Transitioning into Medicare. Both Fully-Funded Status. Retirees were Newly-Eligible to Medicare due to starting Medicare Part B.
These beneficiaries were eligible to kept their retiree insurance with the STATE and enrolled into Original Medicare(A&B). They were both in a very good coverage situation but wanted to know where their gaps in coverage might be for them moving into their retirement. Plus the spouse had a Tertiary(3rd Payor) Health Insurance plan to pay all the claims. They mentioned family history of Cancer. So they wanted more information about Whole Life Lump Sum Products(Cancer Plans).
The neat thing about these policies is they Payout very quickly upon diagnosis and pathology report from your doctor. Beneficiaries are paid within a matter of days in some instances.
Ask about the "Re-Occurance Rider" if you are seeking coverage for Cancer for your and/or your loved ones.
Issue Ages are 18-85. The younger you enroll the more affordable the premium. Whole Life Insurance premiums stay the same over time.
When can I save money for me and my spouse in the individual marketplace?
Anyone who is Medicare-Eligible can shop the individual marketplace.
The process for ANY retiree throughout the state of South Carolina is to Learn what Original Medicare(Federal Fee-For-Service) program is 1st.
Learn the Medicare Rules & Costly Pitfalls to Avoid future risk and concerns.
Then Make an important/informed decision about your Medicare insurance path.
Typically, retirees would have likely saved up enough to afford to pay future medical expenses. But 63% of retirees Top concern is affording future medical expenses. The benefit of enrolling into Original Medicare(A&B) + a Medicare Supplement + a Part D drug plan is that folks can shop their rates when premiums increase over time. Folks who already have with a Medicare Supplement(Medigap) policy take advantage of being able to shop 12 months out of the year for a better price on popular individual marketplace Medicare Supplement Plans like Plan F*, Plan G and Plan N. This is especially good when your health allows to reduce those Medigap rate increases. Part D drug plan premiums increase over time as well and can be shopped at the end of the year. Medicare Part B premiums and cost-sharing go up a few dollars each year. FOR SC STATE Retirees, in my humble opinion, are some pretty BIG DIFFERENCES in premiums with the SC PEBA "Medicare Supplemental Plan" Premiums. Especially, with the Non-Funded & Partially-Funded premiums compared to the individual marketplace Medicare Supplement(Medigap) Plans.
We all know the cost of healthcare goes up over time within the U.S. Healthcare system. This is a known fact from individual ACA plans to small employers to large corporate health plans to STATE or Federal health plans. Unfortunately, duration of coverage adversely affects the entire health insurance industry. Medicare marketplace insurance brokerages like Medicare Savings are ready to help retirees safely over-the-phone to compare & shop for market value rates.
What if I like my "Medicare Supplemental Plan" with SC PEBA?
Beneficiaries are Guaranteed Issued to keep their supplemental policies for life as long as premium payments are made. However, retirees should consider the compounding and long term effects of paying higher than market value rates for your health insurance coverage. Retiree insurance within many retiree systems or an insurance company will never call you to reduce your rate if your situation and health could save you or your spouse money on the same or very similar coverage. Whether it be nominal or significant savings, the individual marketplace for Medicare insurance options are available to every Medicare-Eligible(65+) retiree nationwide that has earned their right into Original Medicare. These companies(300+ nationwide) compete within each state for your business. Medicare Savings is designed to make the individual marketplace easy and simple when shopping for Medicare Supplement(Medigap) Insurance in South Carolina and beyond. Note: You may want to contact SC PEBA to ask about rate increases.
What if I live outside of South Carolina but want to shop for a better rate?
Some states like Mississippi, Texas and Virginia offer very affordable rates compared to states like New York, California and Florida. So it does matter which state you live in and enroll into your Medicare Supplement(Medigap) Plan for the individual Medicare marketplace. Note: If you have multiple residents. Social Security advises that you enroll in a Medicare Supplement Plan where you pay income taxes. But, savy beneficiaries can enroll where they live their "Golden Years". If you move that puts you in to a Guaranteed Issue situation where you have the right to shop certain Medicare Supplement(Medigap) plans in your new state of residence. This is known as Guaranteed Issue Rights or "Medigap Protections".
What does it cost for an independent Medicare marketplace insurance broker to help me choose?
Absolutely nothing! There is no-additional cost when enrolling into a Medicare Supplement Plan in the individual marketplace for Medicare Supplement Insurance with a licensed agent/broker. Medicare Savings will help you shop and enroll into a Medicare Supplement(Medigap) Plan. Insurance companies pay a small commission to our brokerage, Medicare Savings. This helps the insurance company with their over-head expense while our agents and brokerage help you for free. The price of the supplement plan is the same whether you enroll direct thru the company or thru our brokerage. You be tickled to know, an independent broker, is able to help you shop the entire marketplace and advocate for you when you need claims research and actively help you with better marketplace Medicare insurance options. Be aware, captive insurance companies(1 company/brand) will guide you through one or maybe a few prices but cannot show you the entire market. Our independent agents and brokerage are able to be accountable to the client and not tied to only insurance company or brand.
How do I get free quotes for individual marketplace Medicare Supplement(Medigap) Insurance Plans?
Simple! Go to www.MedicareSavings.us or Email me firstname.lastname@example.org for free quotes from over 300+ insurers and company trends. Beneficiaries are NOT able to shop for Medigap Insurance on Medicare.gov or your MyMedicare.gov online account. Or If you are New-To-Medicare and want to Learn How To Enrolll into Medicare(A&B) go to www.startmedicare.us.
How Much are Medicare Supplement(Medigap) Insurance Plans in South Carolina for a Female AGE 65?
-Plan F*(Must be 65 or older before Jan 1, 2021 to be eligible) is full coverage and rates range from $108-$407.
-Plan G*(65 on or after Jan 1, 2021) is similar to Plan F but you take on the Part B Annual deductible($203) along with the monthly premiums. Rates range from $82-$345
-Plan N(Recommended for AGE 65+) is similar to Plan G but you take on $20 doctors visit copays, $50 emergency room(Non-admitted) copays. Along with Part B Annual Deductible($203). If you use a non-participating provider(e.g. OT or PT) they are allowed to charge Part B excess charges. Fortunately, Over 94% of the U.S. healthcare professionals "Accept Assignment" a.k.a full payment from Medicare. So Part B excess charges are non common. But ask any new provider if they accept Medicare Assignment to make sure. Rates range from $64-$312.
Get your FREE Medigap quote hassle-free by getting filling out our secure Google form.
How Much are Medicare Supplement(Medigap) Insurance Plans in South Carolina for a Male AGE 65?
-Plan F*(Must be 65 or older before Jan 1, 2021 to be eligible) is full coverage and ranges from $100-$360.
Medicare Savings is a service started by a former Newberry College Tennis player and 2003 USC Graduate. We help retirees enroll into their Original Medicare(A&B) benefits and find the best Medicare Supplement Insurance Plan company for you.
FREE Medicare Supplement / Medigap Insurance Quotes
Company Trends and Insight
Why does Medicare Advantage offer over 4700 different Medicare health plans?
Medicare Advantage(Part C) are being marketed at "Medicare Health Plans". But in reality they are HMO or PPO network plans that are highly marketed by celebrities, TV commercials and thru online search engines. Especially during the Annual Enrollment Period(AEP) at the end of the year. They don't show you the fine print that these plans are NOT Original Medicare(A&B). Medicare Advantage is the optional alternative for beneficiaries in the individual Medicare marketplace. These insurance options DO NOT have Original Medicare (A&B) as the primary insurance administrator or payer. These private insurance companies become the administrator and primary payer, instead of Medicare. Medicare Advantage(MA) or Medicare Advantage with Part D(MAPD) are offered by private health insurance companies who are paid handsomely by the U.S. government to manage your healthcare cost and administer/pay your health care claims. You can learn the pros and cons of Medicare Advantage on our Medicare Forum here. Many folks are attracted to the $0 or low premiums but when they go to use the plan, they are met with prior-authorization and max out-of-pocket risk of up to $11,500. Although Medicare Advantage plans have around 1/3 participation with seniors nationwide in the marketplace, these plans are typically the ones that receive all the attention from the news media. Huge out-of-network hospital bills, patients concerned about timely authorized care(Prior-Authorization) and doctors concerns about their restrictions recommending healthcare services, medical equipment as well as lower provider payout.
Do I have Original Medicare(A&B) with SC PEBA Retiree Insurance?
YES! Remember, The "Medicare Supplemental Plan" is a standardized group retiree health insurance plan with outpatient drug coverage funded by the Retiree Health Insurance Trust Fund that pays after Original Medicare pays its share. Note that Bluecross Blueshield of South Carolina is the claims administrator for SC PEBA retiree insurance. Express Scripts is the outpatient drug claims administrator. The SC PEBA 2021 Medicare Handbook states two different retiree health plans, the "Medicare Supplemental Plan" and the "Carve-out Plan". The "Carve-Out Plan" from SC PEBA is not recommended due to risk of claims processing challenges and risk of higher out-of-pocket cost with more use. You can learn more about carve-out health care insurance with SC PEBA. Remember, the main reason we can compare the "Medicare Supplemental Plan" to the individual marketplace Medicare Supplement(Medigap) Plans is because they both operate as secondary coverage to Traditional Medicare(Part A&B). Medicare Part A and Part B is the primary health insurance coverage for SC PEBA retirees and the individual marketplace for Medicare supplement insurance options.
Look up SC PEBA Express Script PBM for higher Tier Medications
Contact Express Scripts PBM(SC PEBA) Customer Service if you have questions about their formulary/drug list for your specific Medications. It is Good to KNOW if you or your household has higher than normal out-of-pocket medication expenses when transitioning into Medicare.
One of the Differences with Group /Union Coverage is Medication Coverage/Expense for Higher Tier Rx Drugs
Go to FormularyLookup.com and Smartphone App can help you look up medications covered by "SC PEBA Express Scripts PBM". This will help you determine if your Medications are covered and the results show you marketplace stand alone Part D plans as well.
Download their android or apple app on your phone to look up High Tier Medications with available plans in your area.
Do State retirees like their "Medicare Supplemental Plan"?
Many State retirees are happy with their Medicare Supplemental plan from SC PEBA if they qualify to be 'Fully-Funded'. GASC study shows that retiree participation for SC PEBA 'Retiree Insurance' plans like their Medicare Supplemental Plan deminishes from 79% participation down to 20% for retirees that fall into the 'Non-Funded' eligibility status. However, the individual marketplace for Medicare Supplement(Medigap) insurance options beats out the retiree insurance rates for South Carolinians. Retiree/Retirement systems like South Carolina Retirement Systems(SCRS), Savannah River Site Retiree Association(SRSRA), Dominion Energy Retirees and many other private and public employers that offer internal Medicare insurance options.
Medicare Savings has proven time and time again that we have saved households their retirement dollars from going out of the door because that are many situations where what you(the retiree) are offered for Medicare insurance is well above market value.
Leave your general inquiries or experiences in the comments so others may benefit from your retiree experience or insight. I am your humble Medicare insurance broker that doesn't know it all but I will research your situation and concerns so we can all benefit from up-to-date SC STATE retiree information.