Best Medicare Advantage Plans in South Carolina (2026)

Key Takeaways

South Carolina has 40 Medicare Advantage plans available from eight providers including HMO, HMO-POS and PPO network types. Most plans charge $0 monthly premiums but can be as high as $100 depending on plan type.

Cigna HealthCare is the best Medicare Advantage company for HMO plans in South Carolina, while Wellcare is the best provider for HMO-POS and PPO plans.

When choosing a Medicare Advantage plan in South Carolina, consider your preferred doctors and hospitals, prescription medication needs and your budget for premiums and out-of-pocket costs.

Best Medicare Advantage Providers in South Carolina

South Carolina offers a range of Medicare Advantage plans. We’ve analyzed top Medicare Advantage providers in the state, focusing on CMS star ratings, premiums and maximum out-of-pocket (MOOP) costs to show value by plan type for residents.

Cigna HealthCare is best for HMO coverage with a 4.0-star plan, $0 monthly premiums, and an average $6,638 maximum out-of-pocket (MOOP). Wellcare offers top options for HMO-POS and PPO plans. Its HMO-POS plans average $35 per month with a 4-star CMS rating and the state’s lowest average MOOP at $5,900, while its PPO plans run $28 monthly, also earning 4.0 stars with a higher $6,500 MOOP.


HMO	Cigna HealthCare	4.00	$0	$6,638	HealthSpring Preferred (HMO)
HMO-POS	Wellcare	4.00	$35	$5,900	Wellcare Assist (HMO-POS)
PPO	Wellcare	4.00	$28	$6,500	Wellcare Assist Open (PPO)

Medicare Advantage Plans Explained

Medicare Advantage plans from private companies bundle hospital and medical coverage into one comprehensive package. These plans include everything Original Medicare offers plus extras like dental, vision, and prescription drug benefits.

CMS Star Ratings: Medicare scores plans from 1 to 5 stars based on care quality and member satisfaction. Higher ratings mean better overall performance and customer service.
Monthly premiums: You'll pay your Part B premium plus any additional plan costs. Many Medicare Advantage plans charge $0 in extra monthly fees beyond standard Medicare premiums.
Maximum out-of-pocket (MOOP) limits: This annual cap protects you from unlimited medical expenses. Once you reach this amount, your plan covers all remaining costs for covered services.
Prescription drug coverage: Most plans bundle Part D medication benefits directly into your coverage. Check that your specific prescriptions appear on the plan's approved drug list.

Cigna

Best HMO

MoneyGeek Rating

5/ 5

5/5Affordability

5/5Quality

5/5Availability

CMS Star Rating
4.0
Plan Types
HMO, PPO

pros
- HMO plans have strong 4-star CMS rating
- 3 of 4 plans charge $0 monthly premium
- Enhanced Part D drug coverage included with all plans
cons
- PPO plans have lower 3-star CMS rating
- No HMO-POS plans
Cigna offers two HMO Medicare Advantage plans, both earning 4.0-star CMS ratings with $0 monthly premiums. These plans include enhanced Part D drug coverage and average $5,443 in out-of-pocket maximums. While cost-effective, the narrow networks limit provider flexibility.

Cigna’s two PPO plans have a lower 3-star CMS rating with a $0 premium option and a $25 option. These plans include enhanced Part D coverage and provide greater freedom to see health care providers and specialists without referrals.

WellCare

Best HMO-POS

MoneyGeek Rating

5/ 5

5/5Affordability

5/5Quality

5/5Availability

CMS Star Rating
4.0
Plan Types
HMO-POS, PPO

pros
- Three plans with $0 monthly premium
- All plans rated 4 stars
- Members can see out-of-network providers
cons
- No standard HMO plans
- Higher costs for out-of-network care
- MOOP limits up to $9,250
South Carolina beneficiaries can choose from five Wellcare Medicare Advantage plans, all earning 4-star CMS ratings. The offerings include three HMO-POS plans for core coverage and two PPO options for broader provider access. The Simple HMO-POS is the most affordable, with no monthly premium and a $5,200 out-of-pocket maximum, including enhanced drug benefits that waive deductibles on select tiers.

For PPO options, the Simple Open PPO plan charges no premium and sets a $6,300 MOOP with enhanced drug benefits, while the Assist Open PPO costs $28 per month, caps maximum expenses at $6,500, and includes basic prescription coverage.

Best South Carolina HMO Medicare Advantage Providers

Most HMO Medicare Advantage plans in South Carolina charge $0 monthly, with 7 out of 9 available options being premium-free. Out-of-pocket maximums range from $4,250 to $9,250, averaging $7,543 annually.

Cigna HealthCare leads with a 4.0-star rating across its two plans, both charging $0 monthly with $6,638 average out-of-pocket limits.
Humana offers four plans at $0 monthly premiums but earns a lower 3.0-star rating and has higher $8,509 average maximum costs.
Aetna provides three plans with 4.0 stars and a higher $8,200 average MOOP, though it charges $23 average monthly premiums.


Cigna HealthCare	4.00	$0	$6,638	2	5.00
Humana	3.00	$0	$8,509	4	4.00
Aetna	4.00	$23	$8,200	3	3.99

HMO PROS AND CONS

HMO Medicare Advantage plans offer affordable premiums and coordinated care, but you'll need to stay within their provider networks and get referrals for specialist visits. These cost savings come with less flexibility in choosing doctors and require your primary care physician to manage most of your health care decisions.

Best South Carolina HMO-POS Medicare Advantage Providers

South Carolina has five HMO-POS plans from only two providers, with three plans charging $0 monthly and an average premium of $16. Maximum out-of-pocket (MOOP) limits range from $5,200 to $9,250, and all plans include Part D prescription coverage.

Wellcare is the best HMO-POS provider in the state, providing three plans with 4-star CMS ratings averaging $35 per month with a $5,900 average MOOP.
UnitedHealthcare offers two 3.5-star plans, charging $23 monthly with a $6,700 average MOOP.


Wellcare	4.00	$35	$5,900	3	5.00
UnitedHealthcare	3.50	$23	$6,700	2	4.00

HMO-POS PROS AND CONS

If you want affordable premiums but occasionally need out-of-network care, HMO-POS plans might work well for you. These hybrid plans give you the cost benefits of traditional HMOs while letting you see providers outside your network when necessary, though you'll pay more for out-of-network services.

Best South Carolina PPO Medicare Advantage Providers

South Carolina offers 24 PPO Medicare Advantage plans from eight providers, with most plans providing affordable access at an average $9 monthly premium. Sixteen plans charge $0 per month, though PPO plans come with higher maximum out-of-pocket (MOOP) costs, averaging $7,829.

Wellcare offers two plans at $28 per month with strong 4-star ratings and $6,500 average MOOP.
Clover Health has two PPO options with $0 monthly premiums, a $6,500 average MOOP, and a 3.5-star CMS rating.
Devoted Health ranks third with two $0-premium plans, averaging $6,725 MOOP and 4.5-star ratings.


Wellcare	4.00	$28	$6,500	2	5.00
Clover Health	3.50	$0	$6,500	2	5.00
Devoted Health	4.50	$0	$6,725	2	4.53
Aetna	4.50	$13	$8,658	4	4.44
UnitedHealthcare	4.50	$58	$6,700	1	4.28
Cigna HealthCare	3.00	$13	$5,317	2	4.24
Humana	3.76	$5	$8,217	9	4.17
Blue Cross Blue Shield	4.00	$13	$9,075	2	4.06

PPO PROS AND CONS

PPO Medicare Advantage plans cost more through higher monthly premiums and out-of-pocket maximums, but you're paying for complete provider freedom. You can visit any Medicare-approved doctor without referrals and access both in-network and out-of-network care, though out-of-network services will cost you more.

How to Find the Best South Carolina Medicare Advantage Plans

Finding the right plan requires evaluating your health care needs and budget, not just comparing monthly premiums.

1
Check Your Doctor and Hospital Network
Verify that your current doctors, specialists and preferred hospitals in cities like Charleston or Columbia participate in the plan's network. HMO plans restrict you to in-network providers except for emergencies, while PPO plans allow out-of-network access at higher costs. Learn more about health insurance network types to understand these differences.
2
Compare Maximum Out-of-Pocket Costs
The maximum out-of-pocket limit represents the most you'll pay for covered services annually, which can impact your healthcare expenses. For example, a plan with a $0 premium but $7,833 maximum out-of-pocket costs might exceed a $29 premium plan capped at $6,750 if you require regular medical care in South Carolina's health care system.
3
Review Prescription Drug Coverage
Check that your medications appear on the plan's drug formulary and understand their tier placement, which directly affects your prescription costs. Most Medicare Advantage plans include Part D drug coverage automatically, though some require separate enrollment. Pay close attention to tier levels since higher tiers mean higher out-of-pocket costs.
4
Evaluate Additional Benefits
Medicare Advantage plans frequently offer dental care, vision services, hearing aids, fitness center memberships and transportation to medical appointments. Compare which additional services each plan includes.
5
Consider CMS Star Ratings
Examine each plan's CMS star rating, which evaluates performance on a scale of one to five stars based on quality measures and customer satisfaction. Higher-rated plans deliver better customer service, coordinated care and health outcomes.

Average South Carolina Medicare Advantage Cost

Network structure directly impacts Medicare Advantage costs in South Carolina. Plans with restricted networks keep monthly premiums lower than options offering broader provider access.

HMO plans deliver the most affordable premiums at $9 monthly average with $7,543 maximum out-of-pocket costs. PPO plans cost slightly more at $10 monthly but increase MOOP to $7,829. HMO-POS plans add out-of-network access for $16 monthly with $6,750 MOOP. PFFS plans require $27 monthly premiums but offer the lowest $6,700 MOOP. Regional PPO plans cost the most at $100 monthly with $9,250 maximum expenses for the broadest network flexibility.


HMO	$0	$9	$7,543
HMO-POS	$0	$16	$6,750
PFFS	$27	$27	$6,700
PPO	$0	$10	$7,829
Regional PPO	$100	$100	$9,250

Best South Carolina Medicare Advantage: FAQ

Get answers about South Carolina Medicare Advantage plans:

When can I enroll in a Medicare Advantage plan in South Carolina?

In South Carolina, you can enroll during the Annual Enrollment Period from Oct. 15 to Dec. 7, or the Medicare Advantage Open Enrollment Period from Jan. 1 to March 31. You may also enroll during a Special Enrollment Period if you qualify due to circumstances like relocating or losing other coverage.

Does Medicare Advantage cover prescription drugs in South Carolina?

Yes, most Medicare Advantage plans in South Carolina include prescription drug coverage as part of their benefits. Before enrolling, confirm your medications appear on the plan's formulary and review their tier placement, which directly impacts your out-of-pocket costs at the pharmacy.

Do I need to change Medicare Advantage plans if I move to a different county in South Carolina?

Moving counties in South Carolina may require changing your Medicare Advantage plan since provider networks differ by location. Notify your current insurer within 30 days of relocating to explore your options and potentially enroll in a new plan through a Special Enrollment Period.

Our Methodology: How We Chose the Best South Carolina Medicare Advantage Plans

MoneyGeek assessed Medicare Advantage plans in South Carolina using a scoring system:

Affordability (50%): Costs represent half the total score due to their immediate effect on your spending. We analyzed combined monthly premiums for Part C and Part D coverage (weighted at 30%) and in-network maximum out-of-pocket limits (weighted at 20%). Plans with lower premiums and MOOP thresholds score higher by reducing annual health care expenses.
Star Ratings (40%): CMS star ratings evaluate plan performance in care quality, customer service and member experience. The Overall Star Rating merges Part C (medical benefits) and Part D (prescription drug coverage) scores into one rating on a 1 to 5-star scale. Higher-rated plans score better in our evaluation.
Availability (10%): We consider each insurer's coverage area across the United States. Providers serving more states score higher, as broader availability indicates better infrastructure, stronger support and more continuity if you relocate.

These factors create a fair comparison of Medicare Advantage plans, weighing costs against care quality and service.

About Mark Fitzpatrick

Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.

Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!

He writes about economics and insurance, breaking down complex topics so people know what they're buying.

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