Simpsonville, South Carolina Medicare Companies and Plans (2021)

Simpsonville, South Carolina Medicare plans include Advantage plans from private health insurance companies as well as standalone Part D prescription drug coverage. For those that prefer original Medicare, Simpsonville, SC supplemental plans are also available. Medicare plans in Simpsonville, South Carolina are sold by both large national companies and local insurers.

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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years Leslie Kasperowicz

UPDATED: Oct 13, 2021

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The Highlights

  • Medicare Advantage plans are available in Simpsonville with both PPO and HMO networks
  • Medicare Advantage plans in Simpsonville, South Carolina may include prescription drug coverage, or you may need to buy Part D coverage separately
  • You can buy Medicare supplement coverage in Simpsonville, South Carolina if you have original Medicare and want coverage for out-of-pocket costs

If you’re eligible for Medicare in Simpsonville, South Carolina, you have a lot of choices. Major health insurance companies provide Simpsonville, South Carolina Medicare Advantage plans with a variety of coverage options to choose from. You can choose a plan that includes Simpsonville, SC Part D coverage or buy prescription coverage as a standalone policy.

Simpsonville, South Carolina Medicare supplement plans are available from a number of companies if you choose to stick with original Medicare. These plans can pay for the out-of-pocket costs that Simpsonville original Medicare plans don’t cover, like coinsurance and deductibles.

Ready to buy Simpsonville, South Carolina Medicare coverage? Enter your ZIP code to compare Simpsonville, SC Medicare options available to you right now.

Medicare Advantage Companies in Simpsonville, South Carolina

Medicare Advantage in Simpsonville, South Carolina is offered by some of the same local health insurance companies you may have been covered by before. Take a look at which companies in Simpsonville, SC offer Medicare Advantage as well as which plans they offer to find the coverage and provider network that’s best for you.

Medicare Advantage Companies in Simpsonville, South Carolina

Plan Name Monthly Prem. (Parts C & D) Deductible Additional Gap Coverage Preferred Pharmacy Copay/ Coinsurance 30-Day Supply MOOP for Part A & B Benefits
AARP Medicare Advantage Choice (PPO) – H2577-006-0 $0.00 $95 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 31% $5,900
AARP Medicare Advantage Patriot (HMO-POS) – H8748-019-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $4,500
AARP Medicare Advantage Plan 1 (HMO-POS) – H8748-002-0 $0.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $5,900
AARP Medicare Advantage Plan 2 (HMO-POS) – H8748-025-0 $24.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $2.00, Generic: $8.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $4,500
AARP Medicare Advantage Walgreens (PPO) – H2577-005-0 $0.00 $95 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 31% $6,700
Absolute Total Care (Medicare-Medicaid Plan) – H1723-001-0 $0.00 $0 All Generics, All Brands Tier 1: 0%, Tier 2: 0%, Tier 3: 0% n/a
Aetna Medicare Eagle Plan (PPO) – H5521-279-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $7,500
Aetna Medicare Premier Plan (PPO) – H5521-140-0 $0.00 $150 . Tier 1 and 2 exempt Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 30% $7,500
Aetna Medicare Premier Plus Plan (PPO) – H5521-319-0 $0.00 $0 Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $7,500
Aetna Medicare Value Plus Plan (HMO) – H3146-011-0 $21.00 $250 . Tier 1 and 2 exempt Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% $6,900
Allwell Dual Medicare (HMO D-SNP) – H1436-005-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $8.00, Preferred Brand: $47.00, Non-Preferred Drug: 45%, Specialty Tier: 25% n/a
Allwell Medicare (HMO) – H1436-004-0 $0.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $8.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33%, Select Care Drugs: $0.00 $7,550
BlueCross Secure (HMO) – H7165-001-0 $0.00 $70 . Tier 1 and 2 exempt Yes, some additional gap coverage. Preferred Generic: $5.00, Generic: $15.00, Preferred Brand: $37.00, Non-Preferred Drug: 45%, Specialty Tier: 31% $6,700
BlueCross Total (PPO) – H8003-001-0 $19.00 $100 . Tier 1 and 2 exempt Yes, some additional gap coverage. Preferred Generic: $5.00, Generic: $15.00, Preferred Brand: $37.00, Non-Preferred Drug: 45%, Specialty Tier: 31% $6,900
BlueCross Total Value (PPO) – H8003-004-0 $0.00 $200 . Tier 1 and 2 exempt Yes, some additional gap coverage. Preferred Generic: $5.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: 45%, Specialty Tier: 29% $7,550
Bright Advantage (HMO) – H7409-001-0 $0.00 $445 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: 25%, Preferred Brand: 25%, Non-Preferred Drug: 25%, Specialty Tier: 25%, Select Care Drugs: $0.00 $6,400
Cigna Fundamental Medicare (HMO) – H7020-005-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $5,900
Cigna Preferred Medicare (HMO) – H7020-004-0 $0.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 33% $5,900
Cigna Preferred Plus Medicare (HMO) – H7020-006-0 $29.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $4.00, Preferred Brand: $35.00, Non-Preferred Drug: $95.00, Specialty Tier: 33% $4,900
Cigna Preferred Savings Medicare (HMO) – H7020-007-0 $0.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $2.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 33% $6,950
Clear Spring Health Choice Plan (PPO) – H2334-003-0 $0.00 $200 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $12.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 29% $7,550
Clear Spring Health Deluxe Plan (HMO D-SNP) – H9403-001-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 n/a
Clear Spring Health Gold Plus (PPO) – H2334-005-0 $19.00 $200 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $12.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 29% $6,700
Clear Spring Health Select Plan (HMO) – H9403-004-0 $0.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 33% $7,550
Clear Spring Health Silver Plan (HMO C-SNP) – H9403-003-0 $0.00 $250 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 28% n/a
First Choice VIP Care Plus (Medicare-Medicaid Plan) – H8213-001-0 $0.00 $0 All Generics, All Brands Tier 1: 0%, Tier 2: 0%, Tier 3: 0% n/a
Humana Gold Choice H8145-069 (PFFS) – H8145-069-0 $53.00 $340 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $7.00, Generic: $17.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 26% n/a
Humana Gold Plus – Diabetes and Heart (HMO C-SNP) – H5619-087-0 $0.00 $195 . Tier 1, 2 and 3 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29%, Select Care Drugs: $0.00 n/a
Humana Gold Plus H5178-001 (HMO) – H5178-001-0 $130.00 $445 No additional gap coverage, only the Donut Hole Discount Tier 1: 25%, Tier 2: 25%, Tier 3: 25%, Tier 4: 25%, Tier 5: 25% $6,700
Humana Gold Plus H5619-086 (HMO) – H5619-086-0 $0.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $7,550
Humana Gold Plus SNP-DE H5619-082 (HMO D-SNP) – H5619-082-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% n/a
Humana Honor (PPO) – H5216-217-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $6,700
Humana Together in Health (PPO I-SNP) – H5216-243-0 $27.60 $350 . Tier 1 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $18.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 26% n/a
HumanaChoice – Diabetes (PPO C-SNP) – H5216-244-0 $0.00 $145 . Tier 1, 2 and 3 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 30% n/a
HumanaChoice – Diabetes and Heart (PPO C-SNP) – H5216-245-0 $5.20 $445 . Tier 1 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $17.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% n/a
HumanaChoice H5216-154 (PPO) – H5216-154-0 $0.00 $400 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $5.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% $7,550
HumanaChoice H5216-157 (PPO) – H5216-157-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $6,700
HumanaChoice H5216-210 (PPO) – H5216-210-0 $0.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $7,550
HumanaChoice H5216-237 (PPO) – H5216-237-1 $42.00 $250 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $5.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% $6,700
HumanaChoice H5216-241 (PPO) – H5216-241-0 $28.70 $445 . Tier 1 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% $7,550
HumanaChoice H7617-001 (PPO) – H7617-001-0 $115.00 $445 No additional gap coverage, only the Donut Hole Discount Tier 1: 25%, Tier 2: 25%, Tier 3: 25%, Tier 4: 25%, Tier 5: 25% $6,700
HumanaChoice R3392-001 (Regional PPO) – R3392-001-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $6,700
HumanaChoice R3392-002 (Regional PPO) – R3392-002-0 $87.00 $340 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $7.00, Generic: $17.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 26% $6,700
Lasso Healthcare Growth (MSA) – H1924-001-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. n/a
Lasso Healthcare Growth Plus (MSA) – H1924-004-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. n/a
Molina Dual Options (Medicare-Medicaid Plan) – H2533-001-0 $0.00 $0 All Generics, All Brands Tier 1: 0%, Tier 2: 0%, Tier 3: 0% n/a
Molina Medicare Complete Care (HMO D-SNP) – H8176-001-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $4.00, Preferred Brand: $45.00, Non-Preferred Drug: 34%, Specialty Tier: 25% n/a
NHC Advantage (HMO I-SNP) – H4172-001-0 $30.20 $445 No additional gap coverage, only the Donut Hole Discount Tier 1: 25% n/a
NHC Advantage Gold (HMO I-SNP) – H4172-002-0 $176.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $15.00, Preferred Brand: $45.00, Non-Preferred Brand: $95.00, Specialty Tier: 33% n/a
UnitedHealthcare Dual Complete (PPO D-SNP) – H0271-016-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 n/a
UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP) – R2604-004-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 n/a
UnitedHealthcare Medicare Advantage Choice (Regional PPO) – R2604-001-0 $49.00 $295 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $14.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% $6,700
UnitedHealthcare Medicare Advantage Patriot (Regional PPO) – R2604-005-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $6,700
UnitedHealthcare Medicare Gold (Regional PPO C-SNP) – R2604-003-0 $19.00 $210 . Tier 1, 2 and 3 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% n/a
UnitedHealthcare Medicare Silver (Regional PPO C-SNP) – R2604-002-0 $9.70 $445 No additional gap coverage, only the Donut Hole Discount Tier 1: 25%, Tier 2: 25%, Tier 3: 25%, Tier 4: 25%, Tier 5: 25% n/a
UnitedHealthcare Nursing Home Plan (PPO I-SNP) – H0710-053-0 $27.60 $445 No additional gap coverage, only the Donut Hole Discount Tier 1: 25%, Tier 2: 25%, Tier 3: 25%, Tier 4: 25%, Tier 5: 25% n/a
WellCare Absolute (PPO) – H7326-003-0 $0.00 $90 . Tier 1 and 2 exempt Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 31% $6,700
WellCare Access (HMO D-SNP) – H1416-036-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $6.00, Preferred Brand: $47.00, Non-Preferred Drug: 47%, Specialty Tier: 25% n/a
WellCare Compass (HMO) – H4847-005-0 $13.30 $445 . Tier 1 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 50%, Specialty Tier: 25% $3,450
WellCare Elite (HMO) – H4847-001-0 $0.00 $0 Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $47.00, Non-Preferred Drug: $90.00, Specialty Tier: 33% $3,400
WellCare Flex Complete (PPO) – H7326-004-0 $90.00 $0 Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $9.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $2,500
WellCare Patriot (HMO-POS) – H1416-059-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $3,450
WellCare Plus (HMO) – H4847-003-0 $21.70 $445 . Tier 1 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $8.00, Preferred Brand: $45.00, Non-Preferred Drug: 50%, Specialty Tier: 25% $3,000
WellCare Premier (PPO) – H7326-001-0 $0.00 $100 . Tier 1 and 2 exempt Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 31% $5,500
WellCare Prime (PPO) – H7326-002-0 $30.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $47.00, Non-Preferred Drug: 35%, Specialty Tier: 33% $6,000
WellCare Value (HMO) – H1416-056-0 $0.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 45%, Specialty Tier: 33% $5,900

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Medicare Supplement Companies in Simpsonville, South Carolina

Original Medicare leaves you with some out-of-pocket costs such as deductibles and coinsurance. With a Simpsonville, South Carolina Medicare supplement plan, you can get coverage for some or all of those costs. Medicare supplement plans in South Carolina are standardized, but companies can choose which plans they will sell. Take a look at which companies sell Medicare supplement (Medigap) insurance and which plans they offer.

Medicare Supplement Companies in Simpsonville, South Carolina

Company Plans
AARP – UnitedHealthcare Insurance Company (Level 1) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
AARP – UnitedHealthcare Insurance Company (Level 1/Household) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
AARP – UnitedHealthcare Insurance Company (Level 2) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
AARP – UnitedHealthcare Insurance Company (Level 2/Household) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
AARP – UnitedHealthcare Insurance Company (Standard) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
AARP – UnitedHealthcare Insurance Company (Standard/Household) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
Accendo Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Aetna Health Insurance Company Medigap Plan A,
Medigap Plan B,
Medigap Plan F,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan N
American Benefit Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
American Retirement Life Insurance Company (CIGNA) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
American Retirement Life Insurance Company (CIGNA) (Standard II) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
American Retirement Life Insurance Company (CIGNA) (Standard III) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Assured Life Association Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Atlantic Coast Life Insurance Company Medigap Plan A,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Atlantic Coast Life Insurance Company (Household) Medigap Plan A,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Bankers Fidelity Assurance Company (Preferred) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible
Bankers Fidelity Assurance Company (Standard) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible
Bankers Fidelity Life Insurance Company (Preferred) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan K,
Medigap Plan N
Bankers Fidelity Life Insurance Company (Standard) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan K,
Medigap Plan N
Blue Cross and Blue Shield of South Carolina Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan L,
Medigap Plan N
Blue Cross and Blue Shield of South Carolina (Guarantee Issue) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
Blue Cross and Blue Shield of South Carolina (Non-Guarantee Issue) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
Capitol Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Central States Health and Life Co. of Omaha Medigap Plan A,
Medigap Plan D,
Medigap Plan F,
Medigap Plan N
Cigna National Health Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Cigna National Health Insurance Company (Standard II w/ 15% HHD) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Cigna National Health Insurance Company (Standard II w/ 6% HHD) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Cigna National Health Insurance Company (Standard II) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Cigna National Health Insurance Company (Standard III w/ 15% HHD) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Cigna National Health Insurance Company (Standard III w/ 6% HHD) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Cigna National Health Insurance Company (Standard III) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Cigna National Health Insurance Company (w/ 15% HHD) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Cigna National Health Insurance Company (w/ 6% HHD) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Colonial Penn Life Insurance Company Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan K,
Medigap Plan L,
Medigap Plan M,
Medigap Plan N
Colonial Penn Life Insurance Company (Substandard) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan K,
Medigap Plan L,
Medigap Plan M,
Medigap Plan N
Elips Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan N
Federal Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
GPM Health and Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Garden State Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan M,
Medigap Plan N
Globe Life and Accident Insurance Company (Direct to Consumer) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan N
Great Southern Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
Great Southern Life Insurance Company (Class 1) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
Guarantee Trust Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Humana (Humana Insurance Company) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
Humana (Humana Insurance Company) (Household) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
Humana Achieve (CompBenefits Insurance Company) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan N
Humana Achieve (CompBenefits Insurance Company) (Household) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan N
Humana Healthy Living (Humana Insurance Company) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan K,
Medigap Plan N
Humana Healthy Living (Humana Insurance Company) (Household) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan K,
Medigap Plan N
Humana Value (HumanaDental Insurance Company) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan N
Humana Value (HumanaDental Insurance Company) (Household) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan N
Independence American Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Manhattan Life Assurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Medico Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan N
Members Health Insurance Company Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan M,
Medigap Plan N
Mutual of Omaha Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan N
Nassau Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
National Guardian Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
National Health Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
National Health Insurance Company (Household) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
Oxford Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Pan-American Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Philadelphia American Life Insurance Company Medigap Plan A,
Medigap Plan C,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan M,
Medigap Plan N
Physicians Life Insurance Company (Issue Age) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible
Prosperity Life Group (Preferred) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Prosperity Life Group (Standard) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Resource Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G
Royal Arcanum Medigap Plan A,
Medigap Plan D,
Medigap Plan F,
Medigap Plan N
Shenandoah Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Southern Guaranty Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
State Farm Mutual Automobile Insurance Company Medigap Plan A,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Transamerica Life Insurance Company (Direct) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan M,
Medigap Plan N
USAA Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Union Security Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
United American Insurance Company Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
United Commercial Travelers of America Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
United Insurance Company of America Medigap Plan A,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan N
United States Fire Insurance Company Medigap Plan A,
Medigap Plan B,
Medigap Plan F,
Medigap Plan G,
Medigap Plan G-high deductible,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
Physicians Life Insurance Company (Attained Age) Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan G-high deductible

Simpsonville, South Carolina Standard Medicare Plan Coverage

Wondering what’s covered by each of the standard South Carolina Medicare supplement plans? Take a look at all of the Simpsonville, South Carolina Medicare supplement plans with coverage details.

Simpsonville, South Carolina Standard Medicare Plan Coverage

Plan Name Monthly Cost Copays Coinsurance Deductibles Plan Benefits
Medigap Plan A Premiums range from $68-$940 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $1,484 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: No
Part A deductible: No
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: No
Medigap Plan B Premiums range from $94-$707 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: No
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: No
Medigap Plan C Premiums range from $105-$503 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$0 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: Yes
Part B excess charges: No
Foreign travel emergency: Yes
Medigap Plan D Premiums range from $97-$555 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: Yes
Medigap Plan F Premiums range from $108-$928 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$0 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: Yes
Part B excess charges: Yes
Foreign travel emergency: Yes
Medigap Plan F-high deductible Premiums range from $26-$278 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services after you pay $2,370 deductible $2,370 total plan deductible.
After, you pay: $0 Hospital (Part A) deductible,
$0 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: Yes
Part B excess charges: Yes
Foreign travel emergency: Yes
Medigap Plan G Premiums range from $91-$869 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: Yes
Foreign travel emergency: Yes
Medigap Plan G-high deductible Premiums range from $26-$161 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services after you pay $2,370 deductible $2,370 total plan deductible.
After, you pay: $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: Yes
Foreign travel emergency: Yes
Medigap Plan K Premiums range from $42-$307 depending on your age, sex, health status, and when you buy. 10% Generally your cost for approved Part B services up to $6,220. Then, you’ll pay $0 for the rest of the year. $742 (50% of Part A deductible) Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: No
Medigap Plan L Premiums range from $59-$630 depending on your age, sex, health status, and when you buy. 5% Generally your cost for approved Part B services up to $3,110. Then, you’ll pay $0 for the rest of the year. $371 (25% of Part A deductible) Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: No
Medigap Plan M Premiums range from $69-$696 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $742 (50% of Part A deductible) Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: Yes
Medigap Plan N Premiums range from $65-$589 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services with some $20 and $50 copays $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: Yes

Standalone Medicare Part D Plans in Simpsonville, South Carolina

Prescription drug coverage for Medicare in Simpsonville, South Carolina is covered by a Part D plan. You can purchase Part D coverage in Simpsonville, South Carolina as a standalone plan if it’s not included in your Medicare Advantage coverage. Take a look at the options for standalone Part D plans here.

Standalone Medicare Part D Plans in Simpsonville, South Carolina

Plan Details Tiers
SilverScript SmartRx (PDP)
S5601 – 184 – 0
by Aetna Medicare
Monthly Premium: $7.30
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $19.00
Tier 3: $46.00
Tier 4: 48%
Tier 5: 25%
Clear Spring Health Premier Rx (PDP)
S6946 – 035 – 0
by Clear Spring Health
Monthly Premium: $14.10
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $40.00
Tier 4: 45%
Tier 5: 25%
Elixir RxPlus (PDP)
S7694 – 123 – 0
by Elixir Insurance
Monthly Premium: $15.60
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $6.00
Tier 3: $43.00
Tier 4: 45%
Tier 5: 25%
WellCare Wellness Rx (PDP)
S4802 – 178 – 0
by WellCare
Monthly Premium: $16.70
Annual Deductable: $350
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $8.00
Tier 3: $40.00
Tier 4: 46%
Tier 5: 26%
Humana Walmart Value Rx Plan (PDP)
S5884 – 188 – 0
by Humana
Monthly Premium: $17.20
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: 18%
Tier 4: 35%
Tier 5: 25%
WellCare Value Script (PDP)
S4802 – 144 – 0
by WellCare
Monthly Premium: $19.70
Annual Deductable: $350
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $8.00
Tier 3: $43.00
Tier 4: 47%
Tier 5: 26%
Cigna Secure Rx (PDP)
S5617 – 218 – 0
by Cigna
Monthly Premium: $20.40
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $42.00
Tier 4: 50%
Tier 5: 25%
Clear Spring Health Value Rx (PDP)
S6946 – 006 – 0
by Clear Spring Health
Monthly Premium: $22.50
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $42.00
Tier 4: 33%
Tier 5: 25%
SilverScript Choice (PDP)
S5601 – 018 – 0
by Aetna Medicare
Monthly Premium: $22.90
Annual Deductable: $355
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $5.00
Tier 3: $35.00
Tier 4: 42%
Tier 5: 26%
WellCare Medicare Rx Saver (PDP)
S5810 – 043 – 0
by WellCare
Monthly Premium: $23.60
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $6.00
Tier 3: $42.00
Tier 4: 36%
Tier 5: 25%
Cigna Secure-Essential Rx (PDP)
S5617 – 288 – 0
by Cigna
Monthly Premium: $24.00
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 18%
Tier 4: 47%
Tier 5: 25%
Elixir RxSecure (PDP)
S7694 – 009 – 0
by Elixir Insurance
Monthly Premium: $24.80
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $7.00
Tier 3: 15%
Tier 4: 34%
Tier 5: 25%
Mutual of Omaha Rx Premier (PDP)
S7126 – 078 – 0
by Mutual of Omaha Rx
Monthly Premium: $25.80
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 23%
Tier 4: 45%
Tier 5: 25%
WellCare Medicare Rx Select (PDP)
S5810 – 283 – 0
by WellCare
Monthly Premium: $26.90
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $3.00
Tier 3: $47.00
Tier 4: 42%
Tier 5: 25%
Express Scripts Medicare – Saver (PDP)
S5660 – 225 – 0
by Express Scripts Medicare
Monthly Premium: $28.90
Annual Deductable: $285
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $2.00
Tier 2: $7.00
Tier 3: $35.00
Tier 4: 50%
Tier 5: 28%
WellCare Classic (PDP)
S4802 – 070 – 0
by WellCare
Monthly Premium: $34.20
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $3.00
Tier 3: $30.00
Tier 4: 33%
Tier 5: 25%
AARP MedicareRx Walgreens (PDP)
S5921 – 391 – 0
by UnitedHealthcare
Monthly Premium: $36.70
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $6.00
Tier 3: $40.00
Tier 4: 40%
Tier 5: 25%
Humana Basic Rx Plan (PDP)
S5884 – 134 – 0
by Humana
Monthly Premium: $38.00
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $1.00
Tier 3: 20%
Tier 4: 34%
Tier 5: 25%
AARP MedicareRx Saver Plus (PDP)
S5921 – 354 – 0
by UnitedHealthcare
Monthly Premium: $46.90
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $10.00
Tier 3: $40.00
Tier 4: 40%
Tier 5: 25%
Cigna Secure-Extra Rx (PDP)
S5617 – 254 – 0
by Cigna
Monthly Premium: $48.80
Annual Deductable: $100
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $4.00
Tier 2: $10.00
Tier 3: $42.00
Tier 4: 50%
Tier 5: 31%
Express Scripts Medicare – Value (PDP)
S5660 – 111 – 0
by Express Scripts Medicare
Monthly Premium: $54.70
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $5.00
Tier 3: $41.00
Tier 4: 50%
Tier 5: 25%
Humana Premier Rx Plan (PDP)
S5884 – 155 – 0
by Humana
Monthly Premium: $69.00
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: $45.00
Tier 4: 49%
Tier 5: 25%
Express Scripts Medicare – Choice (PDP)
S5660 – 210 – 0
by Express Scripts Medicare
Monthly Premium: $69.80
Annual Deductable: $100
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $2.00
Tier 2: $7.00
Tier 3: $42.00
Tier 4: 50%
Tier 5: 31%
SilverScript Plus (PDP)
S5601 – 019 – 0
by Aetna Medicare
Monthly Premium: $76.00
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $47.00
Tier 4: 50%
Tier 5: 33%
WellCare Medicare Rx Value Plus (PDP)
S5768 – 132 – 0
by WellCare
Monthly Premium: $79.20
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $4.00
Tier 3: $47.00
Tier 4: 47%
Tier 5: 33%
BlueCross Rx Value (PDP)
S5953 – 001 – 0
by Blue Cross Blue Shield of South Carolina
Monthly Premium: $86.20
Annual Deductable: $300
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $5.00
Tier 2: $20.00
Tier 3: $47.00
Tier 4: 50%
Tier 5: 27%
AARP MedicareRx Preferred (PDP)
S5820 – 008 – 0
by UnitedHealthcare
Monthly Premium: $95.50
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $5.00
Tier 2: $10.00
Tier 3: $45.00
Tier 4: 40%
Tier 5: 33%
Mutual of Omaha Rx Plus (PDP)
S7126 – 008 – 0
by Mutual of Omaha Rx
Monthly Premium: $100.00
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 20%
Tier 4: 34%
Tier 5: 25%
BlueCross Rx Plus (PDP)
S5953 – 002 – 0
by Blue Cross Blue Shield of South Carolina
Monthly Premium: $205.30
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $0.00
Tier 2: $3.00
Tier 3: $20.00
Tier 4: 40%
Tier 5: 33%

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