Charleston County residents shopping for Medicare Advantage coverage this fall will find about as many plans as last year, and most still charge no monthly premium. But many of those plans will let members pay more out of pocket before their coverage caps kick in.

Medicare’s open enrollment period began Oct. 15 and ends Dec. 7, The Associated Press reported. Changes take effect Jan. 1.

A Charleston Business Report analysis of the 2027 plan list from the Centers for Medicare & Medicaid Services, last updated Oct. 18, found 70 Medicare Advantage plans offered in Charleston County next year, up from 69 this year.

Of those, 46 are open to anyone eligible for Medicare in the county. The other 24 are special needs plans limited to people who also qualify for Medicaid, live in institutions such as nursing homes or have certain chronic conditions.

Thirty-nine of the 46 open plans list no monthly plan premium for 2027, up from 36 of 47 this year.

Higher ceilings

Medicare Advantage plans set an in-network maximum out-of-pocket amount, which CMS describes as the limit on what enrollees spend for in-network hospital and medical services.

Of the 43 open plans returning to Charleston County, 30 raised that limit for 2027, 12 kept it the same and one lowered it, the analysis found. Those 30 plans had about 13,700 Charleston County members in October, according to CMS enrollment data.

The median increase was $600. The largest was $3,350, at Clover Health’s LiveHealthy PPO, which goes from $6,500 to $9,850. Humana Gold Plus H5619-152, an HMO with about 1,430 Charleston County members, goes from $7,200 to $9,850.

Nineteen open plans in the county list a $9,850 limit for 2027, the highest of any Medicare Advantage plan there. This year’s highest limit in the county is $9,250.

Four plans leave the county

Four open plans sold in Charleston County this year won’t be offered there in 2027, according to the CMS plan list and the agency’s 2027 plan crosswalk.

The crosswalk lists three as terminated or not renewed: Humana Gold Plus H5619-083, an HMO; HealthSpring True Choice Plus, a PPO; and Devoted Premium 003 SC, an HMO.

The fourth, BlueCross BlueShield of South Carolina’s BlueCross Total PPO, plan 003, is renewing with a smaller service area that leaves out Charleston County. It will still be sold in Berkeley and Dorchester counties. With 1,207 Charleston County members in October, it is the largest of the four in the county.

Not counting BlueCross Total’s members in Berkeley and Dorchester counties, where it will still be sold, the four plans had at least 1,790 members in Charleston, Berkeley and Dorchester counties in October. CMS does not publish counts of 10 or fewer.

UnitedHealthcare, Devoted Health and Humana each add one open plan in the county. Devoted and Humana also add special needs plans.

Big insurers pull back

The changes come as two of the largest Medicare Advantage insurers cut back nationally. Humana and UnitedHealthcare are discontinuing plans that cover about 1 million people starting next year, CBS News reported Oct. 23.

“We regularly evaluate our Medicare offerings to ensure we can continue providing affordable, coordinated care and access to high-quality care. As previously disclosed, we anticipate plan exits for 2027 will impact approximately 600,000 members,” Humana said in a statement to CBS News. UnitedHealthcare said it faces higher costs and increased plan usage, CBS reported.

Those two companies lead the local market. In October, UnitedHealth Group plans had about 9,900 Charleston County members and Humana plans about 9,200, roughly 61% of the county’s enrollment in private Medicare health plans, including employer-sponsored ones, according to CMS contract and plan data. Humana offers 17 of the county’s 46 open plans for 2027, more than any other company.

Who is enrolled

In October, 31,508 of Charleston County’s 87,767 Medicare-eligible residents, or 35.9%, were in Medicare Advantage, according to CMS. The share is higher in Berkeley County, at 44.3%, and in Dorchester County, at 43.2%.

CMS added 2027 star ratings to its plan list Oct. 18. Among the 46 open plans in Charleston County, 26 are rated 4 stars or higher, including three Clover Health plans rated 5 stars. Ten are rated 3 stars, the lowest rating among open plans in the county.

Enrollees who buy drug coverage separately face changes too. Three stand-alone Part D plans are leaving South Carolina next year, according to CMS.

Juliette Cubanski, director of KFF’s program on Medicare policy, told the AP that open enrollment offers “an opportunity to evaluate the coverage they have and see if there might be better options for them in terms of accessing the care that they need at possibly a lower cost.”

How we did this

Charleston Business Report compared CMS’ 2026 and 2027 Medicare Advantage landscape files for Charleston, Berkeley and Dorchester counties, matching plans by contract, plan and segment number. Plan statuses come from CMS’ 2027 plan crosswalk. Enrollment figures come from CMS’ October 2026 county-level enrollment and penetration files. Counts of open plans exclude special needs plans. Employer group plans are not in the landscape file.