Selling to seniors means working with Medicare, Medicare Supplement (Medigap) policies, Medicare Advantage and Part D, Medicaid / long-term care, and stand-alone long-term care (LTC) insurance—an area with strong consumer protections because buyers are often vulnerable. This guide reviews the national fundamentals and then focuses on South Carolina specifics: Medigap regulation and free-look rights, the South Carolina Long Term Care Partnership, SHIP counseling, Medicaid through SCDHHS, and the replacement and suitability rules that protect older South Carolina consumers.

The federal base: Medicare Parts A/B/C/D

Medicare is the federal program for people 65+ (and certain younger people with disabilities or ESRD):

• Part A — hospital/inpatient, skilled nursing (limited), hospice; usually premium-free for those with enough work credits.
• Part B — physician/outpatient services, preventive care, durable medical equipment; carries a monthly premium.
• Part C (Medicare Advantage) — private plans that bundle Parts A and B (often with drug coverage) as an alternative to Original Medicare.
• Part D — prescription drug coverage sold by private insurers.

Eligibility is generally at age 65, or earlier with 24 months of Social Security disability (or immediately for ESRD/ALS). Medicare provides only limited skilled-nursing coverage and generally does not pay for long-term custodial care.

Medicare Supplement (Medigap)

Medigap policies are sold by private insurers to fill Original Medicare's gaps—deductibles, coinsurance, and copays. They are federally standardized into lettered plans (A through N), so a "Plan G" offers the same core benefits from any company; insurers compete on price and service.

• The Medigap Open Enrollment Period is a 6-month window that begins when the applicant is age 65 or older AND enrolled in Part B. During it, coverage is guaranteed issue—no health-based decline or surcharge.
• After that window, insurers may use medical underwriting unless a separate guaranteed-issue right applies (for example, when a Medicare Advantage plan exits the area).

Medicare Advantage and Part D

• Medicare Advantage (Part C) replaces how you receive A and B through a private HMO/PPO network, often adding extras (dental, vision, drug coverage). It is not a supplement—you cannot pair Medigap with an Advantage plan.
• Part D drug plans carry their own enrollment periods and a late-enrollment penalty for those who delay without other creditable coverage.

A core distinction: Medigap supplements Original Medicare; Medicare Advantage replaces how you get it.

South Carolina Medigap regulation: free look, replacement, suitability

South Carolina regulates Medigap sales closely through the South Carolina Department of Insurance:

• Free look — Medicare Supplement (and LTC) policies carry a free-look window during which the buyer may return the policy for a full refund; for these senior policies it is commonly cited as 30 days—verify the current figure.
• Replacement — when a sale replaces an existing Medigap or health policy, the producer must deliver the required replacement disclosures, compare benefits, and ensure the change genuinely benefits the client.
• Anti-duplication — selling a second Medigap policy to someone who already has one, or coverage that duplicates Medicare, is a prohibited unfair practice.
• Suitability and disclosures — producers must deliver the "Guide to Health Insurance for People with Medicare" and an Outline of Coverage, consider the product's suitability for the consumer, and avoid twisting (misrepresentation to induce a switch).

Medicaid and long-term care

Medicaid in South Carolina (administered by SCDHHS — the Department of Health and Human Services, marketed as "Healthy Connections") is the income- and asset-based program that, unlike Medicare, does pay for extended custodial long-term care for those who qualify financially:

• Applicants must meet income and asset limits; many seniors must spend down assets to become eligible.
• A look-back period (commonly cited as 5 years—verify) reviews asset transfers to discourage giving away assets to qualify.
• A community spouse is protected from full impoverishment through spousal asset/income allowances.

Medicare, by contrast, largely does not cover long-term custodial care—the gap the LTC insurance market exists to fill.

Long-term care insurance and the South Carolina Partnership

Stand-alone LTC insurance covers nursing-home, assisted-living, and home care. Benefit triggers are typically the inability to perform a set number of activities of daily living (ADLs) or cognitive impairment. South Carolina follows the NAIC LTC model protections and participates in a Partnership program:

• Inflation protection and nonforfeiture benefits must generally be offered.
• LTC policies generally cannot require prior hospitalization as a condition for benefits.
• Producer LTC training and suitability review are required before selling LTC.
• The South Carolina Long Term Care Partnership links qualified private LTC policies to Medicaid asset protection: dollars paid by a qualifying Partnership policy let the insured shield an equal amount of assets if they later need Medicaid.

South Carolina SHIP and senior counseling

South Carolina operates a State Health Insurance Assistance Program (SHIP)—free, unbiased Medicare counseling for seniors choosing among Medicare, Medigap, Advantage, and Part D options (South Carolina's program is often delivered through its aging-services network). Agents should know SHIP exists as a non-sales resource and may refer clients to it.

Other senior tools

A viatical settlement lets a terminally or chronically ill insured sell a life policy to a third party for a lump sum less than the face amount. Accelerated death benefits likewise let a terminally ill insured access part of the death benefit early. These come up alongside senior planning—know them at a high level.

Key South Carolina numbers to memorize

Common exam traps

• Confusing Medigap with Medicare Advantage. Medigap supplements Original Medicare; Advantage (Part C) replaces how you get A/B—and you cannot hold both.
• Miscounting open enrollment. It is 6 months and requires both age 65 and Part B.
• Using a 10-day free look for seniors. South Carolina senior policies commonly use 30 days—verify.
• Selling duplicate coverage. A second Medigap policy is a prohibited practice.
• Assuming Medicare pays for long-term custodial care. It largely does not—Medicaid or LTC insurance fills that gap.
• Confusing Medicare with Medicaid. Medicare is federal, age-based; Medicaid (SCDHHS) is income/asset-based and central to Partnership asset protection.
• Asserting exact look-back or free-look figures. Treat them as statutory and verify.

Quick recap

Senior sales center on Medicare (Parts A/B/C/D), Medigap (federally standardized A–N), and long-term care. The headline protection is the 6-month Medigap open enrollment beginning at age 65 with Part B, which grants guaranteed issue. South Carolina adds a senior free look (commonly 30 days), strict replacement and anti-duplication rules, and a suitability/twisting prohibition. Medicaid through SCDHHS covers custodial long-term care for those who qualify after a spend-down and look-back, while stand-alone LTC insurance must offer inflation protection and nonforfeiture, uses ADL/cognitive triggers, and connects to the South Carolina Long Term Care Partnership for Medicaid asset protection. South Carolina SHIP offers free counseling. Remember "Medigap supplements, Advantage replaces," the 6-month window, and the 30-day senior free look—and verify any specific figure.