South Carolina Health Insurance Information
Family or Individual
(HMO, PPO, POS or Major Medical Coverage)
Individual or family health insurance can provide the important protection needed in the event of
illness and for regular preventive care. Using the strength and experience of our health insurance
markets, Russell-Massey & Company of Columbia, SC can offer affordable HMO, PPO, POS,
and Major Medical Health Insurance policy coverages throughout South Carolina.
Health insurance plans that allow you the most choices in doctors and hospitals also tend to cost
more than plans that limit choices. Individual and family health insurance plans that help to manage
the care you receive, such as PPO and POS plans, usually cost you less, but you must give up
some freedom of choice.
Learn more about HMO, PPO, and POS managed health care insurance policies we offer
throughout South Carolina by clicking on a link below or click on the link for information on Major
Medical health insurance.
Click on the link below to fill out a secure quote request form for a South Carolina health
insurance policy that provides excellent health insurance coverage and services at an affordable
cost. Or you can speak with one of our South Carolina Health Insurance agent specialists toll
free at (800) 849-7475 to discuss the insurance policy features in more detail.
We are a Columbia, SC insurance agency offering low cost South Carolina health
insurance policy coverage in the following towns, cities and counties in South
Carolina: Chapin, Arthurtown, Saluda Terrace, Sandwood, Arcadia Lakes, Cayce,
Olympia, Forest Acres, Dentsville, Eau Claire, West Columbia, Springdale, Denny
Terrace, Belmont, St. Andrews, Irmo, Oak Grove, Lexington, Galaxy, Bluff Estates,
Hazelwood Acres, State Park, Haskell Heights, Lincolnshire, Ballentine, Killian,
Red Bank, South Congaree, Edmund, Gilbert, Summit, Gaston, Hopkins, Capitol
View, Horrel Hill, Fort Jackson, Pontiac, Elgin, Blythewood, Camden, Richtex,
Whitehall, White Rock, Sumter, Lugoff, Boykin, Rembert, Hagood, Horatio,
Stateburg, Borden, Wedgefield, Oswego, Gadsden, Fort Motte, St. Matthews,
Swansea, Woodford, Winnsboro, Pelion, Steedman, Samaria, Monetta,
Batesburg-Leesville, Stoney Hill, Prosperity, Newberry, Peak, Little Mountain,
Slighs, Pomaria, Jenkinsville, Rion, Winnsboro Mills, Simpson, Smallwood,
Ridgeway, Orangeburg, Lexington County, Fairfield County, Calhoun County,
Sumter County, Kershaw County, Saluda County, and Richland County, SC. We
can also offer cheap South Carolina health insurance coverage premiums
throughout the Palmetto state, including in Florence, Greenville, Spartanburg,
Myrtle Beach, and Charleston, SC.

* Preventive care emphasis
* Primary care physician (PCP) coordinates your total care
* Must get a referral from your PCP to visit a specialist
* Fixed monthly fee
HMO Health Insurance Policy Overview - South Carolina
Subscribers to an HMO receive medical services from participating physicians,
clinics and hospitals. You choose a primary care physician (PCP) from a list of
participating doctors from where you live in South Carolina. That doctor is used for
typical circumstances such as annual exams and usual health issues. If you need
to see a specialist, be hospitalized, or have lab or X-ray work, your doctor will refer
you to a provider or facility within the HMO system. Your doctor must give
authorization for those services to be covered by your HMO. In other words, you
must see HMO approved physicians and use HMO approved facilities or pay the
entire cost of the visit yourself.

Similar to Point-of Service (POS) and PPO's, HMO's have made arrangements for
lower fees with a network of health care providers and give their policyholders a
financial incentive to stay within that network.

You may have to pay some portion of the cost (co-payment) for each office or
hospital visit, such as $20 - $30 per doctor visit, regardless of what the services
cost. Also, some services such as emergency room, mental health and chemical
dependency services, may carry additional costs in a South Carolina HMO health
maintenance plan.
Click on the link below to fill out a secure quote request form for a South Carolina
HMO health insurance policy that provides excellent health insurance coverage and
services at a cheaper cost. Or you can speak with one of our South Carolina Health
Insurance agent specialists toll free at (800) 849-7475 to discuss the policy features.
* Convenient access to quality health care
* Large and diverse network available of primary care physicians,
specialists, hospitals & clinics.
* Pay for services as they are provided
PPO Health Insurance Policy Overview - South Carolina
You can see any health care professional in the network any time you choose to
make an appointment. You don't need referrals for specialists or other services as
you do in an HMO. You can see doctors or specialists outside your PPO network,
however, your portion of the costs will be higher.

You may have to pay some portion of the cost (co-payment) for each office or
hospital visit, such as $20 - $30 per doctor visit, regardless of what the services
cost. Also, some services such as emergency room, mental health and chemical
dependency services, may carry additional costs in a South Carolina PPO health
insurance policy plan.
Click on the link below to fill out a secure quote request form for a South Carolina
family or individual PPO health insurance policy that provides excellent health
insurance coverage and services at an affordable cost. Or you can speak with one
of our South Carolina Health Insurance agent specialists toll free at (800) 849-7475
to discuss the insurance features in more detail.
* Preventive care emphasis
* Pays benefits for out-of-network care, but at a lower level
POS Health Insurance Policy Overview - South Carolina
Less restrictive than an HMO or PPO, a (POS) or Point of Service plan lets you
see any licensed health care professional for anything covered by the insurance.
Care you receive from out-of-plan health care professionals is reimbursed, but
you must pay an often times much higher co-payment or deductible amount.
While you may choose to see a physician outside the network, if you don't receive
permission from your (PCP) primary care physician, you're likely to end up
submitting the bills yourself and receiving only a small reimbursement...if any.

Costs that exceed your deductible are covered by a co-insurance plan in which
you and the insurance company share the cost for services covered by the policy.

Also, some services such as emergency room, mental health and chemical
dependency services, may carry additional costs in a South Carolina POS health
insurance plan.
Click on the link below to fill out a secure quote request form for a South Carolina
family or individual POS health insurance policy that provides excellent health
insurance coverage and services at an affordable cost. Or you can speak with one
of our South Carolina Health Insurance agent specialists toll free at (800) 849-7475
to discuss the insurance policy features in more detail.
Major medical health insurance provides benefits up to a high limit for most types
of medical expenses incurred, subject to a deductible. Once you meet the
deductible, our South Carolina Major Medical Insurance plans pay a percentage of
what is considered the "Usual and Customary" charge for covered services. The
insurance company generally pays 80% of the Usual and Customary costs and
you pay the other 20%, which is known as co-insurance. If the insurance company
charges more than the Usual and Customary rates, you will need to pay both the
co-insurance and the difference.
With South Carolina Major Medical Insurance plans you can choose your doctor and
any hospital for your medical services. You or your doctor send the bill to the
insurance company, which pays part of it. Usually, you have a deductible such as
$250 or more to pay each year before the insurer starts paying. The plan will pay for
charges such as medical tests and prescriptions as well as from doctors and
hospitals.
Major medical insurance coverages offer more choice of doctors (including
specialists, such as cardiologists and surgeons), hospitals, and other health care
providers than managed care plans, such as HMO, PPO, and POS. South Carolina
Major Medical Insurance may not pay for some preventive care, such as check-ups,
and is usually a more expensive health insurance coverage than utilizing a South
Carolina HMO, PPO, or POS plan.
Click on the link below to fill out a secure quote request form for a South Carolina
family or individual Fee-for-Service / Major Medical health insurance policy that
provides excellent health insurance coverage and services at an affordable cost. Or
you can speak with one of our South Carolina Health Insurance agent specialists toll
free at (800) 849-7475 to discuss the health insurance policy features.
Learn more about the other types of South Carolina Individual or Family Health
Insurance polices we offer by clicking on a link below!
Learn more about the other types of South Carolina Individual or Family Health
Insurance polices we offer by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
Learn more about the other types of South Carolina Individual or Family Health
Insurance polices we offer by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
Learn more about the other types of South Carolina Individual or Family Health
Insurance polices we offer by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
Managed Health Care Plans:
**The information, pictures, and other content in this website about particular insurance
services is only provided for informational purposes. Any decisions regarding your
insurance needs should be discussed with a licensed insurance agent.
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Russell-Massey
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General Insurance
South Carolina Health Insurance Solutions!
800-849-7475 toll free
803-779-7854
Serving South Carolina Since 1955
Russell-Massey & Co.
1320 Elmwood Avenue
Columbia, SC 29201
Richland County, SC
Toll Free: (800) 849-7475
Office: (803) 779-7854
Fax: (803) 799-6546
Russell-Massey & Co.
409 Lexington Avenue
Chapin, SC 29036
Lexington County, SC
Office: (803) 941-3650
Fax: (803) 941-3654
National Healthcare Overview
Enrollment began October 1, 2013 and coverage began January 1, 2014
Essential Health Benefits
The Affordable Care Act passed in 2010 requires individual health insurance plans beginning on
January 1, 2014 to offer essential health benefits services. Below is the list of minimum services
required under all health insurance plans.
1. hospitalization
2. maternity and newborn care
3. ambulatory patient services
4. emergency services
5. mental health and substance use disorder services, including behavioral health treatment
6. prescription drugs
7. rehabilitative and habilitative services and devices
8. laboratory services
9. preventive and wellness services and chronic disease management
10.pediatric services, including oral and vision care
Health Marketplace Insurance Plans
You can choose the plan that is right for your budget and needs. All plans offer the 10 essential
health services mentioned above. The cost of each plan will be different whether your state has set
up its own Health Marketplace or uses the National Health Marketplace. Speak with your health
insurance agent for specific costs and enrollment information.
Bronze Plan
Silver Plan
Gold Plan
Platinum Plan
The Bronze Plan has the lowest premium, but you'll pay a higher share of costs when you get care.
On the other end of the cost spectrum, the Platinum Plan will have the highest monthly premiums
and the lowest out-of-pocket costs when care is needed.
Marketplace Health Plans Pricing
All insurance plans available through the Marketplace will be offered by private insurance companies.
Marketplace pricing will show any cost savings you may be eligible for based on your income.
Pre-existing Conditions
An insurance company can't turn you down or charge you more because of your health condition.
It can't refuse to cover treatment for pre-existing conditions.
The only exception is for grandfathered individual health insurance plans--the kind you buy yourself,
not through an employer. If you have one of these plans you can switch to a Marketplace plan during
open enrollment and get coverage for your pre-existing condition.
The Marketplace will also tell you if you qualify for free or low-cost coverage available through
Medicaid or the Children's Health Insurance Program (CHIP).
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Richland County & Lexington County, SC