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South Carolina Health Insurance Consumer Guide
This guide was developed to assist you in choosing the right health insurance plan for you and your family. The coverage options found in South Carolina’s ACA Marketplace may be a good choice for you, and we’re here to help guide you through the coverage options.
South Carolina uses the federally run health insurance exchange HealthCare.gov for residents to purchase ACA Marketplace plans. The Marketplace provides access to health insurance products from private insurers. The federal government helps pay for insurance through an advance premium tax credit if you buy coverage from the exchange.
Depending on your income and other circumstances, you may also get help to lower your monthly insurance premium (the amount you pay to enroll in the coverage) and possibly your out-of-pocket expenses.
Explore our other comprehensive guides to coverage in South Carolina
Dental coverage in South Carolina
Looking to improve your smile? Dental insurance may be a smart addition to your health coverage. Our guide explores dental coverage options in South Carolina.
South Carolina’s Medicaid program
Although South Carolina still has not accepted federal funding to expand Medicaid eligibility under the ACA, the state did increase the income limits for low-income parents to qualify for coverage. South Carolina’s total Medicaid enrollment has grown to more than 1 million people as of 2023.1
Medicare coverage and enrollment in South Carolina
As of September 2022, there were 1,159,851 people enrolled in Medicare in South Carolina.2 Our guide will help you confidently understand Medicare Parts A, B, C and D plans — as well as Medicare supplement (Medigap) plans available in the South Carolina.
Short-term coverage in South Carolina
South Carolina has its own state regulations regarding short-term health insurance policies. Short-term health insurance in South Carolina can’t last more than 11 months, with a total duration of 33 months (including renewals).3 As of 2023, there were at least five insurers selling short-term health insurance plans in South Carolina.
Frequently asked questions about health insurance in South Carolina
Who can buy Marketplace health insurance?
To qualify for health coverage through the South Carolina Marketplace, you must:4
- Live in South Carolina
- Be lawfully present in the United States
- Not be incarcerated
- Not be enrolled in Medicare
Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. In addition, to qualify for financial assistance with your Marketplace plan you must:
- Not have access to affordable health coverage through your employer. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.
- Not be eligible for Medicaid or CHIP.
When can I enroll in an ACA-compliant plan in South Carolina?
The open enrollment period for individual/family health coverage runs from November 1 to January 15 in South Carolina.5
If you need your coverage to start on January 1, you must apply by December 15. If you apply between December 16 and January 15, your coverage will begin on February 1.4
Outside of open enrollment, a qualifying event is necessary to enroll or make changes to your coverage. If you have questions about open enrollment, you can learn more in our comprehensive guide to open enrollment. We also have a comprehensive guide to special enrollment periods.
How do I enroll in a South Carolina Marketplace plan?
To enroll in an ACA Marketplace plan in South Carolina, you can:
- Visit Healthcare.gov to access South Carolina’s health insurance marketplace. Here you will find an online platform to shop, compare, and choose the best health plans.
- Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity.6
How can I find affordable health insurance in South Carolina?
South Carolina uses the federally run exchange for individual market plans, so residents who buy their own health insurance enroll through HealthCare.gov.
In the South Carolina Marketplace, about nine out of ten eligible enrollees save money on premium payments amounting to an average savings of $566/month. After subsidies were applied, the average enrollee’s monthly cost was about $60/month.7
The Affordable Care Act provides income-based advance premium tax credits (subsidies) that offset your premium payments to help keep your expenses down. People with household incomes below 250%of the federal poverty level also qualify for cost-sharing reductions (CSR) that may reduce your deductibles and out-of-pocket expenses when you buy a Silver plan. Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan is the cheapest health insurance option for you.
Source: CMS.gov8
How many insurers offer Marketplace coverage in South Carolina?
There are five insurers offering health plans through the South Carolina exchange for 2023 coverage.9
- Ambetter/Absolute Total Care
- Blue Cross Blue Shield of South Carolina
- Cigna (new for 2023)
- Molina
- Select Health (new for 2023)
In most of South Carolina’s counties, at least one insurer is offering health plans for coverage in 2023.10
Are Marketplace health insurance premiums increasing in South Carolina?
Most insurance companies in South Carolina’s individual market are considering raising average rates for the year 2024:9
South Carolina’s ACA Marketplace Plan 2024 Proposed Rate Increases by Insurance Company |
|
|---|---|
| Issuer | Percent Increase |
| Blue Cross Blue Shield of SC | 6.01% |
| Ambetter/Absolute Total Care | 1.48% |
| Molina | 6.37% |
| Cigna | 10.53% |
| Select Health | -4.60% |
Source: HealthCare.gov9
How many people are insured through South Carolina’s Marketplace?
In the South Carolina marketplace, 382,968 people enrolled in private plans for the 2023 coverage period.11 This was by far a record high for the state, and was an increase of 27% over 2022’s enrollment.
The surge in enrollment during these years happened was due in part to the American Rescue Plan (ARP) which made ACA’s premium subsidies more substantial. Under the ARP – now extended by the Inflation Reduction Act – subsidies are more significant and accessible through the end of 2025.12
Source: 2014,13 2015,14 2016,15 2017,16 2018,17 2019,18 2020,19 2021,20 2022,21 2023,12 202422
What health insurance resources are available to South Carolina residents?
HealthCare.gov
800-318-2596
State Exchange Profile: South Carolina
The Henry J. Kaiser Family Foundation overview of South Carolina’s progress toward creating a state health insurance exchange.
South Carolina Primary Health Care Association (Navigator organization)
South Carolina Consumer Assistance Program
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
(800) 768-3467 / [email protected]
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
Footnotes
- “April 2023 Medicaid & CHIP Enrollment Data Highlights” Medicaid.gov, April 28, 2023 ⤶
- “Medicare Monthly Enrollment ” CMA.gov, Accessed August 2023 ⤶
- “Availability of short-term health insurance in South Carolina” healthinsurance.org, Jan. 7, 2023 ⤶
- “A quick guide to the Health Insurance Marketplace®” HealthCare.gov, Accessed August, 2023 ⤶ ⤶
- “When can you get health insurance?” HealthCare.gov, 2023 ⤶
- “Entities Approved to Use Enhanced Direct Enrollment” CMS.gov, April 28, 2023 ⤶
- “2023 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2023 ⤶
- “2024 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2024 ⤶
- “South Carolina Rate Review Submissions” HealthCare.gov, 2023 ⤶ ⤶ ⤶
- “2023 Qualified Health Plans” CMS.gov, Oct. 26. 2022 ⤶
- “Marketplace 2023 Open Enrollment Period Report: Final National Snapshot” CMS.gov, January 2023 ⤶
- “Health Insurance Marketplaces 2023 Open Enrollment Report” CMS.gov, 2023 ⤶ ⤶
- “ASPE Issue Brief (2014)” ASPE, 2015 ⤶
- “Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report”, HHS.gov, 2015 ⤶
- “HEALTH INSURANCE MARKETPLACES 2016 OPEN ENROLLMENT PERIOD: FINAL ENROLLMENT REPORT” HHS.gov, 2016 ⤶
- “2017 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2017 ⤶
- “2018 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2018 ⤶
- “2019 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2019 ⤶
- “2020 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2020 ⤶
- “2021 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2021 ⤶
- “2022 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2022 ⤶
- “HEALTH INSURANCE MARKETPLACES 2024 OPEN ENROLLMENT REPORT” CMS.gov, 2024 ⤶
