Health Insurance for Early Retirees in South Carolina (Ages 55 to 64)

Bridging to Medicare in South Carolina

If you retire in South Carolina before 65, a Marketplace plan is the most common bridge to Medicare. Tax credits are based on your expected household income for the year, so the way you draw on savings, pensions or retirement accounts can change your cost.

Since the enhanced credits ended after 2025, the cutoff at 400% of the poverty level is back. Going even slightly over it can mean paying full price, and the 2026 benchmark premium for a 40-year-old averaged $564 a month before subsidies, with older buyers paying more.

Do not plan on Medicaid as a fallback. South Carolina has not expanded Medicaid, and early retirees without children generally qualify only if they are disabled or meet another specific category.

Why your income estimate matters so much

Marketplace subsidies are based on your modified adjusted gross income (MAGI) for the coverage year. For early retirees, that number is partly in your control: it depends on which accounts you draw from and when.

Withdrawals from traditional IRAs and 401(k)s count as income. Qualified Roth withdrawals generally don’t. For ACA purposes, MAGI also adds back tax-exempt interest and any Social Security benefits that aren’t taxed. A tax professional and a licensed agent working from the same income plan can make a large difference to what you pay.

Subsidies in 2026

The enhanced federal premium tax credits ended on December 31, 2025. The House passed a three-year extension in January 2026, but the original rules apply for 2026, so households earning more than 400% of the federal poverty level no longer get any premium tax credit and others pay a larger share of income. Even so, more than 89% of South Carolina Marketplace enrollees qualified for help in 2026, and the average subsidized enrollee paid about $76 a month.