South Carolina health insurance questions, answered.
Answers from licensed agents about buying your own coverage in South Carolina, organized by topic.
Getting started
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Open enrollment for 2027 runs from November 1, 2026 to January 15, 2027. To have coverage start January 1, pick a plan by December 15. Outside that window, you need a qualifying life event such as losing other coverage.
No. South Carolina has not adopted the ACA Medicaid expansion. Most working-age adults without children do not qualify for Medicaid unless they are disabled, pregnant or fit another specific group, and parents qualify only with income at or below 62% of the poverty level.
Yes, if your household income is between 100% and 400% of the poverty level. The enhanced credits that removed the 400% limit ended after 2025. In 2026, more than 89% of South Carolina enrollees still got help, averaging $579 a month in savings.
Leaving a job
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Possibly. South Carolina law lets employees on fully insured group plans who were covered for at least six months continue for the rest of that month plus six more months. You pay the full group premium, and it does not apply if you are eligible for Medicare or similar group coverage.
It depends on your income and health needs. COBRA keeps your same plan and doctors, but you pay the full premium plus a fee. Losing job coverage gives you 60 days to choose a Marketplace plan, and tax credits based on your new income may make it cheaper.
Only if you fit a category. Without Medicaid expansion, adults without children usually need to be disabled, pregnant or in another specific group. About 63,000 adults in South Carolina are in the coverage gap, earning too little for tax credits but not qualifying for Medicaid.
Early retirement
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Costs depend on age, location and income. KFF puts the 2026 average benchmark Silver premium for a 40-year-old at $564 a month before subsidies, and older buyers pay more. If your income stays under 400% of the poverty level, tax credits can reduce that a lot.
Tax credits are based on your expected household income for the year, so taxable withdrawals can raise your income and lower your credit. Going over 400% of the poverty level means losing the credit entirely for 2026. A licensed agent can help you estimate where you will land.
Self-employed
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No. South Carolina does not have its own coverage mandate, and there is no federal penalty either. Going without coverage still leaves you exposed to large medical bills.
Use your best estimate of net self-employment income for the year. If your income changes, update your Marketplace application so your monthly credit is adjusted. Any difference is settled when you file your taxes.
No. South Carolina buyers rely on federal tax credits and cost-sharing reductions. About 30% of enrollees used cost-sharing reductions in 2026, which lower deductibles and copays on Silver plans for people with lower incomes.
Short-term plans
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South Carolina allows initial terms of up to 11 months and up to 33 months in total with renewals. Insurers can set shorter limits and do not have to offer renewals. As of early 2026, some sold plans lasting the full 33 months.
Not actively. In August 2025, federal agencies said they would not prioritize enforcing the 2024 rule that limits short-term plans to four months, and they plan new rules. That is why longer plans are again sold in South Carolina.
Usually not. Short-term plans can ask health questions, turn you down, and exclude conditions you already have. If you have ongoing health needs, a Marketplace plan is generally the safer choice.
Non-ACA options
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No. Sharing ministries are faith-based groups whose members share medical costs, but they are not insurance. They do not have to follow ACA rules, and there is no guarantee your bills will be paid.
Short-term plans and sharing ministries often cost less, but they cover less and can exclude health conditions. Before you choose one, check whether you qualify for tax credits, because in 2026 about 30% of South Carolina Marketplace enrollees paid less than $10 a month.
Insurers
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For 2026, six insurers sell Marketplace plans: BlueCross BlueShield of South Carolina (through BlueChoice HealthPlan), Ambetter from Absolute Total Care, Molina, Select Health, UnitedHealthcare and InStil Health. All six filed rates for 2027. Coverage areas vary by insurer, so the choices depend on your county.
Insurers proposed an average increase of about 16.6% before subsidies for 2027, after an average rise of about 21% for 2026. Proposed increases range from about 10.7% (Select Health) to 45.5% (UnitedHealthcare). If you get tax credits, your own change depends on how the benchmark plan in your area moves.
BlueChoice HealthPlan, part of BlueCross BlueShield of South Carolina, had about 314,000 individual market enrollees heading into 2026. Ambetter from Absolute Total Care was next with about 205,000.
Sources
Reviewed October 2026. Rules and prices change every year; a licensed agent will confirm what applies to you.
- HealthCare.gov: Dates and deadlines for 2027 health insurance
- healthinsurance.org: South Carolina ACA marketplace guide (updated August 24, 2026)
- KFF: What we know so far about 2026 ACA marketplace enrollment, premiums and deductibles
- SCDHHS: Program eligibility and income limits
- KFF State Health Facts: Poor uninsured adults in the ACA coverage gap
- South Carolina Code of Laws, Title 38 Chapter 71 (Section 38-71-770 continuation privilege)
- U.S. Department of Labor: COBRA continuation coverage
- HealthCare.gov: Special Enrollment Period
- U.S. Department of Labor: Statement on short-term, limited-duration insurance (August 7, 2025)
- healthinsurance.org: Short-term health insurance in South Carolina
- Georgetown CHIR: What do you know about health care sharing ministries?
- ACA Signups: South Carolina 2026 rate changes
- KFF State Health Facts: Marketplace average benchmark premiums
See what you'd actually pay.
A licensed agent will compare plans from every insurer in your South Carolina county, check your subsidy, and walk you through the options. No cost, no obligation.