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South Carolina Health Insurance

Published: April 2nd, 2020

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Health insurance cost in the Palmetto State has decreased for 2020. If you have a qualifying life event, you can still get an affordable ACA plan.

South Carolina and the Affordable Care Act (ACA)

Since the ACA (also called Obamacare) was implemented in 2013, South Carolina’s uninsured rate has declined nearly every year. The number of uninsured residents dropped from 15% in 2013 to 10% by 2017. This decrease resulted in more than 253,000 residents with health insurance. The uninsured rate rose to 11% in 2017 but fell back down to 10% as of 2018.1

South Carolina’s growth in insured residents occurred although the state did not expand its Medicaid program. Under the ACA, states can expand Medicaid to childless adults who earn up to 138% of the federal poverty level (FPL). As of October 2019, South Carolina has 124,000 uninsured residents who would otherwise qualify it had implemented Medicaid.2

South Carolina Health Insurance Marketplace 

South Carolinians enroll in Obamacare health insurance through the federal Marketplace at Healthcare.gov. About 214,000 residents bought a Marketplace plan during the 2020 open enrollment period (OEP),3 which ended on December 18, 2019.4 Normally, the OEP ends on December 15 each year.

But if you have a qualifying life event, such as marriage or birth of a child, you can buy a plan outside of the OEP. The next open enrollment for plans effective January 1, 2021, starts on November 1, 2020.

Health Insurance Companies in South Carolina

For the 2020 plan year, four South Carolina health insurance companies offer plans on the exchange:

  1. BlueCross Blue Shield of SC (only insurer selling statewide)
  2. Absolute Total Care
  3. Molina Healthcare (new carrier for 2020)
  4. Bright Health (new carrier for 2020)

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How Much Does South Carolina Health Insurance Cost?

Obamacare plans come in bronze, silver, gold, and platinum. The metal levels indicate how much covered costs insurers pay (bronze the least, platinum the most). For 2020, no South Carolina health insurance carrier offers platinum plans, which have the highest monthly premiums.5 Premiums for bronze ones usually cost the least.

  • The average lowest-cost bronze premium for 2020 is $351 per month, down from $373 for 2019.
  • The average lowest-cost silver premium for 2020 is $496 per month, down from $550 for 2019.
  • The average lowest-cost gold premium for 2020 is $529 per month, down from $560 for 2019.

Can I Get Obamacare Subsidies in South Carolina?

The majority of South Carolinians (93%) who enrolled in 2020 Marketplace coverage received subsidies from the federal government.6 Subsidies, or premium tax credits, are based on your income and household size. You typically qualify if your income in 2020 is between $12,760 and $51,040, which is 100% to 400% of the federal poverty level (FPL).

Here are some examples of how much you could save with subsidies:

  • A family of three in Columbia, S.C., earning $45,000 a year, could get a 2020 silver plan for $367 per month with subsidies or $1,256 without — a savings of $889. 

What If My Income is Very Low: Can I Get Cheaper Coverage?

Yes. Depending on your income, you could qualify for an Obamacare bronze plan for as low as $0 per month. Other low-cost options include Medicaid and the Children’s Health Insurance Program.

South Carolina’s Medicaid Program for Low-Income Adults and Children

Medicaid is a public health insurance program funded by the state and federal government. Low-income South Carolinians have access to Medicaid through Healthy Connections, which includes a children’s health insurance program called Partners for Healthy Children. About 930,000 of South Carolina’s 4.9 million residents have Medicaid. This group consists of 3 in 7 children and 1 in 8 adults under 65.7

Nearly a quarter of enrollees are seniors and people with disabilities. The rest are children under 19 and abled-bodied adults under 65. This group doesn’t include childless adults under 65 who would qualify if South Carolina expanded its Medicaid program.8

Other residents who qualify for Medicaid in South Carolina include parents of minor children and pregnant women. Each group that qualifies must meet certain income levels. For example, seniors and people with disabilities qualify with incomes up to 100% of the FPL ($12,760 for a single person).9

Medicare for People 65 and Older and Younger Adults Under 65 With Disabilities

About 83% of South Carolina’s Medicare beneficiaries qualify when they turn 65. Others who qualify are younger adults with disabilities.10

South Carolina has more than 1 million Medicare beneficiaries. Nearly 3 in 4 beneficiaries are enrolled in the federal government’s Original Medicare program, which includes Part A hospital and Part B medical insurance. The rest get these benefits through private Medicare Advantage plans.11 These plans also offer extra benefits, such as Part D prescription drug coverage. Because Original doesn’t cover most prescription drugs, you can buy a separate Part D drug plan from a private insurer. More than 480,000 South Carolina beneficiaries have a separate Part D plan.12

Private companies also offer Medicare Supplement plans in South Carolina. You must get Part A and B through Original Medicare to enroll in Medicare Supplement, also called Medigap. South Carolina health insurance companies offer 10 standard Medigap plans to help pay some to all of your out-of-pocket costs, including coinsurance, copays, and deductibles.

Can I Get Temporary Health Insurance in South Carolina?

Temporary health insurance, also known as short-term health insurance, is available  in South Carolina. These plans provide limited coverage for a set amount of time. In South Carolina, you can get short-term coverage for 30 days up to 11 months.13

Short-term health plans help fill a temporary gap in coverage. Examples include waiting for coverage to start at a new job or aging off of your parents’ health plan when you turn 26.

Keep in mind that short-term health insurance isn’t the same as qualified health coverage under the Affordable Care Act (ACA). Short-term plans aren’t required to include essential health benefits or offer coverage regardless of health status or pre-existing conditions.

Want to learn more about health insurance in South Carolina? Check out this guide about South Carolina Health Insurance Marketplace.

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Article Sources
  1. Kaiser Family Foundation. “Health Coverage of the Total Population.” KFF.org (accessed January 16, 2020).

  2. Kaiser Family Foundation. “Medicaid in South Carolina.” KFF.org (accessed January 15, 2020).

  3. Centers for Medicare & Medicaid & Services. “2020 Federal Health Insurance Exchange Enrollment Period Final Weekly Enrollment Snapshot.” cms.gov (accessed January 15, 2020).

  4. Centers for Medicare & Medicaid & Services. “Federal Health Insurance Exchange Weekly Enrollment Snapshot: Week 7.” cms.gov (accessed January 15, 2020).

  5. South Carolina Department of Insurance. “2020 QHPS Available In The Health Insurance Marketplace Monthly Premiums for Individual Market Coverage.” doi.sc.gov (accessed January 15, 2020).

  6. Kaiser Family Foundation. “Marketplace Effectuated Enrollment and Financial Assistance.” KFF.org (accessed January 16, 2020).

  7. Kaiser Family Foundation. “Medicaid in South Carolina.” KFF.org (accessed January 15, 2020).

  8. Kaiser Family Foundation. “Medicaid in South Carolina.” KFF.org (accessed January 15, 2020).

  9. Kaiser Family Foundation. “Medicaid in South Carolina.” KFF.org (accessed January 15, 2020).

  10. Kaiser Family Foundation. “Distribution of Medicare Beneficiaries by Eligibility Category.” KFF.org (accessed January 16, 2020).

  11. Kaiser Family Foundation. “Total Number of Medicare Beneficiaries.” KFF.org (accessed January 16, 2020).

  12. Kaiser Family Foundation. “Medicare Prescription Drug Plans: Stand Alone PDP Enrollment.” KFF.org (accessed January 16, 2020).

  13. BlueChoice HealthPlan South Carolina. “Stay Covered. Short-Term Choice Health Coverage.” bluechoicesc.com (accessed January 16, 2020).