Your Affordable Options for Health Insurance in South Carolina

By: Shawnda
Updated: October 31, 2022
affordable healthcare plans south carolina

Residents of South Carolina have access to a choice of insurance options. You have choices, including purchasing health insurance via work, shopping in the marketplace, or being eligible for government insurance programs. To learn how to find affordable health insurance in South Carolina, read this guide.

What state residents should know about health insurance in South Carolina?

Market strategies: You can purchase health insurance in South Carolina directly from insurance providers or through the Health Insurance Marketplace at HealthCare.gov. Plans purchased through the Health Insurance Marketplace have guaranteed protections and minimum coverage requirements.

Open enrollment for North Carolina health insurance plans in 2022 is available from November 1, 2021, through January 15, 2022. If you don’t sign up during this period, you can only sign up if a qualifying event occurs, such as pregnancy, marriage, job loss, or move.

Companies offering plans on the Healthcare.gov exchange for South Carolina include several organizations. Some of these plans only apply to select areas of the state, while others apply to the entire state. You can also check Highmark Insurance reviews to find the right plan for you.

Off-exchange health insurance plans: An off-exchange plan complies with the Affordable Care Act (ACA) requirements but cannot be acquired through HealthCare.gov. The BlueChoice Health Plan is the only one of these plans available in South Carolina. Insurance companies provide six other health plans but might not follow ACA regulations.

There are various options for South Carolinians to obtain health insurance. Employers are the most common route (45.4%). The following two are Medicare (16.8%) and Medicaid (18.8%). The final two groupings are the military (2.2%) and nongroup insurance (6.1%). Currently, 10.8% of South Carolina’s citizens lack health insurance.

How can I sign up for the South Carolina health insurance exchange?

Use HealthCare.gov to sign up for an ACA-compliant health plan in South Carolina. You must provide personal information during registration, including your Social Security number, address, and income. Additionally, if you want to register any family members, you will need to provide this information. After registering to receive affordable health insurance quotes, you can compare up to three plans’ premiums, copays, coinsurance, and health insurance deductibles. Finding a plan that is suitable for you or your family will be simpler as a result. The South Carolina Health Insurance Marketplace offers four different plans. In the whole state, just one of the plans is offered. Some regions of South Carolina provide other plans. These strategies are:

  • Complete Care
  • South Carolina’s Blue Cross and Blue Shield (available in all counties)
  • Bright Health of South Carolina, Inc.
  • Healthcare Molina of South Carolina
  • One ACA-compliant plan is offered off-exchange and is available:
  • Plan BlueChoice Health

The Health Insurance Marketplace has options that small businesses can choose from. The Small Business Health Insurance Plans allows employers with between one and 50 employees to purchase health insurance (SHOP). You may be qualified for premium tax credits that lower your premiums if you choose certain ACA plans and your family’s income is between 100% and 400% of the Federal Poverty Level (FPL). Selecting a silver plan also makes you eligible for cost-sharing reductions (CSR).

How can I sign up for individual and family health insurance in South Carolina?

In South Carolina, you can acquire insurance for you or your family through the marketplace or an insurance provider. You must ask yourself crucial questions while selecting insurance for your family or yourself, including:

  • How well-off am I?
  • How wholesome is my family?
  • How much of a monthly premium can I manage to pay?
  • Can I get any subsidies through the ACA marketplace with my income?
  • How much out-of-pocket expenses am I able to afford?

South Carolina residents’ insurance

If you choose a plan for yourself, you’ll have more options. Choosing a low monthly premium and a higher deductible plan is a good idea if you’re in good health. To reduce out-of-pocket expenditures, choose a plan with a higher monthly premium and lower deductible if you have a chronic sickness or condition:

  • Choosing a health maintenance organization (HMO) plan is the best option if you’re in good health. This plan is for you if you want to incur fewer out-of-pocket expenses. But with an HMO plan, your options will be limited. You must select a primary care physician, are restricted to using the insurance company’s in-network medical experts, and need a referral to see a specialist.
  • A preferred provider organization (PPO) plan is a far better option if you have a chronic disease. A PPO offers lower deductibles but a higher monthly cost. Additionally, you’ll be more adaptable. You can seek medical care outside of your insurance’s network, you won’t need a primary care physician, and you can see specialists without a referral.
  • A point-of-service (POS) plan provides an alternative to both PPO and HMO coverage. You are not restricted to using in-network healthcare professionals, but you will still need a referral to see a specialist.

Health Insurance in South Carolina for families

When choosing family health insurance coverage instead of just yourself, the answers to the above concerns become a little more difficult to understand. Although you may be in good health, your spouse may have a chronic illness, and your child may have allergies or asthma. The right plan selection becomes more of a balancing act. You can be qualified for a subsidy and cost-sharing reduction (CSR) plan if you choose an ACA-compliant plan from the marketplace. All ACA-compliant health plans marketed in the United States must include essential health care, cover all pre-existing conditions, and not charge you more if you have one. This is true even if you choose insurance directly from an insurance provider.

How much does health insurance in South Carolina cost?

South Carolina’s Health Insurance Marketplace offers plans in four tiers: Bronze, Silver, Gold, and Platinum. The quality of care is unrelated to the various degrees. Instead, the levels represent the variations in your monthly premium and out-of-pocket costs. The cost of these health insurance policies has reduced overall in South Carolina in 2022:

  • Bronze plans: Bronze plans have large deductibles but modest monthly rates. Additionally, you must pay a 40% coinsurance fee each time you receive medical care. If you don’t have numerous medical demands, a Bronze plan is suitable—the $328 monthly cost for South Carolina’s least expensive Bronze insurance plan.
  • Silver plans: Silver plans cost more than Bronze plans, but their deductibles are lower. At just 30%, the coinsurance cost is also smaller. The largest potential benefits, including lower cost-sharing, are provided by silver plans. South Carolina’s cheapest Silver plan is $438 per month before savings.
  • Gold and Platinum plans: A Gold or Platinum plan can be your best option if you or a family member needs frequent medical attention due to chronic health issues. Under these policies, only 20% for gold and 10% for platinum, respectively, are required as deductibles and coinsurance payments. These plans come with a significantly higher monthly premium. The least expensive Gold plan in South Carolina is $583 per month.

Medicaid

In South Carolina, there are 1,126,621 Medicaid beneficiaries as of January 2021. Medicaid’s annual income threshold in South Carolina is $12,880 for an individual and $21,960 for a household of three. A $4,540 per person increase is allowed if your home has more than eight persons. Resources (assets) for a single person cannot exceed $2,000; for a couple, they cannot exceed $4,000. Medicaid may also be available to you:

  • If your youngster is under 18 years old,
  • If you are a youngster under the age of 18,
  • If you have been given a breast or cervical cancer diagnosis,
  • Should you be blind
  • If you have a disability
  • If you require care in a nursing home
  • If you’re older than 65

On apply.scdhhs.gov, you can submit an online Medicaid application for South Carolina. Apply at your local county office or call Healthy Connections at (888) 549-0820 to get a paper application.

South Carolina CHIP

Children who qualify for CHIP in South Carolina are given free or inexpensive health insurance. Regular check-ups, dental care, vaccinations, and the treatment of illnesses or ailments are all covered. The CHIP income ceiling for families is 208% of the FPL.

What are Medicare choices available to seniors and individuals with disabilities in South Carolina?

You qualify for Medicare, the federal government’s health insurance program if you are at least 65 or handicapped.

The foundational Medicare program is called Original Medicare. Part A (hospital insurance) and Part B are included (medical insurance). There are no out-of-pocket maximums with Original Medicare. The price of prescription drugs is not covered. You must buy a Medicare Part D plan if you need prescription insurance.

Medicare Advantage is another name for Part C of Medicare. HMOs, PPOs, Private Fee-For-Service (PFFS) plans, and Special Needs Plans (SNPs) are the four main types of Medicare Advantage Plans. Each has a different premium, out-of-pocket expense, and level of medical coverage. Plans offer vision, dental, and hearing coverage, and some also include coverage for prescription medicines and gym memberships. In 2019, 59 Medicare Advantage Plans were accessible in South Carolina.

Consider a Medicare Supplemental Health Insurance plan (Medigap) if you are concerned about out-of-pocket expenses under Original Medicare. It includes copays and coinsurance as well as various deductibles. Long-term healthcare, dental treatment, and hearing services are not covered. Numerous Medicare Supplement Insurance options will cover you abroad. A Medicare Advantage Plan won’t function with these plans.

Eligibility

To become eligible for Medicare, you must be at least 65 years old or have a qualifying handicap. A qualifying disability is typically a condition that qualifies you for at least 24 months of benefits from the Railroad Retirement Board or the Social Security Disability Insurance program. If you have Lou Gehrig’s illness or end-stage renal failure, you might be able to qualify more quickly.

Enrollment

You will be enrolled in Medicare by default if you begin receiving Social Security or Railroad Retirement Board payments at least four months before turning 65. Otherwise, you must submit an online application or get in touch with your neighborhood Social Security office. Medicare enrollment is available during the following times:

  • Initial enrollment: You have a three-month window prior to turning 65 and a three-month window following that age to enroll. During this time, you can enroll if you have never had Medicare. You could alter your plan even if you enrolled in Medicare when you were younger.
  • General enrollment: Select this enrollment window if you missed the first one. January 1 through March 31 is the general enrollment period for Medicare. You can select Part D, Medigap, Medicare Advantage, or Original Medicare.
  • Medicare Advantage Open Enrollment: From January 1 to March 31, you can make changes to your Medicare Part C, generally known as Medicare Advantage.
  • Open enrollment: During open enrollment, which runs from October 15 to December 7, you can enroll, change plans, or cancel your coverage.
  • Special enrollment periods: An individual may be eligible for a special enrollment period if they experience a loss of coverage or change in eligibility outside of the open enrollment period.

Resources for Medicare

In South Carolina, you can speak with a certified counselor from the State Health Insurance Assistance Program (SHIP) one-on-one for free about your Medicare options. None of the volunteers are employed by a health organization and will never attempt to upsell you on a plan; their advice is free, objective, and confidential.

Are there options for temporary health insurance in South Carolina?

Short-term health insurance policies in South Carolina must adhere to special regulations that are not ACA compliant. In South Carolina, a short-term health insurance plan can only last for 11 months and cannot be extended for an additional 33 months. Plans that adhere to the ACA are annual. If you’ve lost your work, are changing jobs, or are waiting to enroll in an ACA-compliant plan, short-term health insurance policies may be able to help. You won’t receive the same level of protection from a short-term plan as you would from a big health insurance plan offered through the insurance company’s ACA-compliant plans or the marketplace.

FAQs

In South Carolina, is health insurance required?

Everyone must get health insurance in accordance with the ACA or face a tax penalty. In 2019, the Supreme Court overturned the tax penalty. One state that has made health insurance mandatory is not South Carolina.

Do I have to utilize South Carolina’s Health Insurance Marketplace?

In South Carolina, many insurance providers provide direct plans, including some offering short-term insurance. To utilize a subsidy or meet the requirements for cost-sharing, you must go through the marketplace. A plan on the Health Insurance Marketplace offers more benefits than short-term plans do.

What kinds of cost-sharing health insurance alternatives are offered in South Carolina?

Although most don’t have religious criteria to purchase a plan, faith-based cost-sharing health plans are the most common type in South Carolina. As they are not considered health insurance, these programs are not subject to state or federal regulation. In contrast to ACA-compliant plans, health shares are free to exclude coverage for pre-existing diseases and are not required to cover every aspect of medical care. Make sure the cost-sharing plan you are thinking about buying addresses your health issues.

Do I still need health insurance if I have an HSA/FSA?

Most of the time, yes. It’s improbable that you could save enough money to cover a major illness or accident by utilizing a health savings account (HSA) or flexible savings account (FSA) plan. These are appropriate plans if you wish to pay for copays, deductibles, or coinsurance but not for high medical costs.

If I have health insurance, do I still need short-term disability coverage in South Carolina?

Depending on your risk variables will determine whether you require short-term disability insurance. Short-term disability insurance is designed to cover living costs like groceries and utility payments when you cannot work. It’s not meant to cover expensive medical bills. A short-term disability plan is smart if your job has a high risk of accidents.

Do I still need long-term disability insurance if I have health insurance in South Carolina?

The purpose of long-term disability insurance is to address the same monetary concerns as short-term disability insurance but over a longer time frame. A long-term disability plan is excellent if you have significant risk factors, such as working a job where serious harm is possible.

What is covered by CHIP in South Carolina?

Children who qualify for CHIP in South Carolina are given free or inexpensive health insurance. Regular check-ups, dental care, vaccinations, and the treatment of illnesses or ailments are all covered.

Visit our website NewHealthInsurance.com to learn more.

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