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South Carolina residents can still gain coverage to health insurance, along with potential federal subsidies for it, through the Affordable Care Act. Open Enrollment for 2022 runs from November 1, 2021, through January 15, 2022. Enroll by December 15, 2021, for coverage that starts January 1, 2022.1
South Carolina Health Insurance Facts
- South Carolinians paid an average of $128 a month for an ACA plan after federal subsidies.
- 230,000 enrolled in an ACA plan in 2021.
- Five insurance companies offer health plans on the health insurance marketplace.
- 1.1 million enrolled in Original Medicare or Medicare Advanage in 2020.
South Carolina and the Affordable Care Act
Since the ACA (also called Obamacare) was implemented in 2013, South Carolina’s uninsured rate declined most years through 2019. The number of uninsured residents dropped from 15% in 2013 to almost 11% in 2019. The lowest percentage of the population was uninsured in 2016, just under 10%.2
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 had 124,000 uninsured residents who would otherwise have qualified had the state expanded Medicaid.3
South Carolina Health Insurance Marketplace
South Carolinians enroll in Obamacare health insurance through the federal Marketplace at Healthcare.gov. The 2022 Open Enrollment Period begins November 1, 2021, and ends on January 15, 2022.
More than 230,000 residents bought a Marketplace plan during the 2021 Open Enrollment Period (OEP),4 which ended on December 21, 2020.
As a rule, if you have a qualifying life event, such as marriage or birth of a child, you can buy a plan outside of the OEP.
Health Insurance Companies in South Carolina
For the 2022 plan year, five health insurance companies offer plans on and off the exchange for individuals and families in South Carolina, though not all offer coverage in all counties:
- Absolute Total Care
- BlueCross Blue Shield of South Carolina (only insurer that offers coverage in all counties)
- BlueChoice Health Plan (off exchange only)
- Bright Health Company of South Carolina
- Molina Healthcare of South Carolina
South Carolina and Medicare
About 84% of South Carolina’s Medicare beneficiaries qualify when they turn 65. Others who qualify are younger adults with disabilities.10
South Carolina has nearly 1.1 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. Nearly 482,000 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. Health insurance companies offer eight standard Medigap plans to help pay some to all of your out-of-pocket costs, including coinsurance, copays, and deductibles.13
South Carolina Health Insurance Costs
Obamacare plans come in bronze, silver, gold, and platinum. The metal levels indicate how much of covered costs insurers pay (bronze the least, platinum the most).
No health insurance carrier in the Palmetto State offered platinum plans through federally facilitated exchanges for 2021 or will for 2022.5 Platinum plans have the highest monthly premiums.
The federal Marketplace also offers catastrophic health plans—but they are available only to people under 30 years of age or people of any age who qualify via a hardship exemption or an affordability exemption, based on Marketplace or job-based insurance being unaffordable.
Below are the average lowest premiums for plans sold in the Marketplace for 2022 including rate changes from 2020 and 2021, for a 40-year-old, weighted by county plan selections:6
- The average lowest-cost bronze premium for 2022 is $339, for 2021 is $328 per month, down from $351 for 2020.
- The average lowest-cost silver premium for 2022 is $438, for 2021 is $469 per month, down from $496 for 2020.
- The average lowest-cost gold premium for 2022 is $483, for 2021 is $513 per month, down from $529 for 2020.
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Average Rate Changes
South Carolina and Obamacare Subsidies
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 you do not already have access to a qualified plan through your employer or your spouse’s employer and if your modified adjusted gross income is between $12,880 and $51,520 for an individual, which is 100% to 400% of the federal poverty level (FPL) for 2022.
Here are some examples of how much you could save with subsidies:
- A 28-year-old single non-smoker in Charleston, S.C., earning $30,000 a year would pay $83 per month for a 2022 silver plan with subsidies. This policy costs $320 without subsidies, which is a savings of $237.
- A family of three (two non-smoking 25-year-old adults and one child) in Columbia, S.C., earning $45,000 a year, could get a 2022 silver plan for $83 per month with subsidies or $1,118 without — a savings of $1,035.
South Carolina and Short-Term Health Insurance
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 a short-term plan for 30 days to 11 months and can renew up to 36 months.
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 parent’s 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.
South Carolina and Medicaid
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 had Medicaid in 2019, close to 19%. This group consists of 3 in 7 children and 1 in 8 adults (age 19 to 64).7 One-third of enrollees are people with disabilities. Other residents who qualify for Medicaid in South Carolina include pregnant women and parents of minor children. None of the beneficiaries are childless adults under 65 who might otherwise qualify if South Carolina were to expand its Medicaid program.8
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 for 2021 ($12,880 for a single person).9
State Resources
South Department of Health and Environmental Control
DHEC Constituent Services
2600 Bull Street
Columbia, SC 29201
Phone: 803-898-3432
Email: info@dhec.sc.gov
Website: scdhec.gov
South Carolina Department of Insurance
1201 Main St.
Suite 1000
Columbia, SC 29201
Phone: 803-7373-6160
Email: info@doi.sc.gov
Website: doi.sc.gov
