What You Need to Know
Short-term plans can’t last for more than 11 months at a time in South Carolina, but they can be renewed.
The typical cost of a plan is $100 to $200.
Short-term plans are exempt from the Affordable Care Act (ACA). That means these plans don’t have to offer the same benefits as ACA-compliant plans.
What Is South Carolina Short-Term Health Insurance?
South Carolina short-term health insurance is health insurance that lasts up to 11 months.1 Depending on the plan, it may be renewable, but it can only be renewed for up to 36 months in total under federal law.2 Since South Carolina’s short-term health plans last for 11 months each time you purchase one, they can be renewed for up to 33 months in total.
Short-term plans are exempt from the Affordable Care Act (ACA). That means these plans aren’t required to offer the same benefits as ACA-compliant plans. They also tend to be less expensive than ACA-compliant plans.
Several companies offer short-term health insurance in South Carolina. The typical cost of a plan is $100 to $200 per month. Plans are less expensive if you’re younger.
Learn more about South Carolina’s short-term plans and whether one is right for you.
How to Bridge an Insurance Gap
A short-term health insurance plan might be a good option if you are between jobs or waiting for the start of health insurance coverage at a new job.
Who Should Buy a Short-Term Plan in South Carolina?
South Carolina short-term plans may or may not be right for you. They might be a good fit if:
- You’re looking for an affordable plan. Premiums for short-term medical insurance are typically lower than the premiums for ACA-compliant plans.3 ACA plans sold to individuals in the state’s Health Insurance Marketplace may be subsidized, however.4 This means that, depending on your income, you may receive financial assistance in the form of a tax credit. ACA plans with subsidies may be less expensive than a short-term health plan, so it’s important to compare your options.
- You’re outside of an enrollment period. Insurance through employers and through the state insurance Marketplace have specific times when you can enroll, which are known as enrollment periods.5 Marketplace plans, for example, have an open enrollment period at the end of each year. If you need to enroll outside of those periods, you’re out of luck. Since short-term medical insurance plans are exempt from the ACA, you can enroll any time.
- You’re relatively healthy. These plans typically use medical underwriting to decide whom to accept. That means they decide whether to accept you based on your health status. If you’re healthy, however, this type of plan could be a good fit.6
- You’ll have other coverage soon. Short-term insurance plans can also serve as temporary health insurance if you’ll have other coverage soon — for example, if you’re between jobs or if you’re waiting for health insurance coverage to start with a new job.
A South Carolina short-term health insurance plan might not be a good fit for:
- People with preexisting medical conditions. In addition to medical underwriting, short-term plans typically don’t offer healthcare coverage for preexisting conditions. If you’re pregnant before you purchase a policy, for example, your care may not be covered.7
- People who need ACA-compliant plan benefits. Marketplace insurance plans are required to cover essential health benefits, including pregnancy and maternity care.8 Short-term medical plans aren’t required to provide this minimum essential coverage, so they may exclude these benefits. If you need an essential benefit, an ACA-compliant plan may be best.
|Pros of Short-Term Plans||Cons of Short-Term Plans|
|Affordability||Typically no coverage for preexisting conditions|
|Enrollment flexibility||Medical underwriting may exclude certain people|
|Bridge gaps between insurance coverage||Not required to provide essential benefits|
Health Insurers That Have Short-Term Plans
In South Carolina, four companies currently offer short-term health insurance: Pivot Health, Blue Cross Blue Shield of South Carolina, Everest and Independence American Insurance Company.
How Much Are South Carolina Short-Term Plans?
The cost of a short-term plan depends on several factors, including your age, gender, and how the plan is set up. Here are some costs to consider:
- Deductible: This is the amount you pay for covered services before your plan starts paying.9
- Coinsurance: This is a percentage you pay for certain items and services after you meet your deductible. You might pay 20%, for example, for durable medical equipment such as a wheelchair or walker.10
- Copayment: A copayment or copay is a fixed amount you pay for a service or item. You might pay $50 to see a specialist, for example.11
- Out-of-pocket maximum: This is the most you’ll pay out of pocket while you’re on the plan.12
- Maximum benefit: This is the most your plan will pay in benefits.13
How much do plans cost? A non-tobacco-using, 35-year-old female living in South Carolina would pay:
- $166.08 per month for a plan from Pivot Health with a $10,000 deductible, a maximum benefit of $1,000,000 and no prescription coverage.
- $226.30 per month for a plan from Pivot Health with a $5,000 deductible, a maximum benefit of $1,000,000 and prescription coverage.
What Rules Govern Short-Term Plans in South Carolina?
Who Sells Short-Term Plans in South Carolina?
Several insurance carriers offer short-term health plans to South Carolina residents, including:
- Companion Life (Pivot Health): This company has deductibles ranging from $5,000 to $20,000 and maximum benefit amounts ranging from $500,000 to $1 million.
- Blue Cross Blue Shield of South Carolina: BCBS offers deductibles ranging from $1,500 to $6,650 and a maximum benefit of $1,000,000.
- Everest: This health insurance company offers deductibles ranging from $1,000 to $10,000 and maximum benefit amounts up to $1.5 million.
- Independence American Insurance Company: This company offers limited coverage for preexisting conditions with some of its plans.
Your first step is to decide whether a short-term medical insurance plan is right for you. Consider factors like your health and budget and whether other family members also need coverage. Also, consider what benefits you and your family need and whether those needs can be met with a short-term plan. An experienced insurance agent or broker can help you decide.
If a short-term plan seems like it might be a good fit, take the time to get a quote from at least two or three insurance companies and compare their plans and costs. Short-term plans vary significantly in terms of the benefits they offer and their deductibles, maximum benefits, copays, and coinsurance. Choose a plan with the benefits you need at a price you can afford.