South Carolina

South Carolina’s health insurance marketplace/exchange is run by the federal government, so residents use HealthCare.gov to shop for individual and family health plans. The marketplace provides health insurance to people who need to buy their own coverage, including early retirees, the self-employed, and people who are employed by small businesses that don’t offer health benefits.

Open enrollment in South Carolina for 2022 coverage runs from November 1, 2021 through January 15, 2022. This enrollment window is a great opportunity to take advantage of the subsidy enhancements created by the American Rescue Plan.

Outside of that open enrollment period, residents need a qualifying event in order to enroll in coverage or make a change to their plan. But you may also be able to enroll in coverage through the South Carolina exchange for the final months of 2021 if you received unemployment compensation in 2021

Four insurers offer marketplace coverage in South Carolina. South Carolina’s health insurance marketplace had just one insurer – Blue Cross Blue Shield of South Carolina – offering plans in the exchange in 2018. But Ambetter (Absolute Total Care) joined the exchange for 2019 and Bright Health and Molina started offering plans for 2020.

The four carriers have varying coverage areas. This chart shows where they each offer coverage in 2021.

For 2022, all four carriers will continue to offer plans in South Carolina’s marketplace.

According to rarereview.healthcare.gov, two of South Carolina’s exchange insurers (Absolute Total Care and Bright Health) have proposed overall average rate decreases for 2022.

The other two insurers (BCBSSC and Molina) have proposed fairly modest single-digit rate increases for 2022.

Premiums for existing medical insurance plans changed very little from 2019 to 2020. For 2021, three of the four exchange insurers implemented small average rate decreases, ranging from 0.04 percent to 3.6 percent. Ambetter (Absolute Total Care) increased average premiums by about 8.5% for 2021, but their plans covered fewer than 7,400 enrollees in 2020.

Read our full overview of the South Carolina health insurance marketplace.

In 2014 and 2015, South Carolina residents could buy health insurance through Consumers Choice, the state’s Consumer Oriented and Operated Plan (CO-OP). The CO-OP was funded under the ACA with a grant from the federal government.

Nationwide, about $2 billion was awarded to CO-OPs in 22 states. In South Carolina, Consumers’ Choice Health Plan (CCHPSC) received about $87.6 million. However, by November 2015, officials had announced its closure, and CO-OP members needed to select coverage from another insurer for 2016.

As of 2020, there were only four remaining CO-OPs offering plans in five states, and one of them, New Mexico Health Connections, is closing at the end of 2020.

Read more about the ACA’s CO-OPs.

South Carolina has its own state regulations regarding short-term health insurance plans.  Short-term health insurance plans in South Carolina are currently prohibited from offering coverage which exceeds 11 months, with a total duration of 33 months of short-term health insurance coverage (including renewals).

Read more about short-term health insurance in South Carolina.

As of mid-2021, there were 1,124,218 South Carolina residents enrolled in Medicare. About 37% of them were covered by private Medicare plans (Medicare Advantage) and the rest were enrolled in Original Medicare. Most South Carolina Medicare beneficiaries are eligible due to age, but 16% are under the age of 65 and are eligible for Medicare due to a disability.

Read more about Medicare enrollment in South Carolina, including details about Medicare Advantage and Medicare Part D, as well as state rules for Medigap plans.

• South Carolina Department of Insurance – Oversees, regulates, and licenses health insurance companies, agents, and brokers.
• South Carolina Department on Aging – Information and assistance programs for Medicare beneficiaries
• South Carolina Primary Health Care Association — the federally funded Navigator organization in South Carolina.