South Carolina Health Insurance Exchange: Your Complete Consumer Resource

The South Carolina Health Insurance Exchange, also known as the Health Insurance Marketplace, is a platform where individuals and families can shop for health insurance plans that meet their needs and budget.

You can enroll in a health insurance plan through the South Carolina Health Insurance Exchange if you're a resident of the state and not eligible for employer-sponsored coverage or Medicare.

The open enrollment period for the South Carolina Health Insurance Exchange typically runs from November to December, but you may also be eligible for a special enrollment period if you experience certain life events, such as losing your job or getting married.

To get started, you'll need to create an account on the HealthCare.gov website or call the Health Insurance Marketplace helpline at 1-800-318-2596.

South Carolina has six insurers offering Marketplace coverage for 2025, with five of them returning from 2024. Cigna is exiting the South Carolina individual market, but InStil Health is joining for 2025 with a limited coverage area.

The five returning insurers have decreased their average premiums for 2025, making health insurance more affordable for many South Carolinians. People enrolled in Cigna plans in 2024 will need to select a new plan from a different insurer during the open enrollment period.

Marketplace insurers' coverage areas vary, but at least three insurers are offering health plans through the Marketplace in all but one of South Carolina's counties. A record high 571,175 people enrolled in private plans through the South Carolina Marketplace during the open enrollment period for 2024 coverage.

To qualify for health coverage through the South Carolina Health Insurance Marketplace, you must live in South Carolina and be lawfully present in the United States. Additionally, you cannot be incarcerated or enrolled in Medicare.

To be eligible for financial assistance, your household income will come into play. You'll also need to meet other requirements, such as not having access to affordable health coverage offered by an employer. If your employer offers health benefits but you feel the coverage is too expensive, you can use a calculator to see if you might qualify for premium subsidies in the Marketplace.

You can't be eligible for Medicaid or CHIP, or premium-free Medicare Part A. If you're married, you'll need to file a joint tax return. And, you can't be claimed by someone else as a tax dependent.

Here are the key eligibility requirements at a glance:

Short-term coverage is an option for those who find themselves without comprehensive health insurance.

If you're in need of temporary health insurance in South Carolina, short-term plans can provide coverage.

These plans are designed to be temporary, so you can expect to have coverage for a short period of time.

You can learn more about short-term plan availability in South Carolina by exploring your options.

Premium comparisons are provided for various age groups and tobacco use scenarios, making it easier to find the best plan for your needs.

For a 25-year-old non-tobacco user in South Carolina, shopping on Healthcare.gov, premium comparisons are available for self-only coverage in different counties.

The average enrollee's monthly cost in the South Carolina Marketplace is about $63/month, including those who pay full price, after applying premium subsidies.

A record high 571,175 people enrolled in private plans during the open enrollment period for 2024 coverage, with 95% of enrollees receiving premium subsidies, amounting to an average savings of $552/month.

Note: The average monthly costs for 40-year-old tobacco users and 60-year-old non-tobacco users are not specified in the article sections.

Marketplace health insurance premiums have been a topic of interest for many, and the good news is that in South Carolina, the overall average rate decrease for 2025 is 1.35%. This is a welcome change after several years of premium increases.

The South Carolina Department of Insurance has released the average premium changes for 2025, and some insurance companies are offering significant decreases. For example, Molina's premium decrease is a whopping 7%.

However, not all companies are offering decreases. Cigna is actually exiting the market, which may affect consumers in certain areas.

Here's a breakdown of the average premium changes for 2025 in South Carolina:

It's worth noting that premium changes can vary significantly from year to year. For example, in 2016, the average premium increase was 12.3%, while in 2020, the average premium decrease was 3.9%.

To get a better sense of how premium changes have affected South Carolina over time, here's a quick look at the average premium changes from 2015 to 2024:

This data shows that premium changes can be unpredictable and may be influenced by a variety of factors.

To find affordable health insurance in South Carolina, you can enroll through HealthCare.gov, the federally run exchange for individual market plans. This is the platform used by the South Carolina Marketplace.

A record high 571,175 people enrolled in private plans during the open enrollment period for 2024 coverage in the South Carolina marketplace. This surge in enrollment was driven by the American Rescue Plan and the Inflation Reduction Act, which made premium subsidies more substantial and widely available.

In 2024, 95% of enrollees in the South Carolina Marketplace were receiving premium subsidies, amounting to an average savings of $552/month. This made the average enrollee's monthly cost about $63/month, including those who paid full price.

The Affordable Care Act ensures that people with household incomes up to 250% of the poverty level can enroll in Silver-level plans that have reduced out-of-pocket costs. This means lower out-of-pocket costs for those who need it most.

An estimated 76,000 low-income adults are in the coverage gap in South Carolina, ineligible for any financial assistance with their health coverage. This is due to the lack of Medicaid expansion in the state.

In South Carolina, the open enrollment period for individual and family health coverage runs from November 1 to January 15. This is the time when you can enroll in an ACA-compliant plan without a qualifying life event.

If you need your coverage to start on January 1, you must submit your application by December 15. Otherwise, your coverage will begin on February 1 if you apply between December 16 and January 15.

Outside of open enrollment, a special enrollment period is necessary to enroll or make changes to your coverage. This is triggered by a specific qualifying life event.

A record high 571,175 people enrolled in private plans during the open enrollment period for 2024 coverage in the South Carolina marketplace. This surge in enrollment was driven by the American Rescue Plan and the Inflation Reduction Act.

The American Rescue Plan made the ACA's premium subsidies more substantial and more widely available, contributing to the enrollment spike in 2024. These premium subsidy enhancement provisions have been extended through 2025.

The unwinding of the pandemic-era Medicaid continuous coverage rule also contributed to the enrollment spike in 2024. Over 169,000 South Carolina residents transitioned from Medicaid to a Marketplace plan during this process.

A record high 571,175 people enrolled in private plans during the open enrollment period for 2024 coverage in South Carolina's marketplace.

The American Rescue Plan played a significant role in this surge, making the Affordable Care Act's premium subsidies more substantial and widely available.

These premium subsidy enhancement provisions have been extended through 2025 by the Inflation Reduction Act, ensuring more people can afford health insurance.

More than 169,000 South Carolina residents transitioned from Medicaid to a Marketplace plan during the unwinding process after a three-year pause during the pandemic.