South Carolina Health Insurance Marketplace
In South Carolina, the federal government operates the health insurance Marketplace.
South Carolina now has its own Marketplace for health insurance, where you can shop for and buy insurance in person, online, or by phone.
South Carolina Plans, Benefits, and Costs
Last year average total cost for Health Insurance for a 40 Year Old Non-Smoker in your state was $0 per month after tax subsidies. See if you qualify for a free or low cost plan.
Companies can offer four types of plans: bronze, silver, gold, and platinum. These “metal level” plans all cover the same benefits in your state. What differs is how much they pay on average toward the costs of the services the plan covers.
Tobacco Surcharge: South Carolina allows insurance companies to charge tobacco users 50% more than non-tobacco users.
Who Is Selling Insurance in the South Carolina Marketplace?
On exchange plans in South Carolina
Off exchange plans in South Carolina
All approved plans in the state must cover the same package of benefits, called essential health benefits. In South Carolina, the benefits include:
- Outpatient services, such as doctor visits or tests done outside a hospital, including skilled nursing,chiropractic care, and non-emergency treatment when traveling outside the U.S.
- Emergency services
- Hospital stays
- Pregnancy and baby care
- Mental health and substance abuse services, including behavioral health treatment
- Prescription drugs, including generic and certain brand name drugs
- Rehab and habilitative services, such as those that help people recover from an accident or injury and those that help people with developmental issues.
- Lab tests
- Preventive and wellness services, along with those that help people manage chronic conditions
- Services for children, including dental and eye care
Some services not included: Infertility treatment and bariatric surgery.
Will These Benefits Be in All Plans?
Although all health insurance policies have to include these benefits, some states may allow insurance companies to substitute a service that has the same value. For example, one type of lab test may be substituted for another. Make sure to read the summary of benefits of the plans you are considering to see if they include the coverage you need.
You may be eligible for financial aid to help pay for insurance. Here’s what South Carolina will offer:
Medicaid Expansion: Some states are expanding Medicaid so more people can get health insurance coverage. Although South Carolina is not expanding Medicaid coverage, you may still qualify.
Premium Subsidies (also known as Tax Credits ): You may qualify for a subsidy — money to help pay your health insurance premium each month. The subsidy may be sent directly to your health insurance company and is available on insurance bought in the Marketplace. In general, you’ll be eligible if you’re single and make about $45,960 or less a year, or if you have a family of four and make about $94,200 or less a year.
Cost-sharing subsidies: Depending on your income, you may also qualify for cost-sharing subsidies that will reduce your costs when you receive medical care. Cost-sharing subsidies are available only with silver-level plans.
CHIP: The Children’s Health Insurance Program provides coverage for children of some families who have a low income but are not eligible for Medicaid.