Health Insurance Overview
South Carolina residents have several options for health insurance coverage. While the state has not expanded Medicaid, many residents can find affordable coverage through the federal marketplace at HealthCare.gov, often with significant subsidies to lower monthly costs.
Medicaid in South Carolina
South Carolina has not expanded Medicaid under the Affordable Care Act. The state's Medicaid program, called SC Healthy Connections, covers:
- Children under 19 (income limits up to 208% of poverty)
- Pregnant women (up to 199% of poverty)
- Parents/caretakers with very low income (below 67% of poverty)
- Adults age 65 and older who meet income requirements
- Individuals with qualifying disabilities
How to Apply for SC Medicaid
You can apply for SC Healthy Connections Medicaid through:
- Online: Visit apply.scdhhs.gov
- Phone: Call 1-888-549-0820
- In Person: Visit your local Department of Social Services office
- Mail: Download and mail the application
Health Insurance Marketplace
South Carolina uses the federal Health Insurance Marketplace at HealthCare.gov. During open enrollment, you can compare plans from multiple insurers and see your subsidy amount before enrolling.
How to Enroll
- Visit HealthCare.gov
- Create an account and answer questions about your household
- Review your eligibility for Medicaid or subsidies
- Compare available plans in your area
- Select a plan and pay your first premium
Average Costs and Subsidies
Many South Carolina residents qualify for substantial help paying for coverage:
- Premium Tax Credits: Available for households earning 100-400% of the federal poverty level
- Cost-Sharing Reductions: Lower deductibles and copays on Silver plans for those under 250% poverty
- $0 Premium Plans: Some residents qualify for Bronze plans with no monthly premium
The average South Carolinian saves over $500/month with subsidies. Your actual savings depend on your income, age, and location.
Frequently Asked Questions
Has South Carolina expanded Medicaid?
No, South Carolina has not expanded Medicaid under the Affordable Care Act. This means adults without children generally cannot qualify for Medicaid in South Carolina. However, children, pregnant women, elderly individuals, and people with disabilities may still qualify under traditional Medicaid rules.
How do I apply for health insurance in South Carolina?
South Carolina uses the federal marketplace at HealthCare.gov. You can apply online, by phone at 1-800-318-2596, or with help from a licensed insurance agent. Open enrollment runs from November 1 to January 15 each year.
Who qualifies for SC Healthy Connections Medicaid?
SC Healthy Connections Medicaid covers children under 19, pregnant women, parents with very low income, seniors 65+, and people with disabilities. Income limits are strict for adults - parents typically must earn less than 67% of the federal poverty level to qualify.
Can I get financial help for health insurance in South Carolina?
Yes, if your income is between 100% and 400% of the federal poverty level, you may qualify for premium tax credits on HealthCare.gov. Cost-sharing reductions are also available for Silver plan enrollees earning up to 250% of poverty. Many South Carolinians pay less than $50/month after subsidies.
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