South Carolina Health Insurance: 2023 Coverage Guide
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South Carolina Affordable Healthcare Insurance
People in South Carolina have a few options when it comes to picking a health insurance plan so it's wise to compare rates carefully. Whether you're an individual or you're buying coverage for a family, you can compare prices for different coverage options with SmartFinancial. This way, you'll know you're getting the best value. Keep in mind that you may only enroll in a health plan during open enrollment unless you have a qualifying event.
When Is Open Enrollment in South Carolina?
November 1, 2022 – January 15, 2023
How to Get Health Insurance in South Carolina
You can estimate how much you need in terms of coverage by taking a look at the previous year. This information will help you decide which health plan is right for you, and which coverage tier will be most economical. A higher premium sometimes means savings, especially if you see care providers regularly. Compare health insurance companies and health insurance quotes before you buy. After you submit a form you'll get several rates from competing health insurance companies. We'll then connect you with an agent so you can buy coverage or ask questions about the plans you're considering.
What Types of Health Insurance Are Available in South Carolina?
HMOs, EPOs, PPOs and POS plans, which are all managed very differently, are available in South Carolina. You can also choose different levels of coverage, which are categorized in this order, from least coverage to most: catastrophic, bronze, expanded bronze, silver and gold. While higher levels of coverage cost more monthly, they usually carry little out of pocket expenses like copays and coinsurance. Deductibles will differ too, so if you're buying a PPO plan at a higher tier, your deductible will be much lower but you'll pay more in premiums.
Does Health Insurance Cover Pre-existing Conditions?
It is now illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.
Do I Qualify for a Special Enrollment Period?
Common reasons people qualify for a special enrollment period:
Lost or quit a job. You may have lost a job, changed jobs or even started your own business. If you lost a job and with it your health insurance, you qualify for the special enrollment period. If you changed jobs and are not offered health insurance, you qualify to buy health insurance after the enrollment period.
Turned 26. If you were on your parents' health insurance plan but turned 26 after the enrollment period, you can enroll in an individual health plan.
Moved to another state or out of an HMO coverage area. You may have had a health plan that was only valid in one state but you moved to another state after the enrollment period. You can sign up for a new health plan.
Cobra coverage ended. If you extended your healthcare with Cobra and reached the deadline, you can enroll in a new health plan.
Divorce. If you were married and shared a health plan coverage with your spouse but divorced, you still have time to enroll in a new health plan.
Marriage. If you recently married, you may be able to get added onto your spouse's policy or start an entirely new one together.
Birth or adoption of a child. If your baby was born or brought home after the open enrollment date, you can still buy health insurance for that child.
Death of spouse or partner. If you were covered under your spouse or partner's health plan but that person passed away, you can take advantage of the special qualifying events exception to enroll in an individual plan.
Spouse of partner loses coverage. If you previously had health insurance through a partner or spouse who lost his/her coverage for any qualifying reason, you are eligible to buy an individual plan or buy coverage with that spouse/partner again.
Is Health Insurance Required in South Carolina?
No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it's not required in every state, buying health insurance is necessary to avoid medical bankruptcy.
How Much Is Health Insurance in South Carolina?
The average cost of health insurance in South Carolina for a 40-year-old is about $501 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.
How to Save on Health Insurance in South Carolina?
Medicare in South Carolina
Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig's Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.
How Many People Are on Medicare in South Carolina?
21% of the population of South Carolina is on Medicare.
How Much Is Medicare in South Carolina?
If you do not qualify for Medicare, you can buy it for $499 a month for Part A in 2022 and a standard monthly premium for Medicare Part B was $170.10, or even higher depending on income.
Original Medicare vs Medicare Advantage: What's the Difference?
Medicare is a government-subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $7,550 but many plans set their maximums at a much lower cost. That is why it's important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.
How to Get Medicare Coverage in South Carolina
If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.
Types of Medicare Plans Available
Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).
How Do I Qualify for Medicare?
To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.
How Can I Save on Medicare in South Carolina?
You can save on Medicare by signing up for Part B as soon as you're eligible. People who enroll late must pay a penalty every year. If you're interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.
South Carolina State Health System Ranking
Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2020 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the South Carolina Health System are listed below:
- South Carolina: Overall Ranking: 41 of 51
- South Carolina: Overall Performance: Better than Average
- South Carolina: Access and Affordability: 41
- South Carolina: Prevention and Treatment: 42
- South Carolina: Avoidable Hospital Use and Cost: 25
- South Carolina: Healthy Lives: 40
- South Carolina: Health Care Disparities: 47
South Carolina Health Insurance Coverage
The people of South Carolina have different kinds of health insurance while some South Carolina residents are not insured at all. See the breakdown below:
- Private coverage: 47%
- Medicaid: 19%
- Medicare: 21%
- Uninsured: 13%
Report: America's Health Insurance Plans
South Carolina Health Insurance Companies
The following carriers offer health insurance and/or medicare in South Carolina.
- Ambetter from Absolute Total Care
- BlueChoice HealthPlan
- BlueCross BlueShield of South Carolina
- Absolute Total Care, Inc.
- Bright Health Company of South Carolina
- Molina Healthcare of South Carolina, Inc.
- Constant Care