Health insurance in South Carolina for 2027

South Carolina uses HealthCare.gov. For plan year 2027, CMS lists South Carolina as a federally facilitated marketplace state. I help people in South Carolina enroll through HealthCare.gov and HealthSherpa.

Who’s filed to sell for 2027. These are the eight companies whose 2027 South Carolina individual-market rate filings are on CMS’s rate review site, as I read it on October 27, 2026. I’ve left out the prices they asked for, because those were requests, not approved rates. The middle column is whether CMS’s 2026 plan data show the company selling individual medical plans on HealthCare.gov that year. The last is CMS’s flag for whether the company’s 2027 filing includes HealthCare.gov plans.

Some of these sell under other names. In its 2027 filing, Absolute Total Care’s HealthCare.gov products are named “Ambetter” and “Ambetter + Vision + Adult Dental”, Select Health of South Carolina’s is “Select Health Next SC HMO”, and InStil Health’s is “InHealth Basic”. Celtic Insurance Company’s 2027 products carry the name “Ambetter Health Solutions”, but they aren’t flagged as HealthCare.gov plans.

Molina Healthcare of South Carolina’s 2027 filing isn’t flagged as including HealthCare.gov plans, though its 2026 plans were on HealthCare.gov. KFF’s tracker of insurer changes, updated October 7, 2026, lists no South Carolina entry or exit, and I couldn’t find an announcement either way. If your plan is from Molina, read your renewal letter closely, and check HealthCare.gov’s plan list on or after November 1. CMS’s bulletin says it posts the filings that have rate changes, and the flag shows what each company filed, not what HealthCare.gov will show you once 2027 plans are posted, so a missing name, or a No in the table, isn’t proof either way.

When I read CMS’s rate review site again on October 31, 2026, it had marked all eight filings final. South Carolina’s Department of Insurance reviews and approves rates for plans sold on and off HealthCare.gov, and I haven’t found its approved 2027 rates posted. I haven’t yet gone through the 2027 plan files CMS posted on October 30, so I can’t tell you yet which plans, prices or counties 2027 will have. HealthCare.gov says you can apply for 2027 coverage starting November 1.

Signing up. Open enrollment starts November 1, 2026. A plan you pick by December 15 starts January 1, 2027. A plan you pick from December 16 through January 15, 2027 starts February 1. For either start date, you must pay your first premium for coverage to start. If you have HealthCare.gov coverage now, HealthCare.gov says it will automatically re-enroll you in a plan for next year, and you’ll get a letter telling you whether it’s the same plan or a different one. If you don’t want that plan, pick a different one by December 15 so it starts January 1. HealthCare.gov also says that even if you’re automatically re-enrolled, plan costs can change. My open enrollment checklist goes through how to check a plan’s costs, doctors and drugs before you pick one.

The January 15 end date is contested. CMS gives that date, and so does HealthCare.gov’s own dates page. A federal rule finalized in June 2025 would have ended open enrollment on December 15 instead. A federal district court threw out that part of the rule in June 2026, the government appealed, and the appeals court set argument for October 30, 2026. Until a court changes them, CMS’s dates are the ones that count. My 2027 open enrollment guide follows the case.

If you’re healthy and you won’t get a tax credit, for example because your income is above four times the poverty line, a private short-term plan is one more thing to compare with a full-price HealthCare.gov plan. It’s a health plan sold outside HealthCare.gov for a set period, and it has limits a HealthCare.gov plan doesn’t.

What South Carolina’s Department of Insurance says about how long one can last. The Department has stated its limit in bulletins. The part of the Code of Laws that covers accident and health insurance (Title 38, Chapter 71) mentions short-term plans only to leave them out of its definition of individual health insurance coverage (the kind you buy yourself, not through an employer), and I found nothing in that chapter, or in the Department’s regulations (Chapter 69 of the Code of Regulations), that sets a length. The Department’s 2018 bulletin required a first term of 11 months or less and renewals totaling 33 months or less. Its Bulletin 2024-13, dated November 22, 2024, “supersedes and replaces” that bulletin and sets out the federal rule written in 2024: a first term of no more than 3 months, and no more than 4 months in total with renewals. The federal rule applies to policies sold on or after September 1, 2024. The bulletin also notes, citing the federal rule’s preamble, that coverage sold to individuals through a group trust or association, other than in connection with a group health plan, has to meet the federal definition of short-term insurance, or it’s subject to the federal rules for comprehensive individual health insurance. I haven’t found anything from the Department since then, though I couldn’t open its lists of 2025 and 2026 bulletins. Its consumer page, which has no date, says this coverage “cannot last for longer than 11 months in South Carolina (although it may be able to be renewed).”

What the federal government says. On August 7, 2025, the three federal departments behind the 2024 rule said they “do not intend to prioritize enforcement” of its definition until new rulemaking is issued and applies. HHS added that it encourages states to take a similar approach, and that it won’t treat a state as failing to enforce during this period if the state does, or if it uses its own definition. A proposed new federal rule has been under review at the Office of Management and Budget since May 30, 2026, and hasn’t been published. The 2024 rule’s length limits applied only to policies sold on or after September 1, 2024; whether a new one would reach a policy you already have won’t be known until it’s published.

What that means for you. What South Carolina allows is unsettled, and it could change. Check the term on the certificate before you sign.

What they leave out, and other limits:

• No tax credit. HealthCare.gov: “If you buy a plan outside the Marketplace any time, during Open Enrollment or not, you can’t get premium tax credits or other savings based on your income.”
• They aren’t marketplace plans. South Carolina’s insurance code leaves short-term plans out of its definition of individual health insurance coverage, as federal rules do, and the Department’s consumer page says this coverage “does not provide the same protections as major medical coverage and can be subject to pre-existing condition exclusions, among other limitations.”

What to ask before you buy one. Ask the insurance company or me, and check each answer against the certificate:

• how it defines a pre-existing condition, and what it won’t pay for because of one;
• whether the application asks about your health;
• whether there’s a waiting period before sickness benefits start;
• what it excludes, and the most it pays for the coverage period;
• how long its term is, whether it can be renewed, and whether a later plan would count something that started on this one as pre-existing;
• whether the insurance company can cancel it before its term ends, and what happens if you want to cancel;
• whether its ending would let you sign up for a HealthCare.gov plan before the next open enrollment;
• if it’s sold through an association, what membership costs and how it’s billed.

These plans have exclusions and limitations, and rules about when a policy can be kept or when it ends. For costs and every term of a plan’s coverage, call me or the insurance company that offers it. My comparison of Aetna, Cigna and UnitedHealthcare goes further into short-term plans that use Aetna’s or Cigna’s network.

Who should look at one. A short-term plan is worth a look if you’re healthy, don’t take regular prescriptions, and would pay full price for a HealthCare.gov plan anyway. If you have a condition that needs ongoing care, or you’re pregnant or hoping to be, a HealthCare.gov plan is the safer choice.

The tax credit that lowers your monthly premium is still there for 2027, for plans you enroll in through HealthCare.gov. Between the poverty line and four times it, the credit is figured so that what you’d pay for your area’s benchmark plan, the second-lowest-cost silver plan, comes to a set share of your income. If benchmark prices go up, the credit goes up with them, though other plans’ prices can still move by more or less. For 2027 coverage, four times the poverty line is $63,840 a year for one person, $86,560 for two, $109,280 for three and $132,000 for four. Above that, there’s no credit at all; that top limit came back when a temporary law ended with 2025. And starting with 2027, fewer people who aren’t U.S. citizens qualify: the credit is limited to U.S. citizens and nationals, green card holders, Cuban or Haitian entrants, and people here under the Compacts of Free Association.

South Carolina hasn’t expanded Medicaid under the Affordable Care Act, so Medicaid here covers set groups of people, not every adult under an income line. The groups include children, pregnant women, parents and caretaker relatives with a dependent child at home, and people who are 65 or older, blind or disabled. The limit for parents is low. South Carolina’s Department of Health and Human Services (SCDHHS) says a parent or caretaker relative qualifies at or below 62% of the poverty line, which is $1,411.53 a month for a family of three (its figures effective March 1, 2026). Its eligibility table for the same date says 67%. The two documents give different limits and I haven’t found SCDHHS saying why, so ask what applies to your household when you apply.

That leaves a gap, because the tax credit for a HealthCare.gov plan starts at the poverty line. For 2027 coverage, the poverty line is $15,960 a year for one person, $21,640 for two, $27,320 for three and $33,000 for four. HealthCare.gov puts it plainly: if your state hasn’t expanded Medicaid, your income is below the poverty line and you don’t qualify for Medicaid under your state’s rules, “you won’t qualify for either health insurance savings program.” It still says you should fill out a Marketplace application.

South Carolina has asked the federal government to cover some of the parents just above that limit. Its program, Palmetto Pathways to Independence, would cover parents and caretaker relatives aged 19 to 64 with income from 67% of the poverty line up to 100%, if they meet work or community engagement requirements. SCDHHS sent the application on June 23, 2025, and medicaid.gov lists it as pending, with no decision, as I read it on October 27, 2026. It isn’t in effect.

You can apply for Healthy Connections Medicaid online, and HealthCare.gov says you can apply for Medicaid and CHIP any time, all year.

Healthy Connections covers children under 19 through its Partners for Healthy Children program, if they meet its residency and citizenship rules, for families with income at or below 208% of the poverty line: $5,720.00 a month for a family of four, in SCDHHS’s figures effective March 1, 2026. Its eligibility table for the same date says 213%. The two documents give different limits and I haven’t found SCDHHS saying why, so ask what your family qualifies for when you apply. SCDHHS says the program’s plans include both Medicaid and the Children’s Health Insurance Program (CHIP). Above the limit, your children can be on your HealthCare.gov plan, where the tax credit can help pay for their coverage too.