Health insurance in South Carolina, 2027
South Carolina uses HealthCare.gov and did not expand Medicaid. Here is how it works, who gets help paying, and the gap that catches some adults.
Last checked October 16, 2026 · Written by licensed advisors · Sources are numbered and listed under Notes and sources
South Carolina uses HealthCare.gov
South Carolina has no state marketplace of its own: you compare plans and apply for a tax credit on HealthCare.gov, the federal marketplace, or with a licensed agent who works with it. For 2026 coverage, 587,567 South Carolinians picked a Marketplace plan during open enrollment.1
- Marketplace
- HealthCare.gov
- 2026 plan selections
- 587,567
- Medicaid expansion
- No
The dates for 2027
Open enrollment for 2027 coverage runs from November 1, 2026 to January 15, 2027. Choose a plan by December 15 for coverage that starts January 1, 2027.
Losing other coverage, moving to South Carolina, marrying or having a baby can open a special enrollment window, usually 60 days.2
- November 1, 2026Open enrollment for 2027 starts (key step)
- December 15Last day to choose a plan that starts January 1 (key step)
- January 15, 2027Open enrollment ends
- February 1, 2027Coverage starts for plans chosen December 16 to January 15
Heads up: Choose a plan after December 15 and it starts February 1, not January 1. If nothing else covers you in January, that is a month without coverage.
Who can get help paying
If your household income is between 1 and 4 times the federal poverty level, you can usually get a tax credit on a Marketplace plan. For a family of three that is $27,320 to $109,280 a year.
South Carolina did not expand Medicaid. Parents qualify only at low incomes, about 67% of the poverty level, and other adults generally don’t qualify on income alone. Children qualify at much higher incomes through Medicaid.34
The coverage gap
Who it affects: Adults in South Carolina earning under the poverty level.
Because South Carolina did not expand Medicaid, an adult earning less than the poverty level, $15,960 for one person, often can’t get Medicaid, and is under the floor for a Marketplace tax credit. Parents in the gap are those who earn between about 67% and 100% of the poverty level.
If your income is close to the poverty line, the estimate you give matters. Expected raises, a second job or a spouse’s income can move you above it.53
What to do: Estimate your income carefully if you are near either line.
Which insurers sell plans
Insurers file their 2027 South Carolina plans with the state and with HealthCare.gov, and the final list appears when open enrollment opens on November 1. Which ones you can choose depends on your county.2
What to do: Send us your ZIP code, your doctors and your prescriptions. We check which plans in your county include them.
Help from a licensed agency
Our agency is licensed in South Carolina, and we work with South Carolinians by phone and video, from our Chicago office. We compare the plans in your county and show you what to keep in mind on each one, at no cost to you.6
Related guides
Obamacare Hotline and/or Medicare Po Polsku are private companies not affiliated with any local, state, or federal government agency. This guide is general information, not tax or legal advice.