South Carolina Affordable Care Act






South Carolina Affordable Care Act Comprehensive Guide

In this article, you will learn about the Affordable Care Act health care reform laws in South Carolina.  You will get an understanding of how the health care law impacts you as a citizen of the state.  Learn how to sign-up for Affordable Care Act, learn about the Affordable Care Act penalty and subsidies, and much more.

What is South Carolina Affordable Care Act?

Affordable Care Act, also know as Obama Care, was signed into law in March 2010.  The goal of Affordable Care Act is to provide US citizens with affordable health insurance and to reduce the cost of health care spending for families and in America.

The Key Points of the Affordable Care Act / South Carolina Obamacare:

How to Apply for South Carolina Affordable Care Act?

South Carolina Affordable Care Act marketplace is run by the Federal government.  Click on HealthCare.gov to access South Carolina Affordable Care Act Marketplace.  You can preview the different insurance plans and see participating doctors before selecting the final health insurance plan.

State Federal or State Marketplace  Website Medicaid Expansion?
South Carolina Federal www.HealthCare.gov No

When can I apply for South Carolina Affordable Care Act (South Carolina ACA)?

South Carolina Affordable Care Act’s Open Enrollment 2015-2016 starts on November 1, 2015, and ends on January 31, 2016.  To have health insurance coverage beginning on January 2016, you must apply before December 15, 2015, deadline.

In order to qualify for Tax Credit or Premium Tax Subsidies, you must purchase health insurance from the Affordable Care Act Marketplace during Open Enrollment period.

If you qualify for South Carolina Medicaid health insurance, then you can sign-up Medicaid anytime of the year.

When is the deadline for South Carolina Affordable Care Act (SC ACA)?

Important dates for South Carolina Affordable Care Act deadlines:  The absolute last day to purchase health insurance from the Marketplace is January 31, 2016.

  • December 15, 2015: Last day to enroll in or change plans for new coverage to start January 1, 2016
  • January 1, 2016: 2016 coverage starts for those who enroll or change plans by December 15.
  • January 15, 2016: Last day to enroll in or change plans for new coverage to start February 1, 2016
  • January 31, 2016: 2016 Open Enrollment ends. Enrollments or changes between January 16 and January 31 take effect March 1, 2016.

How much is South Carolina Affordable Care Act?

There are four different plans within the South Carolina Affordable Care Act.  The metal plans represent the various levels of coverage you receive and what the plan pays on average.  The plan levels DO NOT represent the quality of the health coverage/doctors you receive.

  • Bronze Plan: The plan pays 60% of the cost, you pay 40% of the cost
  • Silver Plan: The plan pays 70% of the cost, you pay 30% of the cost
  • Gold Plan: The plan pays 80% of the cost, you pay 20% of the cost
  • Platinum Plan: The plan pays 90% of the cost, you pay 10% of the cost

The cost of Affordable Care Act in South Carolina depends on the metal plan you choose and the number of people in the household.   Platinum plans have the highest insurance premiums (monthly cost) and Bronze plans have the lowest insurance premiums.

State Year Avg. Monthly Silver Plan (before Tax Credits) US Average
South Carolina 2015 $276 $268

What are the South Carolina Affordable Care Act Eligibility Requirements?

In order to get South Carolina Affordable Care Act, you must meet the following requirements:

  • Must live in South Carolina
  • Must be a US citizen, national, or lawfully present immigrant
  • Cannot be currently incarcerated (be in jailed)
  • Have a valid Social Security Number
  • and few other requirements

Do I need to get South Carolina Affordable Care Act?

Yes, every individual in South Carolina needs to have health insurance.  The Individual Mandate of Affordable Care Act health care law requires US Citizen to enroll in a health insurance plan or pay a penalty.  If you have Medicaid or company sponsored health insurance, you have met the insurance coverage requirement.

You can choose not to have health insurance, but you have to pay the penalty in addition to the hospitals/doctors medical fee if you do get sick.

How much is Affordable Care Act Penalty in South Carolina?

The penalty (or also called individual shared responsibility payment) is calculated in two ways.

For 2016 year, the ACA penalty is as follows:

  1. By percentage of income (2.5% of household income or maximum of National Average Bronze plan premium)
  2. By number of people in the household ($695 per adult, $347.50 per child or maximum $2085)

You’ll pay whichever penalty is higher. 

How much are South Carolina ACA Subsidies? What are the requirements?

Affordable Care Act Subsidies are also called, “Premium Tax Credits.”

ACA subsidy lowers your premium – the amount you pay each month to your insurance plan.The amount of your ACA Subsidy depends on the estimated household income that you put on your ACA Marketplace application.

In order to qualify for Affordable Care Act Subsidy, your income must be between 100% to 400% of the Federal Poverty Level.

Affordable Care Act - Federal Poverty Level
Federal Poverty Level Insurance Premium After PTC Subsidy
Up to 133% FPL 2% of income
133-150% FPL 3%-4% of income
150-2000% FPL 4%-6.3% of income
200-250% FPL 6.3%-8.05% of income
250-300% FPL 8.05%-9.5% of income
300-400% FPL 9.5 of income
Over 400% FPL No Government Subsidy

Medicaid Expansion under the Affordable Care Act

With the new health care reform, the Federal government offered incentives for states to expand the Medicaid program.  30 states out of the 50 states plus Washington DC expanded Medicaid program while 20 states decided not to expand Medicaid due to expected future cut back funding from the Federal government.

South Carolina did not expand the Medicaid program under the Affordable Care Act Health Care Reform as of 2015/2016.

State Medicaid Expansion
South Carolina No

Insurance Companies that offer Affordable Care Act Health Insurance Plans in South Carolina:

The following insurance companies are offering Affordable Care Act Plans in the Marketplace.

  • BCBS of SC
  • BlueChoice Health Plan
  • Consumers’ Choice Health Plan (CO-OP)
  • Coventry Health Care of the Carolinas
  • Coventry Health Care

Frequently Asked Questions (FAQ) on South Carolina Affordable Care Act:

  1. Who runs the South Carolina Affordable Care Act? Federal
  2. Where can I sign up for South Carolina Affordable Care Act? Click here
  3. Do I need to get health insurance or Affordable Care Act? Yes, if not, you have to pay a penalty.
  4. How much is South Carolina Affordable Care Act? Click here for the average ACA premium
  5. Did South Carolina expand Medicaid under Affordable Care Act? No

Click here for more Frequently Asked Questions on Obamacare / Affordable Care Act.

For more Information on South Carolina Obamacare / Affordable Care Act:

Federal HealthCare.Gov Marketplace
Toll-Free: 1-800-318-2596
Website: HealthCare.gov

South Carolina Department of Insurance
1201 Main Street, Suite 1000
Columbia, SC 29201

Mailing address:
Post Office Box 100105
Columbia, SC 29202

Consumer services:
(800) 768-3467
(803) 737-6180
consumers@doi.sc.gov

If you have a hard time affording health coverage and you have questions about eligibility or current Medicaid benefits, go to:  

South Carolina Department of Health and Human Services
P.O. Box 8206
Columbia, SC 29202
http://www.scdhhs.gov/service/how-apply

South Carolina five largest cities in terms of population: Columbia, Charleston, North Charleston, Mount Pleasant, and Rock Hill.  You can apply for Affordable Care Act Health Insurance in any city in South Carolina.