South Carolina

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Last updated: 14th August 2018. The South Carolina open enrollment period opens up on Nov 1, 2017 through Dec 15th, 2017. If you miss the open enrollment period you may still be able to apply and get coverage if you meet certain criterion. Missing the deadline without getting coverage may cause a tax penalty. Click Here to get a free health insurance quote.

You don’t have a choice to not get health insurance any longer, at least in most cases. Unless you are Native American or you have religious reasons for not having coverage, you are required to have insurance that satisfies the requirements of Obamacare. South Carolina does not have an exchange of their own, so you will be choosing plans from the federal exchange and the companies that offer those plans in SC when you enroll. It’s a good idea to understand the basics of getting coverage before you start along the process, though.

Understanding SC Obamacare Enrollment – First, you have to realize that open enrollment has a limited window that typically runs from November to January each year. You will have to choose a plan during this time, or you will not be able to get the Obamacare coverage you need until the following year. If you are Native American, or if you qualify for Medicaid, you will not have to wait until open enrollment. You can enroll at any time of the year.

Some people may also qualify for special enrollment. You need to have a qualifying event in your life for this to happen though. Some of the examples of qualifying events would be have having a child, adopting a child, getting married, or moving to South Carolina. Then, you will have 60 days from the date of the qualifying event that you can start looking for and choosing your healthcare plan.
Choosing a Plan and Provider

The state has a number of providers on and off the exchange. If you are looking for plans from companies on the exchange offering Obamacare in South Carolina, you can choose from Coventry, BlueChoice Health Plan, BlueCross BlueShield of South Carolina, and United Healthcare. Several companies also offer plans that are not part of the exchange – Celtic, Cigna, Freedom Life, and National Foundation Life.

There are a number of plan tiers available, each based on precious metals. Bronze plans have high out of pocket payments and low premiums, silver have somewhat higher premiums and lower out of pocket payments. Gold follows suit, and at the top are the platinum plans. They have the highest monthly premiums, but will take care of 90% of the out of pocket costs.

All of the plans, no matter the level or the provider, will have the essential benefits including outpatient care, emergency services, treatment in the hospital, maternity and newborn care, addiction treatment and mental health services, prescription drugs, rehabilitative services and devices, pediatric care, preventative services and lab services.

Paying for Your SC Obamacare Plan – Once you choose a plan, you will pay for it just the same as you would any other insurance policy. Make sure you keep paying your monthly premium to the insurance company to ensure your policy isn’t cancelled. You can also choose to have your tax subsidies applied to your plan immediately to help lower your monthly payments.

Renewing Your South Carolina Obamacare Plan – Most of the plans for Obamcare in South Carolina will automatically renew at the end of the year, so you will not have to do anything. However, you should always check out the new plans that are available to see if there is anything that works better for your needs and budget.

Obamacare South Carolina Plans and Networks

If you are going to be getting Obamacare coverage in South Carolina at the next open enrollment, or during special enrollment if you qualify, it is important to have a good understanding of the type of plans and providers that are available in the state. There are a number of options from which you can choose, and you always want to take your time to sift through each of them to see what they can offer and the price you will have to pay. Just make sure you keep in mind the enrollment deadlines.

The Providers Available in South Carolina – South Carolina has providers on the exchange for Obamacare, as well as providers who are off the exchange. The exchange providers include Coventry, BlueChoice Health Plan, BlueCross BlueShield of South Carolina, and United Healthcare. In addition, you could opt for plans off the exchange. You can choose from Celtic, Cigna, Freedom Life, and National Foundation Life.

It is important to keep in mind that they have a number of different plans from which you can choose, each of which may have some additional features or benefits that would work well for you or your family. They also have different prices so be aware of what you are getting. To help with this, let’s look at the different plan tiers to get a better understanding of what they mean.

The Plan Tiers and Levels – As you will find in other states, the plans on the exchange are separated into different levels or tiers, each of which is based on a precious metal. There are a number of plans from different providers on each of the tiers, but what do these tiers actually mean? They are a shorthand way of understanding the basics of what the plans will cost and provide.

There are bronze, silver, gold, and platinum tiers. The plans that fall into the bronze category are going to have the lowest monthly premiums, while they will have the highest out of pocket costs. When you choose a silver plan, the monthly premiums are a bit higher, but the out of pocket costs are a little lower. Gold plans have still higher monthly premiums, but they can pay for a significant portion of out of pocket costs. At the top of the tier are the platinum plans. These have the highest monthly premiums, but they will pay for 90% of the out of pocket costs for things such as copays and deductibles.

The Essential Benefits – All of the plans, regardless of the provider or the tier, will contain the essential benefits that Obamacare requires. These benefits include outpatient care, emergency services, treatment in the hospital, maternity and newborn care, addiction treatment and mental health services, prescription drugs, rehabilitative services and devices, pediatric care, preventative services and lab services.

Take your time when you are choosing your plan and make sure you understand everything it entails. In addition, make sure that you check out the options for other plans during each of the open enrollment periods, so you can find the best deal. Click Here to get a free health insurance quote.

Financial Assistance for Obamacare South Carolina

When Obamacare was coming down the pipeline, it caused many to worry about the affordability of the system. Residents in South Carolina were already working hard to make ends meet, and having an added monthly premium to pay for healthcare was unwelcome. It wasn’t that people thought healthcare was a bad investment for their life, but the cost was frightening for many. Fortunately, there are some ways to help make paying for the healthcare quite a bit more affordable.

Qualifying for Medicaid – One of the first things to realize is that South Carolina was not one of the states that decided to expand Medicaid. This means that it will be more difficult for people to qualify for the healthcare service, but it doesn’t mean it is impossible. When you fill out your application for South Carolina Obamacare, you will find out if you qualify for Medicaid. If you do, you will not have to worry about the growing cost of healthcare. However, because they didn’t expand, you should not count on qualifying. There are other ways that you can get some help though.

CHIP – Those who have children may be able to enroll them in CHIP, which can provide low cost or no cost healthcare. This coverage will provide them with checkups, immunization, dental care, doctor visits, prescriptions, and hospital care. Even if you are unable to qualify for Medicaid, your kids could qualify for that program or for CHIP. If money is tight, you should certainly apply to see what sort of help you could receive.

Tax Subsidies – Another way that you can get some financial assistance for Obamacare in South Carolina is to use tax subsidies. When you apply for coverage, you will find out how much you are able to receive in subsidies. Most people in the state are going to qualify, and those who do not have a high income, so they don’t really need it. The amount you receive is based on your income and the number of people in the family who will be receiving healthcare. The more people in the family and the lower the income, the greater the subsidy.

When you get your subsidies, you can use them in one of two different ways. You could choose to have them applied at the end of the year when you pay your taxes. This way, you could reduce the amount you owe or you could get a larger refund. You could also have them applied immediately, as many people do. This way, they will go right toward your monthly premiums. This will reduce the amount that you owe each month, making the plans far more affordable.

As you can see, even when the money is tight, there are several things you can do to help reduce the cost of Obamacare in South Carolina. These financial assistance options can help you get coverage you need, and they ensure you will not have to pay the penalties for not having any healthcare coverage.

Obamacare South Carolina Tax Information

Many people in South Carolina voiced concerns over what Obamacare’s implementation would mean for their tax situation. Not only were they concerned about their taxes going up, they also worried that it would fundamentally change the way they had to do taxes, or that it would increase the amount of work they had to put into their taxes. While there are some changes, it is not a huge concern for most people, and it is relatively easy to implement. Some residents also wondered how the government was going to know whether they had Obamacare and how they would find and fine them. It’s all through the taxes, as you will see.

The Forms for Taxes – Before your taxes are due, you will receive a form in the mail that has the information you need for your taxes and records. The form that you receive will depend on the type of coverage you have. Those who have Obamacare in South Carolina will receive the 1095-A form, also called the Healthcare Marketplace Statement. Those who chose to get insurance coverage through a private company will receive a 1095-B form from that company. If you have coverage through your place of employment, you will receive the Employer Provided Health Insurance Offer and Coverage form, or the 1095-C.

Those who will be receiving the 1095-A for Obamacare in South Carolina will have to wait for this form to arrive before they can do their taxes. It contains the information you need to fill out Form 8962. Once you have the 1095-A and use it to fill out 8962, you will send your taxes, along with the 8962, to the IRS. Keep the 1095-A for your records.

However, if you are going to receive the 1095-B or 1095-C, you do not have to wait for them to do your taxes. The IRS already has the information it needs. You can simply turn your taxes in as soon as you would like.

File Your Taxes – If you do not file your taxes, or you do not fill out these forms, then the IRS will know that you do not have coverage. They will then fine you. The current fines are very high, and they are likely to get higher in the coming years. Right now, it is $695 for adults without coverage (or 2.5% of their income, whichever is higher), and $347.50 for children without coverage. Also, if you do not file and you have coverage, you will not be able to get tax subsidies to help reduce the cost of your coverage the following year.

For the most part, people will find that these additional forms are not very difficult to incorporate into their taxes. If you have relatively simple taxes, the additional form should not take long. Of course, if you have complicated taxes, or if you do not like doing your taxes, you can always hire someone else to do them for you. Make sure that you take care of the taxes as soon as possible, so you do not have to worry about turning them in before the deadline.

Common Mistakes on the Obamacare SC Application Process

When it comes time to fill out your Obamacare application for coverage in South Carolina, you have to be careful. Whether you are applying for special enrollment or during the open enrollment, it is essential that you take your time on the application to fill out everything properly. It is very difficult, and in many cases impossible, for the government to handle the enrollment application errors that are coming their way. Therefore, you should avoid the need to appeal your enrollment error by not making an error in the first place. By understanding some of the most common errors, it can help you avoid them when it comes to your application.

Not Filling It Out Entirely or Using Incorrect Information – One of the biggest problems that the government has seen is people not filling out the entire form. It is important to fill out each piece of the application if you do not want to experience delays. If you have questions about parts of the application, you can talk with a professional about those areas before you fill them out. Make sure that you add the correct Social Security number, birthdates, and names in the right sections. One error that has happened quite a bit is people putting their spouse in their dependent’s section along with their children. Put everyone in the appropriate category.

You should also remember that Obamacare in South Carolina and the rest of the country has changed the length of time that you can keep your kids on your insurance. You can now keep them on your plan up until they are 26 years old.

Incorrect Income – Your income is a very important part of the application, so make sure that you are accurate with your information. The amount of income you have will determine the amount of tax subsidies that you can use. Those who have lower incomes and a larger number of dependents will qualify for more subsidies. However, you should never try to deflate your income and put a false number just to try to get more in tax subsidies. The IRS will find out and they will no longer allow you to use subsidies to help offset your healthcare costs.

Applying On Time – Another problem that people have been having when it comes to the application process for Obamacare in South Carolina is actually filling it out and turning it in on time. Remember that there is an open enrollment period each year, and unless you qualify for a special enrollment or you are Native American, or qualify for Medicaid, you need to abide by the enrollment dates.

As long as you take your time with your application for Obamacare in South Carolina, and you double-check the information before you turn in the application, you should not have any issues with errors that could cause delays or denials. Take your time and get the coverage you need so you can avoid penalties for not having insurance. They are currently $695 for an adult and $347.50 for a child without coverage.

Enrollment and Tax Credit for Small Business

Obamacare South Carolina small business owners were quite worried when they first heard about Obamacare. They knew that it was going to require that everyone had health insurance, and they wondered if it meant that their business would need to start providing coverage for their employees. If that was the case, they feared that it could be the death knell for their business, simply because they couldn’t afford the cost. However, there was good news. Businesses that had 50 or fewer employees were not required to provide coverage.

What Do You Need to Do? – Consider the number of full time equivalent employees you have at the job. A full time equivalent is 30 hours on average per week or 130 hours per month. Keep in mind that one FTE could actually be made up of two of your employees. If you have two people who are working 15 hours on average per week, they would be considered one FTE. Factor this in when you are determining whether you are required to offer insurance or not.

Should You Enroll? – Even though you might not be required to provide insurance by the law, that doesn’t mean it’s a bad idea. In fact, offering coverage for Obamacare in South Carolina to your employees might be a good option. Consider some of the benefits. For starters, you will find that your employees will like the idea of having coverage through their employer, and it can make them more loyal. They are less likely to want to leave the job, and that could mean a reduced turnover rate for you. Another benefit is the increased health of your staff. There are less likely to be sick days, and employees who are healthy and happy tend to be more productive.

One of the other great benefits is the fact that you will have access to small business tax credits. These can help you to reduce the amount you owe in taxes, and it is a great incentive for businesses who want to offer their employees coverage.

Does Your Business Qualify? – You could go through the Small Business Health Options Program, or SHOP to find companies that offer plans for small groups such as your business. However, you have to qualify. You will need to have 25 or fewer employees, and you need to pay at least half of their premiums, or 35% if you are nonprofit. The average wages for the employees need to be less than $50,000 per year as well. Keep in mind that if you are going to offer coverage, you have to offer it to all of the employees at the company, not just a select few.

When you are choosing plans for your employees, think about the type of coverage that would work the best for them. You may want to meet with them to discuss what type of plan might be best.
Consider the benefits of offering coverage and then start shopping for a good plan for your employees.

Obamacare South Carolina Fact Sheet

South Carolina residents know Obamacare is now the law of the land and that they need to have health insurance. However, they do not always have the facts about Obamacare and what it means for them and for others in the state and around the country. Let’s look at the most important facts about Obamacare that you should know.

You Are Not Forced to Get Healthcare – One of the misconceptions of Obamacare in South Carolina and the implementation of the Affordable Care Act is that if you do not have coverage, you will go to jail. The truth is that no one is going to force you to get health coverage. However, they will require you to pay a tax penalty for not having coverage. These penalties are high, and in the coming years, they could get even higher. As it stands now, the fines are $695 for an adult that does not have coverage (or 2.5% of their income – whichever is highest), and $347.50 for children who do not have health coverage.
Preexisting Conditions Are No Longer a Barrier to Coverage

In the past, if you had a preexisting condition, it could be very difficult to get an insurance company to provide coverage. Today, thanks to Obamacare, they are not allowed to deny you coverage. In addition, they can’t charge you more or increase a person’s rates just because you develop a condition or disease down the line.

The Cost of Obamacare South Carolina – The amount it costs for Obamacare varies based on a number of factors. The type and level of coverage that a person chooses, as well as the amount of tax subsidies they receive are two of the elements that will determine the overall cost of the insurance.
Enrolling in Obamacare

If you are going to enroll in Obamacare, you need to do it during the open enrollment period in most cases. The open enrollment is usually from November to January each year. If you do not enroll during that time, or change plans during that time if you are already covered, you can’t do so until the following open enrollment. However, there are some exceptions to this rule. Those who qualify for Medicaid are able to enroll at any time of the year, as are Native Americans.

In addition, you could qualify for special enrollment if you have an event in your life that would necessitate it. For example, if you and your spouse have a child, or you move to South Carolina, you could then enroll in Obamacare during a 60-day enrollment. Keep in mind that the 60 days begins at the date of the event. So, if you move to the state, the 60 days would start on the day that you move. Make sure you enroll during that time.

You Get the Essential Benefits – All of the plans include the essential benefits. These include outpatient care, emergency services, hospitalization, maternity and newborn care, mental health services and addiction treatment, rehabilitative devices and services, prescription drugs, lab services, preventative services, and pediatric services. Now that you know more about the facts of Obamacare in South Carolina, you will have a better idea of how to incorporate it into your life.

What’s New for Obamacare SC in 2016?

Residents of South Carolina who are already on Obamacare, those who are getting in now through special enrollment, and those who are going to be signing up during the following open enrollment need to know what’s happening with the system in the state. Knowing the changes that occurred this year can make it much easier to understand the way the coverage works and what they need to do to get it. While many things have stayed the same, there are some differences you need to consider as well.

The open enrollment for 2016 proved to be successful, as there were 231,849 people enrolled in the plans, including new enrollees as well as renewals. Even with the cancelled enrollments accounted for, the enrollment for 2016 was 10% higher than it was in 2015. People know that enrollment is now a requirement unless they are willing to pay the penalties. The fines for not having some type of health coverage that satisfies the Obamacare requirements is $695 or 2.5% of their income, whichever is higher. The current penalty for children without coverage is $347.50.

The Providers – There are currently four companies offering coverage on the exchange for South Carolina Obamacare. They include Coventry, BlueChoice Health Plan, BlueCross BlueShield of South Carolina, and United Healthcare, which is new in 2016. It is important to note that Consumers Choice Co-Op stopped offering plans in 2016, so people who were using that provider before had to change to one of the new providers.

The cost of the coverage in South Carolina for the Obamacare plans is rising as well in a number of cases. Coventry has increased their rates by an average of 31.8% on their plans that are on the exchange, as well as those plans that are off the exchange. The two other companies that were available previously in SC have increased their rates as well, although their increases are much lower than Coventry’s. BlueChoice Health Plan has an average increase of 8.89%, while BlueCross BlueShield of South Carolina has an average increase of 8.66%.

In addition to the companies that are offering plans on the exchange, there are a number of carriers that offer plans off exchange that you may want to consider. They include Celtic, Cigna, Freedom Life, and National Foundation Life.

Getting Coverage – If you don’t have coverage right now, you will have to wait for the next open enrollment, which starts in November, 2016. However, those who are Native Americans can enroll at any point during the year, as can those who qualify for Medicaid. However, some people may also qualify for a special enrollment. Those who have qualifying events in their life, such as having a child, moving to the state, or getting married will qualify. They will then get 60 days to look through the plans and choose the one that is right for them and their family. It is a good idea for everyone, even if they already have a plan, to look at the other options available during open enrollment, just to see if they might be able to find something better or more affordable.

Cons and Pros of Obamacare SC

Whether you love the idea of Obamacare or you hate it, having health coverage is now the law in South Carolina, and that means you need to get coverage. Of course, you should take the time to understand that there are both pros and cons to the system. Understanding the good and the bad will help to give you a better overview of what to expect, and why it might not be as bad as you think. First, let’s examine some of the biggest cons to South Carolina Obamacare.

Cons of Obamacare South Carolina  – First, people really do not like the idea that they are being forced into getting healthcare coverage. Even if they know that having coverage is a good idea for health and to protect their finances in the event of illness or injury, the idea of being told by the government that they have to have coverage doesn’t sit well with them. Even worse, they know that they will have to pay a fine if they do not have coverage. The fines are currently $695 per person, or 2.5% of their income, whichever is higher. For children, the penalty is $347.50.

Another issue with South Carolina Obamacare is the fact that the state did not expand Medicaid. While the onus for this is on the state, the fact of the matter is that there is now a gap where some people who are unable to qualify for Medicaid because of their income are still not making enough to pay for Obamacare plans and to make ends meet.

The open enrollment is not well-received either. You are only able to enroll in a plan during this limited time each year, from November to the end of January. Those who don’t sign up on time have to wait until the next year unless they qualify for special enrollment.

The Pros of Obamacare South Carolina – Naturally, there are a number of benefits to help offset those negatives. To help most people pay for their insurance costs, tax subsidies are available. You can apply these to your taxes at the end of the year, or you can apply them right away to reduce the monthly premium costs.

Another benefit is that the insurance companies are no longer able to deny someone coverage just because they suffer from a preexisting condition. This means people who really need to have coverage can now get it, and the insurance companies can’t charge them more for it. Parents are also able to keep their children on their health insurance plans until they are 26 years old. This can be helpful for those who are younger adults and who are still struggling to make ends meet.

The plans for Obamacare in South Carolina have helped a number of people who truly need to have health coverage finally get it. The benefits, for most, seem to outshine the negatives. When you are looking for a plan that will work for you, consider the overall cost and the features it offers, and make sure you look early so you can apply or change your plan during open enrollment.

Obamacare SC Common Questions

Many people in South Carolina only know the very basics of Obamacare, and some do not even know the basics. They only know what little they’ve gleaned from their news sources, but they’ve never actually looked into what the Affordable Care Act means for them. Even though it has been the law for several years now, a number of people still have quite a few questions when it comes to Obamacare. Let’s look at some of the most commonly asked questions regarding Obamacare in South Carolina so you can have a better idea of how it will affect you.

Does Coverage Need to Be Through Plans on the Exchange? – To satisfy the requirements for Obamacare in South Carolina, you do not have to choose plans from the exchange. There are other carriers that are not on the exchange that have plans you could use as well. In addition, if you have coverage through your employer, you will not need to have additional Obamacare coverage.

What If I Choose No Coverage? –  If you decide that you really do not want to have any health insurance, you will not go to jail for it, which was a common misconception among many. Even though you won’t go to jail though, you will have to pay a penalty to the IRS. They will add the penalty to your taxes. The penalty is $695 for an adult without coverage (or 2.5% of their income, whichever is higher). For children without coverage, the cost of the fine is $347.50. This could eventually go up.

Who Offers Coverage in Obamacare South Carolina? – Obamacare exchange providers and off exchange providers are available. The exchange providers include Coventry, BlueChoice Health Plan, BlueCross BlueShield of South Carolina, and United Healthcare. You can choose from Celtic, Cigna, Freedom Life, and National Foundation Life if you are looking for a plan that is off the exchange instead.

What Do the Tiers Mean? – When you first start looking at the various plans that are available, you will notice that they are placed into different tiers, each of which is named after a precious metal. The bronze tier plans have high out of pocket expenses, but they have low monthly premiums. These are generally a good idea for someone who is in good health and who does not visit the doctor often. At the opposite end are the platinum plans, which have expensive monthly premiums and pay for 90% of the out of pocket costs.

What Are the Essential Benefits? – All of the plans, regardless of the provider and whether they fall into the bronze, silver, gold, platinum, or catastrophic tiers have the essential benefits. These include ambulatory care, emergency services, treatment in the hospital, maternity and newborn care, addiction treatment and mental health services, prescription drugs, rehabilitative services and devices, pediatric care, preventative services and lab services.

Now that you have a better understanding of some of the most common questions regarding Obamacare in South Carolina, and their answers, you should be much better prepared to find and choose a plan during the next open enrollment, or special enrollment if you qualify.

Unique Aspects of SC Obamacare – If you are going to be getting Obamacare in South Carolina, you might be wondering what makes it different from coverage in other states, if anything. For the most part, things are very similar. You need to abide by the open enrollment dates to get coverage. The open enrollment for 2016 ended in January, and it will not open up again until November. The only way to get coverage on the exchange now is to qualify for Medicaid, be a Native American, or qualify for special enrollment with a qualifying event. For example, if you just moved to South Carolina, or you recently had a child, you can qualify for a 60-day enrollment period to find your coverage.

No Medicaid Expansion – When the Affordable Care Act was announced, it caused many states to look at their Medicaid system to see how it would be affected. In a number of cases, they found that it would likely cause a gap where people who were not able to get onto Medicaid because of their income levels might still not be able to afford Obamacare. Most of the states decided that they would expand their Medicaid coverage to eliminate, or at least start to close this gap. South Carolina was not one of those states, and they decided that they would not expand Medicaid.

This means that it could still be difficult for some people to get the coverage they need due to their income and the costs. However, they may still be able to qualify for tax subsidies from the government which can reduce the amount of money they need to pay for their coverage each month.

Providers on and Off the Exchange – Though there are many similarities between Obamacare in South Carolina and in other states, one of the main differences will be with the providers. In SC, you will find four current carriers that offer plans on the exchange. These carriers include Coventry, BlueChoice Health Plan, BlueCross BlueShield of South Carolina, and United Healthcare. Those who are looking for plans off the exchange will find several options as well including Celtic, Cigna, Freedom Life, and National Foundation Life.

You Will Receive the Essential Benefits – Even though there are a number of unique plans and carriers in the state, you can be sure that each of those plans will come with the essential benefits at least. These are benefits deemed necessary by Obamacare. South Carolina residents will receive outpatient care, emergency services, treatment in the hospital, maternity and newborn care, addiction treatment and mental health services, prescription drugs, rehabilitative services and devices, pediatric care, preventative services and lab services as a part of their plan.

Even though there are many similar aspects to the system in SC as there are in other states around the country, it is always important to check out the differences and to keep up with changes as they occur. For example, South Carolina recently tried to revoke Obamacare in the state, but they weren’t successful. It’s a good idea to keep abreast of these types of things, just in case there are changes you should know about.

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