COBRA Alternatives in South Carolina for 2027
Leaving a job in South Carolina gives you three paths: keep your old plan through COBRA or South Carolina's continuation law, switch to a Marketplace plan during a special enrollment period, or apply for a private plan that can start on the first of next month if approved. The cheapest path depends on your health, your income for the year and how much of your deductible you have already met. South Carolina individual premiums are also rising 22.1% on average for 2027.
Private health insurance in South Carolina
Most people I help in South Carolina end up on a private plan, not a Marketplace plan. Private, medically underwritten health insurance is priced on your age, zip code and health instead of your income, so a strong year never raises your premium and there is no tax credit to pay back in April.
Why people leave the Marketplace
- Premiums keep climbing. South Carolina Marketplace premiums are rising 22.1% on average for 2027.
- The subsidy cliff. Above 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four) you pay full price.
- Surprise tax bills. Underestimate your income and you repay the tax credit in April.
- Narrow networks. Many plans are local HMOs or EPOs that need referrals and cover little outside the area.
- High out-of-pocket costs. 2027 out-of-pocket maximums reach $12,000 per person and $24,000 per family.
- One window a year. Outside open enrollment you need a qualifying life event to enroll or switch.
What a private plan does differently
- Start any month. If approved, coverage can begin the first of next month, with no wait for open enrollment.
- Networks that travel. Many private plans use national PPO networks, which can give you in-network doctors outside South Carolina too. Networks vary by plan.
- Can cost less than full-price Marketplace plans for some healthy applicants above the subsidy line.
- Accident coverage the Marketplace does not offer. A private plan can be paired with accident coverage, a separate policy. What it includes varies by plan.
- Approval is based on health. You answer health questions, and acceptance is not guaranteed.
With a significant health condition, or income low enough for a large tax credit, a Marketplace plan can be the better fit, and I will tell you if it is. Either way you see both side by side.
Private plans are not ACA Marketplace plans. Benefits, exclusions and pre-existing condition rules differ by plan and by state, so review the plan details before you enroll.
Get a private plan quoteLearn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace
South Carolina continuation law
Section 38-71-770 covers insured group medical plans. You qualify after six months of continuous coverage, whatever the reason coverage ended, unless you stopped paying your share. Coverage lasts the rest of the month plus six more policy months. You pay the entire group premium, including the share your employer used to pay, before each policy month begins. Your employer must tell you about the right and the premium when you leave. It does not apply if federal COBRA gives you longer coverage, or if you are eligible for Medicare or similar group coverage.
Switching off COBRA in South Carolina
South Carolinians leaving COBRA or state continuation use HealthCare.gov. When continuation ends, you have 60 days to pick a plan, and applying before your last covered day lets the new plan start the first of the following month. Ending COBRA early by choice, or by skipping payments, does not open a special enrollment window. South Carolina's state continuation runs only about six months, so mark its end date the day it starts. For questions or complaints, call the Department of Insurance Office of Consumer Services at 803-737-6180, or toll-free in state at 1-800-768-3467.
The South Carolina individual market you would switch into
South Carolina buyers enroll through HealthCare.gov. The state's continuation law covers insured group plans and lasts the rest of the month coverage ends plus six months, after six months of coverage, at the full group premium. South Carolina's insurance department adopted the federal short-term limits in 2024, three months initial and four months total, replacing its older 11- and 33-month limits. Final 2027 individual rates average about 22 percent higher, among the largest increases on this list, while small-group plans rise a comparatively modest 8.9 percent.
Other South Carolina rules to know
- Short-term plans: South Carolina's insurance department adopted the federal short-term limits in 2024, three months initial and four months total, and has not issued newer guidance.
- Where to enroll: South Carolina uses HealthCare.gov. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027. Private, medically underwritten plans can start the first of any month if approved.
- 2027 rates: individual plans 22.1% on average, small-group plans about 8.9%. See the South Carolina 2027 rate page.
What COBRA really costs
Under federal COBRA, which covers employers with 20 or more employees, you can keep your group plan for up to 18 months but pay up to 102 percent of the full premium, including the share your employer used to pay. That is often the most expensive option available. You have 60 days to elect it, and coverage is retroactive, so some people wait and elect only if they need care.
When COBRA is still worth keeping
Keep COBRA when you have met most of your deductible this year, are in the middle of treatment, or need a specific doctor who is not in other networks. Otherwise compare it against a Marketplace plan, which may come with a tax credit, and a private plan.
Do not miss the 60-day window
Losing job-based coverage opens a 60-day Marketplace special enrollment period. Voluntarily dropping COBRA later does not open a new one outside open enrollment, so decide while the window is open.
For 2027 the Marketplace credit stops at 400 percent of the poverty level: $63,840 for one person, $86,560 for two and $132,000 for a family of four. The out-of-pocket maximum for 2027 Marketplace plans is $12,000 for one person and $24,000 for a family. The full guide covers the rest.
Compare South Carolina plans
Licensed in South Carolina. Private plans priced first, Marketplace alongside when it fits. No fee.
South Carolina questions
Where do South Carolina residents enroll in 2027 coverage?
South Carolina uses HealthCare.gov. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027.
What continuation rights does South Carolina give after leaving a small employer?
South Carolina requires insured group plans to offer continuation for the rest of the month coverage ends plus six months, after at least six months of coverage, at the full group premium.
How much are South Carolina premiums rising for 2027?
Individual-market premiums are set to rise 22.1% on average, and small-group plans about 8.9%.
Is a Marketplace plan cheaper than COBRA?
Often, especially if your income qualifies for a tax credit. Above the subsidy line, a private plan may cost less than both for a healthy buyer.
Can I drop COBRA and get a Marketplace plan later?
Only during open enrollment, unless you have another qualifying event. Your special enrollment window after losing job coverage lasts 60 days.
Sources: www.scstatehouse.gov, www.healthcare.gov, doi.sc.gov. Facts checked October 2026. See all South Carolina health insurance rules.
COBRA alternatives in other states
Written by Frank Caballero, licensed health insurance agent in South Carolina and 30 other states, NPN 21032307.