Short-Term Health Insurance in South Carolina: 2027 Rules
A short-term health plan in South Carolina is a temporary policy meant to fill a gap of weeks or a few months, not a full replacement for major medical coverage. It can exclude pre-existing conditions, cap what it pays and decline applicants, and South Carolina adds its own rules on top of the federal limits. With South Carolina Marketplace premiums rising 22.1% on average for 2027, more people are looking at short-term plans, so it pays to know what they leave out. I don't sell short-term plans; this page explains how they work in South Carolina and the year-round options I do offer.
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
Short-term plan rules in South Carolina
South Carolina permits short-term health plans and regulates them through the South Carolina Department of Insurance. Its Bulletin 2018-08 set the state's own limits at an initial term of up to 11 months and a total of up to 33 months with renewals. In November 2024, Bulletin 2024-13 told insurers the stricter federal four-month cap applied. After federal officials announced in August 2025 that they would not prioritize enforcing that cap, healthinsurance.org reported that by early 2026 some insurers in the state were again offering policies lasting up to 33 months, though many plans run only three to six months and renewal is optional. Pre-existing conditions are normally excluded. Confirm current limits with the department, since a 2025 state bulletin on this point could not be located.
When a short-term plan fits in South Carolina, and what to use instead
Along the Grand Strand and the Lowcountry, plenty of South Carolinians work seasonal hospitality jobs that wind down after Labor Day, and others sit through a 60- or 90-day waiting period at a new manufacturing employer. Those are the narrow cases where a short-term policy can work as a placeholder. It typically excludes past health conditions, is not ACA coverage, and qualifies for no premium subsidy. South Carolina uses HealthCare.gov as its Marketplace, and losing job-based coverage gives you 60 days to enroll there outside open enrollment. Healthy applicants can also look at a year-round, medically underwritten private plan; if approved, it can start the first of a month, with no need to wait for November. Frank can help you weigh which one suits your situation.
The South Carolina individual market
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
- 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.
- 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 a short-term plan is
Short-term limited-duration insurance is temporary coverage outside the ACA rules. It can ask health questions, turn applicants down, exclude conditions you already have and leave out benefits such as maternity care, mental health care or prescriptions. It is not Marketplace coverage, so no subsidy applies to it.
Why the time limit matters
A 2024 federal rule caps short-term plans at three months, or four with renewals. In August 2025 federal regulators said they would not prioritize enforcing that cap, so the real limit now depends on your state, from a few months to as long as three years. However long it lasts, when the plan ends you are not guaranteed a new one, and losing a short-term plan does not open a Marketplace enrollment window.
The two options that last all year
A Marketplace plan accepts everyone during open enrollment or within 60 days of losing other coverage. A medically underwritten private plan is year-round coverage priced on age, ZIP code and health; it is not a Marketplace plan, approval depends on your health answers, benefits vary by plan, and if approved it can start the first of a month. For most people who need more than a short bridge, one of these two is the better fit.
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.
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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 short-term plan cheaper than a Marketplace plan?
The premium often is, but the plan covers less, can exclude pre-existing conditions and ends after a few months. Compare it with what you would actually pay for care under each option.
Can I get a short-term plan after open enrollment ends?
Where your state allows them, yes, but they are temporary. A year-round private plan can also be applied for in any month and, if approved, can start the first of a month.
Sources: www.healthinsurance.org, doi.sc.gov, www.cms.gov. Facts checked October 2026. See all South Carolina health insurance rules.
Short-term plans in other states
Written by Frank Caballero, licensed health insurance agent in South Carolina and 30 other states, NPN 21032307.