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Losing health coverage in South Carolina

COBRA works the same in every state, but almost everything around it does not — enrollment dates, which products are legal, and what coverage actually costs here. This is what is specific to South Carolina.

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South Carolina assigns a separate rating area to each of its 46 counties, one of only two states to do so, which means your county determines your options unusually precisely. South Carolina has not expanded Medicaid, leaving a coverage gap that contributes to an 11.2% uninsured rate, and the COBRA burden of 14.2% of median monthly income is among the heaviest in the country.

What the numbers say about South Carolina

11.2%of under-65 residents uninsured — the 13th highest of 51
14.2%of median monthly household income taken by a single COBRA premium — the 9th highest of 51
1.15%monthly layoff and discharge rate

South Carolina ranks the 11th highest of 51 on our State COBRA Exposure Index, which combines those three measures. Uninsured figures are 2024 Census estimates covering all 46 counties in the state.

What is different about South Carolina

South Carolina uses the federal marketplace at HealthCare.gov.

Open Enrollment for 2027 coverage runs from November 1, 2026 to January 15, 2027, the federal schedule. Enroll by December 15, 2026 for coverage starting January 1.

Short-term plans are available here, but they are not comprehensive coverage — typically medically underwritten, often excluding pre-existing conditions, and not minimum essential coverage. They can suit a short, defined gap such as a new employer’s waiting period. They are not a substitute for a marketplace plan.

Where plans are priced

Individual health plans are not priced statewide. South Carolina is divided into geographic rating areas, and the plans available to you — and what they cost — depend on which one your county falls into. Two households an hour apart can face a different list at a different price. This is why a national quote figure means very little, and why a licensed agent will ask for your ZIP code before anything else.

COBRA in South Carolina

COBRA is federal law, so it works identically in every state. If your employer had 20 or more employees you have 60 days to elect from the later of losing coverage or receiving your notice, then 45 days to make the first payment, and coverage reaches back to the day your old plan ended. You pay 102% of the full premium.

What varies by state is what happens when federal COBRA does not apply. If your employer had fewer than 20 employees, South Carolina may have its own continuation law — often called mini-COBRA — with different durations and eligibility. Ask about this specifically if you worked for a small employer, because it is easy to be told "you do not qualify for COBRA" and not be told about the state alternative.

How COBRA works in detail · COBRA compared with a marketplace plan · All your options after a job ends

The largest counties in South Carolina

Because plans are priced by rating area rather than statewide, the figures below differ between places that sit an hour apart. Each one has its own page with the local uninsured count, how many people bought marketplace coverage there, and how many insurers actually sell in it.

CountyUninsured, under 652026 plan selectionsInsurers
Aiken County10.4%17,7413
Anderson County11.4%22,4873
Berkeley County10.1%26,9754
Charleston County9.5%51,1034
Dorchester County10.0%17,9344
Greenville County11.5%60,9993
Horry County14.1%50,9853
Lexington County10.8%30,6893
Richland County10.3%46,2174
Spartanburg County12.4%34,5014
York County9.0%21,0744

The 11 largest counties in South Carolina by population, covering 69% of the state's under-65 residents. Uninsured rates are 2024 Census estimates; plan selections and insurer counts are from the 2026 CMS public use files. Figures for every county in South Carolina — including those without their own page — are in the state data set.

Common questions

How much is health insurance in South Carolina?

There is no single answer, because South Carolina is split into geographic rating areas and prices differ between them. Your age, household size and income all change the figure too. What we can say concretely is that a full COBRA premium consumes about 14.2% of median monthly household income here, which is the 9th highest of 51 in the country — one reason so many people in South Carolina look for an alternative.

When is Open Enrollment in South Carolina?

November 1, 2026 to January 15, 2027 for 2027 coverage, following the federal schedule. Enroll by December 15, 2026 if you want coverage starting January 1.

Can I get short-term health insurance in South Carolina?

Yes, they are available in South Carolina. They are not comprehensive coverage — typically medically underwritten and not minimum essential coverage — so they suit a short, defined gap rather than an ongoing need.

What if my employer in South Carolina had fewer than 20 employees?

Federal COBRA would not apply, but South Carolina may have its own continuation law covering smaller employers. Durations and eligibility differ from federal COBRA. Ask specifically about state continuation — people are often told they do not qualify for COBRA without being told the state alternative exists.

Does losing my job in South Carolina let me buy insurance right away?

Yes. Losing job-based coverage opens a 60-day Special Enrollment Period for a marketplace plan, and only 30 days to join a spouse's or parent's employer plan. Medicaid has no window at all and can be applied for any day of the year.

Is Medicaid an option in South Carolina?

It is worth checking first either way, because there is no enrollment window and no premium, and eligibility is assessed on your current monthly income rather than your annual figure. Be warned, though: South Carolina has not expanded Medicaid. That leaves a coverage gap — adults earning too much for the state's restrictive Medicaid limits but too little to qualify for marketplace subsidies. Losing a job can drop you into that gap rather than out of it, which is exactly why it is worth finding out where you stand before you decide anything else.

Why does my premium differ from someone else in South Carolina?

Because plans are priced by rating area rather than statewide, and your age and household composition also matter. Someone in a neighboring county can genuinely face a different set of plans at different prices.

Is there a health insurance agent near me in South Carolina?

You do not need one physically nearby. Plans in South Carolina are sold and priced by county, and a licensed agent can look up exactly what is available in yours from anywhere. Calling (866) 821-1808 connects you with a licensed agency covering South Carolina.

Talk it through with a licensed agent

Which option is right depends on your state, your income and which doctors you need to keep. A licensed agent can walk through it with you in about eight minutes.

Call (866) 821-1808

Free to call, no obligation, and we never ask you for payment. CobraScout is paid by the agency that answers, not by you. TTY 711.

Sources

Published by CobraScout · Last checked against the sources above on August 26, 2026 · See our editorial policy and corrections policy

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