Free Health Insurance South Carolina 2027: Who Qualifies & How to Enroll
South Carolina's health insurance marketplace is HealthCare.gov, and open enrollment for 2027 coverage runs November 1, 2026 – January 15, 2027. Enroll by December 15 for a January 1 start. South Carolina hasn't expanded Medicaid and the enhanced tax credits expired after 2025, so your income decides whether free health insurance is realistic. Here are the 2027 income limits, what Healthy Connections Medicaid covers, the coverage gap explained honestly, and how to enroll without overpaying.
Get a Free 2027 Quote ↓Free Health Insurance in South Carolina: What “Free” Really Means in 2027
Quick answer: Lower-income South Carolinians may qualify for a $0-premium HealthCare.gov plan in 2027 after the premium tax credit. Single adults earning $15,960 to $63,840 can qualify for tax credits. Open enrollment runs November 1, 2026 to January 15, 2027; enroll by December 15 for January 1 coverage. South Carolina hasn't expanded Medicaid, so some adults under $15,960 face a coverage gap.
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Free health insurance in South Carolina comes from two places. The first is a premium tax credit on the South Carolina health insurance marketplace, HealthCare.gov, which CMS lists as a federally facilitated Marketplace for plan year 2027. The second is Healthy Connections Medicaid, run by the South Carolina Department of Health and Human Services (SCDHHS), which covers children, pregnant women, parents with very low income, and people who are aged, blind or disabled. If your household income falls between 100% and 400% of the federal poverty level, the credit pays part or all of your monthly premium directly to the insurer, and at lower incomes that math can land on a $0-premium plan. The same federal rules apply statewide, from Columbia and Charleston to Greenville and Myrtle Beach.
Here's what changed for 2027. The enhanced premium tax credits of 2021–2025 expired at the end of 2025, and under current law they are not back for 2027 unless Congress acts. Credits are smaller than in 2025, and the 400% FPL cliff is back: earn $1 over the line and your credit is $0. South Carolina also hasn't expanded Medicaid, so the income line at the bottom of the scale matters as much as the one at the top. Our open enrollment 2027 guide covers the national picture; this page is the South Carolina version.
FreedInsure LLC is an independent brokerage; its licensed agent, Constantino Lardi (NPN 20230457), is licensed in 42 states, South Carolina included. We project your 2027 income, calculate your credit, compare the plans sold in your county, and enroll you — and our help is 100% free to you. Call (844) 788-3733 or see if you qualify.
South Carolina Health Insurance Income Limits for 2027
Marketplace savings for 2027 coverage are based on the 2026 federal poverty guidelines: $15,960 for one person and $33,000 for a family of four. The IRS sets how much of your income you're expected to pay for the benchmark Silver plan, and the tax credit covers the rest. Here's how affordable health insurance in South Carolina prices out across the income scale.
| 2027 Household Income | Household of 1 | Household of 4 (approx.) | What You Typically Get |
|---|---|---|---|
| Under 100% FPL | Below $15,960 | Below $33,000 | No marketplace credit, and Healthy Connections has no expansion-adult group. The coverage gap (see below) |
| 100–150% FPL | $15,960–$23,940 | $33,000–$49,500 | The biggest credits — you pay about 2.15%–4.30% of income for the benchmark Silver plan; $0-premium bronze plans may be available after the credit, and 94% CSR Silver plans are available |
| 150–200% FPL | $23,940–$31,920 | $49,500–$66,000 | You pay 4.30%–6.78% of income for benchmark Silver, plus 87% CSR Silver plans that shrink deductibles |
| 200–250% FPL | $31,920–$39,900 | $66,000–$82,500 | You pay 6.78%–8.66% of income; 73% CSR Silver plans still trim cost sharing |
| 250–400% FPL | $39,900–$63,840 | $82,500–$132,000 | Credits taper — you pay 8.66%–10.22% of income for the benchmark Silver plan |
| Over 400% FPL | Over $63,840 | Over $132,000 | No tax credit in 2027 under current law — full-price plans, so shopping smart matters most |
Family-of-four figures are derived from the 2026 guidelines, so treat them as approximate. Income means your projected 2027 household income — W-2 wages, 1099 and gig income, self-employment, everything. Getting it right matters more than ever: for tax years after 2025 there is no cap on repaying excess advance credits, so a low estimate can mean paying back the full difference at tax time. Starting January 1, 2027, federal law also limits premium tax credits to fewer groups of lawfully present immigrants; green card holders, Cuban/Haitian entrants and COFA migrants remain eligible. Want a number now? Try the 2027 ACA subsidy calculator or read our full ACA income limits guide.
The $1 problem: at 400% of FPL — $63,840 for a single person — the 2027 credit stops cold. One extra dollar of projected income and the whole credit disappears. If you're anywhere near the line, read how to avoid the 2027 subsidy cliff before you enroll, or call (844) 788-3733 and we'll run the math free.
Did South Carolina Expand Medicaid? No — Here's What Healthy Connections Covers
South Carolina is one of 10 states that have not expanded Medicaid, according to KFF (October 2026). The state program is Healthy Connections Medicaid, run by SCDHHS. It covers specific groups, but there is no expansion-adult group: working-age adults can't qualify on low income alone. These are the monthly income limits on SCDHHS's Program Eligibility and Income Limits page, effective March 1, 2026:
| Family Size | Parent/Caretaker Relatives (62% FPL) | Partners for Healthy Children (208% FPL) | Pregnant Women and Infants (194% FPL) |
|---|---|---|---|
| 1 | $824.60 | $2,766.40 | $2,580.20 |
| 2 | $1,118.06 | $3,750.93 | $3,498.46 |
| 3 | $1,411.53 | $4,735.46 | $4,416.73 |
| 4 | $1,705.00 | $5,720.00 | $5,335.00 |
Partners for Healthy Children covers children under 19, and SCDHHS says its plans include Medicaid and the Children's Health Insurance Program (CHIP). Pregnant Women and Infants coverage continues for 12 months after the baby's birth, and the infant is covered up to age one. Parent/Caretaker Relatives (formerly Low Income Families) covers adults with a dependent child in the home. Adults without dependent children have no full-coverage group unless they are aged, blind or disabled (at or below 100% FPL) or fit another specific group, such as former foster youth up to age 26 or women needing breast or cervical cancer treatment. A limited Family Planning benefit is available up to 194% FPL; SCDHHS says it does not meet the standard for minimum essential coverage, so enrollees may still qualify for marketplace tax credits.
The parent limit is the one that surprises people: 62% FPL is $1,705 a month for a family of four, or about $20,460 a year. Medicaid uses the current year's poverty guidelines, so expect these dollar amounts to change after HHS publishes the 2027 guidelines and SCDHHS adopts them. Our Medicaid income limits by state page shows how South Carolina compares with the 40 states and Washington, DC that have expanded Medicaid, including neighboring North Carolina, which expanded Medicaid in December 2023.
The South Carolina coverage gap
Marketplace credits start at 100% FPL — $15,960 for a single adult buying 2027 coverage. An adult without children who earns less than that generally has no Healthy Connections group to fall into and no marketplace credit. A parent in a family of four earning between about $20,460 and $33,000 is in the same spot, although the children may still qualify for Partners for Healthy Children. People in the gap can still buy a marketplace plan, just at full price.
If that's you, three things genuinely help. First: count all your income. Marketplace eligibility uses projected annual income — W-2, 1099, gig work, side jobs, a spouse's pay. A realistic projection at or above $15,960 can qualify you for a premium tax credit. Second: community health centers charge on a sliding scale, and nonprofit hospitals run financial-assistance programs — ask before you pay any bill. Third: if your situation changes mid-year — marriage, a move, a new baby, or losing other coverage — a 60-day Special Enrollment Period can open. We cover more options in can't afford health insurance and don't qualify for Medicaid and our low-cost health insurance guide.
Two more 2027 notes. The federal Medicaid work requirement that starts by January 1, 2027 applies to expansion adults, and South Carolina has no expansion group; SCDHHS lists its earlier Community Engagement waiver among its currently inactive waivers. To apply for Healthy Connections, use apply.scdhhs.gov, mail, fax, or a county office; for questions, call the SCDHHS Member Help Center at (888) 549-0820. If you apply on HealthCare.gov and are eligible for Medicaid, your application is sent to SCDHHS automatically.
We'll tell you the truth either way. Healthy Connections is a state program, not something we sell. If your kids, a pregnancy, or your family's income makes it your best option, we'll say so and point you to SCDHHS — no charge. If a marketplace plan with a tax credit is the better path, we'll build it correctly and document your income projection. Ten minutes: (844) 788-3733.
The South Carolina Health Insurance Marketplace: Carriers & Plans for 2027
South Carolina's marketplace runs on HealthCare.gov, and every plan sold there is ACA-compliant: the 10 essential health benefits, no pre-existing condition exclusions, and preventive care at no cost. Carrier lineups vary by county and can change every plan year, so a statewide list can mislead you. Once open enrollment opens November 1, 2026, you can compare the 2027 plans for your ZIP code on HealthCare.gov. Before recommending anything, we confirm which carriers are actually selling 2027 plans in your county — and whether your doctors and prescriptions are in network.
Bronze
Lowest premiums — they can be $0 after credits at lower incomes — with the highest deductibles. Marketplace bronze plans now count as HSA-eligible, and the 2027 HSA limit is $4,500 for self-only coverage.
Silver
The sweet spot for most subsidy-eligible households. Between 100% and 200% FPL, Cost-Sharing Reductions cap the 2027 out-of-pocket maximum at $4,000 for a single person — richer-than-Gold coverage at a Silver price.
Gold
Higher premium, lower out-of-pocket. The smart pick when you know care is coming — a planned procedure, a pregnancy, ongoing prescriptions.
Add-Ons
Dental & vision, critical illness, and hospital indemnity plans can sit alongside your ACA plan. Critical illness and hospital indemnity pay set cash benefits; they supplement major medical coverage and don't replace it.
One honest warning: a $0 premium is not $0 care. The 2027 out-of-pocket maximum for marketplace plans is $12,000 for an individual ($24,000 for a family), and a free bronze plan can sit near the top of that range. Under about 250% FPL, a CSR Silver plan that costs a little each month is often the far better deal than the “free” one. That's the judgment call a broker exists for.
Over 400% FPL or between jobs? Compare a full-price ACA plan with short-term health insurance in South Carolina, and we'll show you both side by side. Short-term plans can cost less, but they are not ACA-compliant coverage, can exclude pre-existing conditions, and are temporary. South Carolina's most recent insurance department guidance on short-term plans, issued in November 2024, follows the federal limit of no more than 3 months initially and 4 months in total with renewals. Federal regulators said in August 2025 they would not prioritize enforcing that limit, so your advisor confirms the maximum term available in South Carolina for your start date. Past January 15 with no qualifying event, you can't buy an ACA plan until the next open enrollment, so ask us what can cover the wait.
South Carolina Open Enrollment 2027: Key Dates
South Carolina uses the federal Marketplace, so the HealthCare.gov calendar applies: open enrollment runs November 1, 2026 – January 15, 2027. South Carolina isn't on CMS's lists of states moving to their own exchange for 2027 or 2028. Neighboring Georgia now runs its own exchange, so if you're moving in or out of South Carolina, check our 2027 open enrollment deadlines by state.
November 1, 2026
Open enrollment opens on HealthCare.gov. Compare 2027 plans, premiums, and your new credit amount.
December 15, 2026
Last day to enroll for coverage that starts January 1, 2027. This is the deadline that matters most.
January 15, 2027
Open enrollment ends. Enroll between December 16 and January 15 and coverage starts February 1, 2027 — a one-month gap if your current coverage ends December 31.
After January 15
You'll need a qualifying life event (losing job coverage, losing Medicaid, moving, marriage, or a birth) to open a 60-day Special Enrollment Period.
Enrolling through FreedInsure takes about 15 minutes: (1) we project your 2027 income precisely — the step that matters most in a non-expansion state with the cliff back, (2) we compare every plan in your county against your doctors and prescriptions, and (3) we submit the enrollment and stay on as your advisor all year. Same plans, same prices as going direct. Not sure where you land? Start with our see-if-you-qualify checker or call (844) 788-3733.
Straight talk on auto-renewal: if you already have a South Carolina marketplace plan and do nothing, you'll most likely be re-enrolled in the same or a similar plan. With premiums and credit amounts changing for 2027, last year's plan at last year's assumptions can be this year's overpay. Never let a plan auto-renew without a 15-minute re-shop — here's how to decide — and do it before December 15 so any change starts January 1.
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Free Health Insurance South Carolina FAQs for 2027
Sources
- Dates and deadlines for 2027 health insurance — HealthCare.gov
- States by Marketplace Type for Plan Year 2027 — CMS
- Program Eligibility and Income Limits — South Carolina Department of Health and Human Services
- Rev. Proc. 2026-26: 2027 applicable percentage table — IRS
- 2027 maximum out-of-pocket and cost-sharing reduction parameters — CMS
- Poverty guidelines — HHS Office of the Assistant Secretary for Planning and Evaluation
- Waivers — South Carolina Department of Health and Human Services
- State-based Exchanges — CMS
- Questions and answers on the premium tax credit — IRS
- Rev. Proc. 2026-24: 2027 HSA limits and Notice 2026-5: bronze plans as HDHPs — IRS
- Bulletin 2024-13: short-term limited-duration insurance — South Carolina Department of Insurance
- Status of state Medicaid expansion decisions — KFF (non-government tracker)
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