South Carolina Health Insurance

Information is the most important tool you can have at your disposal while shopping for health insurance, and if you’re currently seeking coverage in South Carolina you would be well-advised to first read up on the current state of insurance regulations here.  The list below covers the most significant laws currently affecting health insurance transactions in South Carolina.

• Health insurance companies operating in South Carolina are licensed by the state, which means that any insurer that bears a proper license is guaranteed to be operating within the bounds of the state’s regulatory laws.  Unless otherwise noted, unlicensed companies won’t necessarily abide by any of the regulations mentioned in this article.
• All licensed insurers in South Carolina must guarantee their customers the ability to renew their health coverage as many times as they wish.  In other words, as long as you’ve made sure to abide by the terms of your policy, your health insurance provider cannot prevent you from renewing that policy when it runs out.  In addition, if you begin to suffer health complications your insurer cannot respond by cancelling your coverage.
• Pre-existing conditions are a matter in which South Carolina residents must take special care, since the protections they enjoy under state law are less strict than in many other states.  HMO customers can expect their insurers to consider any health complication suffered up to 12 months before enrollment a “pre-existing condition,” while for indemnity (fee-for-service) policy-holders this period can extend up to five years in the past.  In either case, those writing the policy may choose to exclude pre-existing conditions from coverage for a set period of months or years, or possibly even permanently.
• Insurers in South Carolina are free to accept or decline any application for health coverage, at their discretion; in most cases, this decision will be based on an assessment of typical risk factors like age, health, and family history.  If your application is accepted, the premiums you pay on your policy will likely be determined based on these same risk factors.
• Small  businesses in South Carolina that have between 2 and 50 employees are automatically ensured access to any group health insurance policy that is currently available to other small businesses here, or to coverage with comparable benefits.  The cost of this health plan can vary based on characteristics like age, health, and demographics of the company’s workforce, but are somewhat constrained by state law.
• Group coverage for any small business may come with certain requirements that must be met for the policy to remain in effect, such as a minimum percentage of one’s employees remaining enrolled in the company plan at any given time.  The specific requirements will vary on a case-by-case basis.  Failing to meet these terms can mean the termination of coverage, but at no point may an insurer cancel coverage on the grounds that one or more of the insured employees has fallen ill.
• Self-employed workers in South Carolina are not automatically granted access to group health coverage unless they have at least one other person working for them.  The option of purchasing individual health coverage is always there, however, and self-employed South Carolina residents may be able to deduct a majority of the premiums for this coverage from their tax liability.

Once you have decided on the kind of health insurance you’re looking for, you should be ready to look at quotes from competing companies.  Don’t forget to examine the details of each policy that seems like a good deal, however, since the precise wording can often have a major impact on what the insurer is legally obligated to do for its customers.  When in doubt, don’t be afraid to look up any unfamiliar word or phrase you encounter.

From Our Customers