Open Enrollment in South Carolina: Everything You Need To Know

Updated August 2026 for the 2027 coverage year.

Open Enrollment for 2027 coverage runs November 1 through December 15, 2026, and coverage starts January 1. It is the one window each year when anyone can enroll in a Marketplace health plan or change the one they have, without needing a life event to qualify. Miss it and you generally wait a year.

South Carolina uses the federal Marketplace, so those dates apply here. Two things make this year worth more attention than usual, and both are covered below.

What are the deadlines?

November 1: the window opens and plans for next year become visible.

December 15: the window closes, and it is the deadline for coverage that starts January 1.

The window used to stretch into mid-January. It does not anymore. If your habit was to sort this out over the holidays, that habit will now cost you a year.

What happens if you do nothing?

You will usually be re-enrolled automatically into the same plan, or into whatever the insurer maps it to if your plan is not offered again.

That sounds safe. It is not the same as keeping what you have, because three things reset every January:

• What it costs. Premiums and deductibles are set annually.
• The drug list. A prescription covered cheaply this year can move tiers or come off entirely.
• The network. Doctors and hospitals come and go.

There is also a fourth thing this year: verification rules mean your tax credit may not follow you automatically. A plan that quietly renews can renew without the help attached, and the first sign is a January invoice that looks nothing like December’s.

Your insurer sends a renewal notice in the fall explaining what is changing. It is the single most valuable piece of mail you get all year and the one most likely to go straight in the recycling.

What changed for 2027 coverage?

Four things, and if you have had a Marketplace plan for a few years, none of them work the way they used to:

• The 400% subsidy cliff is back. From 2021 through 2025, help was available above 400% of the federal poverty level. That expired at the end of 2025. Now one dollar over the line means the credit goes to zero, not down gradually. It hits hardest in your fifties and early sixties, when full-price premiums are highest.
• Excess credits are repaid in full. The old caps on paying back credit you were not entitled to are gone starting with 2026 coverage. Estimate your income carefully, and report changes during the year.
• Auto-renewal is not the same as reviewing. Review and update your Marketplace application every year. Automatic reenrollment may continue in some circumstances, but your plan, premium, tax credit, network, and eligibility can change.
• The window is shorter. December 15, not January 15.

Our guide to health insurance subsidies in South Carolina goes through how the credits work and who qualifies.

How should I compare plans?

Not on the monthly premium. That is one line in the math, and it is the line that misleads most often.

Start with your doctors and your prescriptions. Check that your doctors and hospital are in the network for next year, and run your actual medication list against next year’s drug list. A plan that fails either test is not cheap at any price.

Understand what the metal tiers mean. Bronze costs less monthly and more when you use care. Gold is the reverse. Silver sits between them and does something the others do not, which is the next point.

If your income is under roughly 250% of the poverty level, look hard at silver. Cost-sharing reductions lower your deductible and copays, and they only attach to silver plans. Choosing bronze for the lower monthly number can forfeit a silver plan that has both a lower deductible and a similar total cost. This trade gets made wrong constantly.

Then compare estimated total cost for the year, premium plus what you expect to spend. If you want the plan structures themselves explained, see HMO, PPO, POS and more.

What do I need to apply?

Have these ready and enrollment takes about twenty minutes:

• Names, dates of birth, and Social Security numbers for everyone on the application
• A realistic estimate of next year’s household income
• Information about any coverage offered to you at work
• Your current plan details, if you have one

The income estimate is the one that deserves real thought. It drives your credit, and under the current rules you repay every dollar of any overage.

What if I miss December 15?

Then you generally wait, unless a qualifying life event opens a Special Enrollment Period. Losing coverage, marriage, divorce, a new baby, or a permanent move can each open a window, usually 60 days. The details are in our guide to Special Enrollment Periods.

And if you are uninsured and wondering whether it matters now that the tax penalty is gone, we wrote about that too. Short version: no fine, but the hospital bill never went anywhere.

If you are on Medicare, this is not your season

Worth saying plainly, because the two get mixed up every fall. Medicare has its own window, the Annual Enrollment Period, October 15 through December 7, with entirely different rules. Nothing on this page applies to it. See our Medicare Annual Enrollment Period guide instead.

Frequently asked questions

When is Open Enrollment in South Carolina for 2027 coverage? November 1 through December 15, 2026, with coverage starting January 1, 2027. South Carolina uses the federal Marketplace, so those are the dates that apply here. The window used to run into January and no longer does.

What happens if I do nothing and let my plan renew? You will usually be re-enrolled in the same plan or something close to it, but that is not the same as keeping what you have. Costs, drug lists, and networks reset every January, and your tax credit is recalculated from the information on file. Review and update your Marketplace application every year: automatic reenrollment may continue in some circumstances, but your plan, premium, tax credit, network, and eligibility can change. Doing nothing is allowed. Doing nothing without reading your renewal notice is where people get hurt.

Can I still get help paying for coverage? You may. Premium tax credits are still available, generally between 100% and 400% of the federal poverty level. What changed is that the temporary rule extending help above 400% expired at the end of 2025, so that upper limit is a hard line again. Whether you qualify depends on household size, income, and what you are offered at work.

What if I miss the December 15 deadline? You generally wait until the next Open Enrollment unless a qualifying life event opens a Special Enrollment Period. Losing coverage, marriage, a new baby, or a permanent move can each open a window, usually 60 days long. Missing December 15 with no qualifying event usually means a year without Marketplace coverage.

Is this the same as Medicare Open Enrollment? No, and mixing them up is common. If you are on Medicare, your season is the Medicare Annual Enrollment Period, October 15 through December 7, and none of the Marketplace rules here apply to you. Different dates, different plans, different rules.

Want a second set of eyes before December 15? Call or text 803-848-0089 or start on our health insurance page. Tell us your household size, roughly what you expect to earn next year, and the prescriptions you take. Our help costs you nothing.