2027 Open Enrollment in South Carolina: Dates, Deadlines & What Changed

Open enrollment for 2027 health coverage in South Carolina runs from November 1, 2026 to January 15, 2027 on HealthCare.gov. To have coverage start January 1, you need to enroll or change plans by Tuesday, December 15, 2026. If you enroll between December 16 and January 15, your coverage starts February 1.

If you read that 2027 enrollment would end December 15, that came from a federal rule that would have shortened the window. A court vacated that part of the rule, and HealthCare.gov kept January 15 as the final day. We re-checked HealthCare.gov on November 8, 2026, and it still lists January 15.

South Carolina does not run its own exchange. It uses the federal Marketplace, HealthCare.gov, so these dates apply in every county from Oconee to Beaufort. The same plans and prices are available whether you enroll on HealthCare.gov, through an agent like us, or through our self-enroll link.

December 15 is a real deadline, but it isn't the end of open enrollment. It's the cutoff for a January 1 start date.

The confusion this fall has a second source. In 2025, a federal rule (the Marketplace Integrity and Affordability rule) included a change that would have shortened open enrollment starting with 2027 coverage. Under it, enrollment would have ended no later than December 31, and many news reports said HealthCare.gov's 2027 window would close December 15. Some articles published this year still describe that shorter window.

That piece of the rule did not survive. A federal court vacated the provision, and CMS kept HealthCare.gov's longer window. CMS's own Plan Year 2027 fact sheet says open enrollment began November 1, 2026 and closes January 15, 2027. Litigation over the rule has continued, so we'll update this page if anything changes before January 15.

Plan around December 15. Enrolling by then gets you a January 1 start and avoids a one-month gap. Treat January 15 as a backstop.

The calendar is familiar, but several changes this year make it risky to let your coverage roll over without a look.

Carriers left, and new ones arrived

• Molina sold Marketplace plans in 37 South Carolina counties in 2026 and has none in 2027.
• UnitedHealthcare leaves Cherokee, Chester, Colleton, Lancaster, Laurens, Lee, Marlboro and Union counties.
• InStil leaves Spartanburg County.
• Oscar enters Charleston, Colleton, Florence, Horry, Marion and York counties.
• First Choice Next (Select Health of South Carolina) newly enters Aiken, Beaufort, Darlington, Florence, Lexington, Orangeburg and York, bringing it to 27 counties.

If your carrier left your county and you don't choose a plan, HealthCare.gov may re-enroll you in a similar plan with another company. That plan may not include your doctors. See Got Auto-Enrolled Into a New Plan After Molina's Exit? and Molina Is Leaving the South Carolina Marketplace for 2027.

The benchmark price rose in every county

The benchmark silver plan, the second-lowest-cost silver plan that sets your premium tax credit, went up in all 46 counties. The enrollment-weighted average increase is 24.8% for a 40-year-old, before subsidies.

The benchmark plan itself also changed in many counties. In Richland, for example, the 2027 benchmark is BlueCross's Blue Congaree Silver 1, and in Greenville it is First Choice Next Silver Signature. When the benchmark changes, your subsidy changes, even if your own plan didn't. Our county-by-county rate changes show every county.

Enhanced subsidies expired

The enhanced premium tax credits that removed the upper income limit ended after 2025. For 2027, the credit is generally limited to households between 100% and 400% of the federal poverty level unless Congress acts. For a single person, 400% FPL is $63,840; for a family of four, it is $132,000. Read Who Qualifies for an ACA Subsidy in South Carolina in 2027? for the full breakdown.

Repayment caps are gone

Starting with tax year 2026, the IRS requires you to repay the full amount of any excess advance premium tax credit. So make a realistic income estimate on your 2027 application. Our guide on estimating your 2027 income walks through it. This is general information, not tax advice; a CPA can help with your specific situation.

About 587,600 South Carolinians picked a Marketplace plan during 2026 open enrollment. We suggest every one of them check these things this year:

1. Log in and read your 2027 renewal notice. Confirm your carrier is still in your county and note your new premium after subsidy.
2. Update your income and household. Use your best estimate of 2027 income, not last year's.
3. Check your doctors and hospitals. Nearly every SC Marketplace plan is an HMO; BlueCross's BlueEssentials and BlueConnect plans are EPOs, and there are no PPOs. Out-of-network care generally isn't covered except in emergencies. See how to check your doctors and prescriptions.
4. Check your prescriptions. Drug lists differ by carrier. Wegovy and Zepbound, for example, are on no SC Marketplace carrier's 2027 formulary.
5. Compare at least two metal levels. If your income is under 250% FPL, compare silver plans with cost-sharing reductions first.
6. Pay your first premium. Coverage doesn't start until it's paid.

Our last-minute checklist and Don't Auto-Renew go deeper.

Networks and drug lists can change; we verify with the carrier before you enroll. Last verified: November 2026.

If you miss December 15, you can still enroll through January 15 for a February 1 start. See Missed December 15? You Can Still Enroll Until January 15 and Final Week: January 15 Is the Last Day.

After January 15, you can only enroll or change plans if you qualify for a Special Enrollment Period, usually because of a life event like losing other coverage, moving, getting married or having a baby. You generally have 60 days from the event to act. Our guide to Special Enrollment Periods in SC explains which events count. If you don't qualify, short-term health insurance can bridge a gap, though it isn't ACA coverage.

Fall is crowded with enrollment periods, and we hear from families every year who mix them up:

If someone in your household is on Medicare, see our Medicare AEP final-week checklist, Medicare Advantage Open Enrollment and Medicare overview.

Our licensed agents in Irmo help families across all 46 counties compare plans, check doctors and prescriptions, and enroll before the deadline. A short call before December 15 is usually all it takes.

For carriers, prices and networks in your county, start with our South Carolina Health Insurance 2027 guide.