Health Insurance Marketplace

Get covered, stay covered.

I'm uninsured – what are my options?

Under the Affordable Care Act (ACA), most people are required to have insurance coverage or pay a penalty on their tax returns. For 2017, the penalty for an individual will remain at $695 or a designated percent of the household annual income, whichever is greater.

There are a variety of coverage options based upon your age, income and family size.

Types of coverage available include:

  • Employer coverage – health insurance you get through your employer.
  • Medicaid – for individuals who meet certain financial and non-financial requirements.
  • Medicare – for individuals age 65 and over.
  • Health Insurance Marketplace (offered through the Affordable Care Act) – for individuals and families who do not qualify for employer coverage or Medicaid/Medicare.
  • Privately purchased insurance – Individuals may buy their own health insurance from insurance companies, brokers or other sources.

Marketplace open enrollment is Tuesday, Nov. 1, 2016 to Tuesday, Jan. 31, 2017. For more information about Marketplace insurance coverage options and enrollment, you can receive free, confidential assistance from certified enrollment specialists in South Carolina. Appointments can be scheduled by calling 1-888-998-4646 or visiting the link at SignUpSC.org.

To compare your options and get answers to your questions, you also can visit HealthCare.gov and sign up for email or text updates, or call their Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. You may enroll online at Healthcare.gov.
 

Why should I get coverage?

Coverage could be more affordable than you think, and a certified enrollment assistant can help you evaluate your options. Generally, you want to get coverage through your employer, Medicaid or Medicare. If you are ineligible for those programs, Marketplace coverage is available, and financial help is available for many to offset the premiums and out-of-pocket costs of these plans.

Without insurance, you will pay a federal penalty for not having coverage, and you will be required to pay for all medical services out of pocket. Care delivered in an emergency department is more expensive than in a primary care setting, such as family doctor. A short hospital stay can cost thousands of dollars. Once you have insurance coverage, you can reduce your financial obligations for any unexpected health care needs, and you generally will be covered for preventive services as well.
 

I am uninsured and not eligible for any coverage options, but I need medical care. What do I do?

Patients without coverage who do not meet the criteria for financial assistance are considered self-pay. Generally, we expect you to make financial arrangements for your care before services are provided. As a courtesy for self-pay patients, we can provide a twenty percent discount off our total charges.
 

Do I qualify for financial assistance?

Palmetto Health offers financial assistance to residents of Richland, Lexington, Fairfield and Sumter counties who:

  • Don’t qualify for Medicaid or low-cost health insurance through the federal government
  • Meet certain asset limits (real estate, cash/savings, etc.), and
  • Have annual incomes less than 100 percent of federal poverty guidelines (for example, an individual making less than $12,060, or a family of four making less than $24,600).

To determine if you are eligible for financial assistance, you must meet with a Palmetto Health financial counselor and complete an application. You can make an appointment with a Palmetto Health financial counselor by calling 803-296-CARE(2273).

Learn more about Palmetto Health Financial Assistance »

Federal Poverty Guidelines for 2017

Persons in Family/Household

100% of FPG

200% of FPG

1

$12,060

$24,120

2

$16,240

$32,480

3

$20,420

 

$40,840

4

$24,600

$49,200

5

$28,780

$57,560

6

$32,960

$65,920

7

$37,140

$74,280

8

$41,320

$82,640

 

 

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