Health Insurance Marketplace

Get covered, stay covered

I'm uninsured – what are my options?

Under the Affordable Care Act (ACA), individuals can get insurance coverage through the health insurance marketplace.

Coverage options

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

  • 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 (offered through the Affordable Care Act).
  • Privately purchased insurance – Individuals may buy their own health insurance from insurance companies, brokers or other sources.

Enrollment assistance

Marketplace open enrollment starts Thursday, Nov. 1, 2018, and ends Saturday, Dec. 15, 2018. Below are options for enrolling and receiving assistance for open enrollment:

Self enrollment: or 1-800-318-2596 (TTY users should call 1-855-889-4325)
Palmetto Project – Insure SC: or 1-888-998-4646
Lourie Life and Health: or 803-256-2067 or 1-888-553-3323
Insurance Advantage: or 803-744-9665 or 1-866-744-4014

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 eligible for coverage. If you are ineligible for those programs, Health Insurance 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 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 a 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 20 percent discount off our total charges.

Do I qualify for financial assistance?

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

  • Do not qualify for Medicaid or low-cost health insurance through the health insurance marketplace
  • 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 $12,140 or a family of four making less than $25,100).

To determine if you are eligible for financial assistance, you must meet with a Prisma Health financial counselor and complete an application. You can make an appointment with a Prisma Health financial counselor by calling 803-296-CARE(2273). Information also is available at our Financial Assistance web page.

Federal Poverty Guidelines for 2018

Persons in family/household
100% of FPG

















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