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An Overview on Medical Insurance in South Carolina

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Medical Insurance in South Carolina

Medical Insurance in South Carolina

Introduction: The health insurance situation in South Carolina is average. In accordance to a survey conducted by The Center for Disease Control, more than 13% of the total South Carolina people did not get any coverage under South Carolina medial insurance for each year, between 2001 and 2003.

In the below-mentioned article, we have discussed about some important South Carolina health insurance regulations and South Carolina alternative medical insurance options.

Regulations for South Carolina Medical Insurance

South Carolina Department of Insurance has introduced some regulations to regulate the South Carolina health insurance market and control the activities of different medical insurance companies.

  • All South Carolina individuals having coverage under medical insurance through an employer or group can not be refused or restricted obtaining coverage under that particular employer or group South Carolina medical insurance policy.
  • South Carolina individuals seeking individual South Carolina medical insurance, however, can be refused or restricted access to coverage, depending on age, health and other deciding criteria.
  • South Carolina medical insurance policies should have a guaranteed provision for renewal. The guaranteed renewability provision allows an individual renew his or her existing insurance plan, if and only if he or she has disbursed all the premiums, in time and provided no fake information during the term of that plan.
  • South Carolina health insurance organizations (both the HMOs and non-HMOs) can inflict a pre-existing waiting period.
  • The insurers are allowed to keep away coverage for the health condition during the term of a waiting period.
  • HMOs consider a pre-existing condition as an illness for which an individual has been treated, received medical advice or otherwise diagnosed within one year, before the commencement of coverage.
  • South Carolina HMOs can implement a waiting period for no more than one year.
  • The non-HMOs consider a pre-existing condition to be an illness for which the policy holder files a claim within initial two year of the policy, if the South Carolina health insurance company determines that the illness was present prior to the beginning of coverage.
  • The South Carolina non-HMOs can also impose elimination riders, which can exclude health conditions, body systems or body parts from coverage, even permanently, throughout the term of an insurance policy.
  • Most of the South Carolina health insurance companies consider pregnancy as a pre-existing condition and thus subject to an exclusion period.
  • All newborns and adopted children can enjoy coverage, automatically, under parent's individual South Carolina medical insurance plans that offer dependant coverage. However, coverage is accessible only for the first 31 days from the day of birth or adoption. After that, the plan should be modified, accordingly.
  • South Carolina residents between jobs or medical insurance policies are able to apply for coverage under temporary South Carolina medical insurance.

South Carolina Medical Insurance Alternative Options

South Carolina Department of Insurance offers some medical insurance alternative options to let the uninsurable South Carolina residents get coverage. Individuals facing difficulties getting South Carolina medical insurance can also able to take advantage of the programs.

  • South Carolina Health Insurance Pool or SHIP: The program is the state's high risk pool that helps the uninsurable South Carolina residents to get coverage. Pre-existing conditions may be applied.
  • South Carolina Medicaid: This program is available to all South Carolina individuals who meet all the qualifying as well as income criteria.
  • Partners for Healthy Children: This program is South Carolina's Children's Health Insurance Program (CHIP) that offers coverage to the children and teens. Nevertheless, children from the families that are not eligible for South Carolina Medicaid or otherwise unable to afford the cost of South Carolina medical insurance are able to apply for the program.

South Carolina Department of Insurance

Mailing Address:
P.O. Box 100105
Columbia, South Carolina 29202-3105
Customer Services Telephone No: (803) 737-6180
Toll Free (accessible only in South Carolina): 1-800-768-3467
Fax No: (803) 737-6231


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