Individual Health Insurance in South Carolina

An individual health insurance plan is coverage that is purchased individually, as opposed to a group plan furnished through the workplace or government. Those who may not be eligible for group plan coverage include self-employed individuals, or individuals who work for a small company that does not offer group health coverage. For some, COBRA benefits may have expired, forcing them to find other means of obtaining health care coverage. Others in South Carolina may not be eligible for government health care plans such as Medicaid or Medicare. While there are a number of reasons one may not be eligible for a group health insurance plan, individual plans are generally less expensive than a group plan and may offer similar benefits. Therefore, for some, an individual plan may be the best option in South Carolina. The term “individual” may be misleading in that these plans not only cover a single individual, but can be purchased to cover dependents and families as well.


Types of Individual Health Insurance Plans in South Carolina

•PPO (Preferred Provider Organization)

The PPO is a flexible, comprehensive plan that provides coverage with any health care providers. This type of plan allows the individual to see any doctor or health care specialist and still be covered under the plan.


•HMO (Health Maintenance Organization)

The HMO plan allows for coverage within a healthcare network. The plan will only cover expenses incurred from a health care provider specified within the HMO network. These networks generally consist of a very large number of health care providers, ensuring professional, convenient health care to the insured. HMO plans are usually the least expensive of individual health insurance plans.


•HSA (Health Savings Account)

HSA plans are used in conjunction with a high deductible health insurance plan. A Health Savings Account allows the individual to save for future, qualified medical expenses in a tax-free savings account. While the HSA is a tax advantaged savings account, there are penalties for withdrawing funds for non-medical related reasons. An individual owning an HSA may not receive any other health coverage outside of a high deductible health insurance plan. Generally, premiums for HSA plans are low, while deductibles are high.


•FFS (Fee For Service)

The FFS insurance plan is the simplest of individual health insurance plans. Simply put, the individual pays the health care provider directly for the services, and is in turn reimbursed for the percentage of cost determined by the health insurance policy.


•South Carolina High Risk Pool

For individuals who may be turned down for other individual plans due to a pre-existing condition, a South Carolina High Risk Pool health insurance plan may be the only option available. Often, these plans are considered as a last resort only after all other attempts at attaining health insurance have been made. High Risk Pool insurance plans usually include extremely high premiums and deductibles. South Carolina like most states offers a High Risk Pool insurance plan. Information concerning a South Carolina's plan can be obtained from the South Carolina Department of Insurance. In order to attain this kind of health insurance plan, one must have previously been denied health care coverage and unable to find any other plan at a lower deductible than the one offered by the High Risk Pool health insurance plan.