In South Carolina, as in many other states, your health insurance options are somewhat dependent on your health status. Even if you are sick, the laws protect you in the following ways.
- Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more, because of your health status. This is called nondiscrimination.
- All group health plans in South Carolina must limit exclusion of pre-existing conditions. There are rules about what counts as a pre-existing condition and how long you must wait before a new group health plan will begin to pay for care for that condition. Generally, if you join a new group health plan, your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage.
- Your health insurance cannot be canceled because you get sick. Most health insurance is guaranteed renewable.
- If you leave your job, you may be able to remain in your old group health plan for a certain length of time. This is called COBRA continuation coverage or state continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage.
- If you lose your group health insurance and meet other qualifications, you will be HIPAA eligible. If so, you can buy individual health coverage from the South Carolina Health Insurance Pool (SCHIP). You will not face a new pre-existing condition exclusion period. There are limits on what you can be charged for a SCHIP policy.
- If you have had difficulty obtaining affordable individual health insurance because of your health condition, you may also be eligible for SCHIP coverage. In this case you may face a new pre-existing condition exclusion period. There are limits on what you can be charged for a SCHIP policy.
- If you are a small employer buying a group health plan, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. All health plans for small employers must be sold on a guaranteed issue basis.
- If you are a small employer buying a group health plan then your premiums can vary due to health status, age, industry, or other characteristics. There are limits on what you can be charged based on these factors.
- If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The South Carolina Medicaid program offers free or subsidized health coverage for pregnant women, families with children, elderly and disabled individuals with very low incomes.
- If your children are 18 years old or younger, do not have health insurance and meet other qualifications, you may be able to buy insurance for them through South Carolina’s Partners for Healthy Children Program.
- If you believe that you may be at risk for cancer, you may be eligible for free screening and treatment. The Best Chance Network (BCN) provides qualified women with free breast and cervical cancer screening. In addition, women diagnosed with cancer through this program may be eligible for medical care through the South Carolina Medicaid program.
- If you are a woman who has been diagnosed with breast or cervical cancer outside of the Best Chance Network, you may be eligible for free treatment through South Carolina Medicaid.
- If you lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program, you may be eligible for a federal income tax credit to help you pay for new health coverage. This credit is called the Health Coverage Tax Credit (HCTC), and is equal to 65% of the cost of qualified coverage, including COBRA and health insurance offered through the South Carolina Health Insurance Pool (SCHIP).
- If you are a retiree aged 55-65 and are receiving benefits from Pension Benefit Guarantee Corporation (PBGC), then you may be eligible for the HCTC.
