Open Enrollment for 2027 Marketplace health plans runs from November 1, 2026 through January 15, 2027. If you buy your own health insurance in South Carolina, this is a year to actually look at your plan instead of letting it renew on its own. Several federal rule changes take effect in 2027, and some of them change what people pay or whether they qualify for financial help at all.

We're Mauldin Insurance Group, a family-owned independent agency based in Lexington, SC and serving the Midlands. We've worked through the 2027 Marketplace updates, and here is what South Carolina families and individuals should know before they pick a plan.

Key dates for 2027 Open Enrollment

Enroll by December 15 if you want coverage to start January 1.

Date	What happens
November 1, 2026	Open Enrollment begins
December 15, 2026	Last day to pick a plan for coverage starting January 1, 2027
January 15, 2027	Open Enrollment ends. Plans picked December 16 through January 15 start February 1, 2027

If you already have a Marketplace plan and do nothing, you'll most likely be renewed automatically. That keeps you covered, though your plan, premium, and financial help can all change from this year. Automatic renewal also uses whatever information is on file, which may not match your life today.

What's changing for 2027

The biggest changes for 2027 are higher out-of-pocket limits, fewer immigrants qualifying for financial help, and stricter rules on paying back tax credits.

Higher out-of-pocket maximums

The most a Marketplace plan can make you pay out of pocket in a year is going up to $12,000 for an individual and $24,000 for a family. That's a noticeable jump from 2026, so many renewing plans will come with higher deductibles and out-of-pocket limits.

People with lower incomes can get much lower limits, but only on a silver plan with cost-sharing reductions:

Household income	Out-of-pocket max (self / family)
100% to 200% of the federal poverty level	$4,000 / $8,000
Over 200% to 250% of the federal poverty level	$9,600 / $19,200
All others, or anyone not on a qualifying silver plan	$12,000 / $24,000

This is where people get hurt. Someone who qualifies for that $4,000 cap but picks a bronze plan to save a few dollars a month gives it up completely.

Fewer immigrants qualify for financial help

Starting in 2027, premium tax credits and cost-sharing reductions are limited to U.S. citizens, U.S. nationals, and three groups of noncitizens: lawful permanent residents (green card holders), Cuban and Haitian entrants, and COFA migrants. Other lawfully present immigrants, including many refugees, asylees, and visa holders, can still buy a Marketplace plan but will pay full price. Lawfully present immigrants with income under 100% of the poverty level also lose the special rule that used to let them get help.

If someone in your household had help paying for coverage in 2026 and isn't in one of those groups, call us before December 15. A full-price bill in January is avoidable if you plan for it now.

Paying back extra tax credits

Your tax credit is based on what you expect to earn. If your actual income comes in higher, you pay back the difference when you file your taxes, and that repayment is no longer capped. A low estimate can turn into a large tax bill. We'll help you build a realistic estimate based on what you're earning now, not just last year's return.

The low-income special enrollment period is gone

People with income at or below 150% of the poverty level used to be able to sign up any month of the year. That option has ended. Outside Open Enrollment, you now need a qualifying life event like losing other coverage, moving, getting married, or having a baby.

More plans work with a Health Savings Account

All bronze and catastrophic Marketplace plans now count as HSA-eligible. An HSA lets you set money aside tax-free and use it tax-free for deductibles, copays, and other qualified medical costs, and the money rolls over every year. For 2026 the contribution limits are $4,400 for self-only coverage and $8,750 for family coverage, plus $1,000 more if you're 55 or older. HSAs are opened through a bank or credit union, not the Marketplace. Your tax professional can tell you how much makes sense for you to put in.

Adult dental

Adult dental still isn't a required benefit on Marketplace plans. Some plans include it, and you can always add a stand-alone dental plan. If dental matters to you, tell us up front so we compare the right options.

New steps to protect your coverage

When an agent works on your application this year, you'll be asked to confirm it yourself before anything is submitted.

• A one-time code or link. You'll get a text, email, or phone call with a passcode or link. Once you confirm it, we can make updates to your application. Keep your phone handy during your appointment.
• ID proofing for some people. You may get a link to verify your identity. You have to complete it yourself before your application can go through.
• Verified Social Security or immigration document number. An agent can only be tied to your application when this information verifies.

These steps exist because of a wave of people having their plans switched or agents swapped without their knowledge. They add a minute or two, and they make sure nobody touches your coverage without your say-so.

One more thing worth knowing: a legitimate agent will never ask for your HealthCare.gov username or password, and will never create a HealthCare.gov account for you. If someone does, that's a red flag.

How Mauldin Insurance Group helps

We sit down with you, look at every Marketplace plan available where you live, and help you pick the one that fits your doctors, prescriptions, and budget. Plan prices are set by the insurance companies, so you pay the same premium whether you enroll with us or on your own.

Here's what that looks like in practice:

• Plan comparison across carriers. We compare premiums, deductibles, and out-of-pocket limits side by side instead of showing you one company's options.
• Doctor and prescription checks. Before you enroll, we confirm your doctors are in network and your medications are covered.
• A realistic income estimate. We walk through your current pay, side income, and household changes so your tax credit is right and you don't get surprised at tax time.
• The silver vs. bronze math. If you qualify for cost-sharing reductions, we'll show you what you'd give up by choosing bronze, and when a bronze plan with an HSA actually makes more sense.
• Help after you enroll. If the Marketplace asks for income or eligibility documents, we tell you exactly what to send and keep an eye on the deadline. If your income or household changes during the year, we help you report it within the 30 days the Marketplace requires.
• Small business options. If you own a small business and traditional group coverage is too expensive, we can explain how an Individual Coverage HRA lets you give employees a set amount each month to buy their own plans.

Jennifer Mauldin leads our health insurance practice, and we're available into the evening for people who can't get away during the workday.

What to have ready for your appointment

Bringing these makes the appointment quicker and helps avoid follow-up paperwork later:

• Social Security numbers, or immigration document numbers, for everyone applying
• Recent pay stubs, or a simple income and expense ledger if you're self-employed
• Last year's tax return, plus notes on anything that's changed since
• Your current plan information, if you have Marketplace coverage now
• A list of your doctors and prescriptions
• Information about any job-based coverage offered to someone in your household, even if you didn't take it
• A phone or email you can check during the appointment for your one-time code

Frequently asked questions

When is Open Enrollment for 2027 health plans in South Carolina?

November 1, 2026 through January 15, 2027. Pick a plan by December 15 for coverage that starts January 1.

What happens if I enroll after December 15?

If you pick a plan between December 16 and January 15, your coverage starts February 1, 2027. You'd have no Marketplace coverage in January.

Will my plan renew automatically?

Usually, yes. Your premium, plan details, and financial help may still change, so it's worth reviewing before December 15.

Why is my out-of-pocket maximum higher in 2027?

The federal limit rose to $12,000 for individuals and $24,000 for families. Many plans are adjusting their deductibles and out-of-pocket limits to match.

Can I still get a lower out-of-pocket limit?

If your household income is between 100% and 250% of the federal poverty level, a silver plan with cost-sharing reductions can bring your limit down to as low as $4,000 for an individual.

I'm a lawfully present immigrant. Can I still get help paying for coverage?

Only if you're a lawful permanent resident, a Cuban or Haitian entrant, or a COFA migrant. Others who are lawfully present can still buy a Marketplace plan at full price. We can walk through your options.

Can I sign up anytime if my income is low?

Not anymore. The special enrollment period for people at or below 150% of the poverty level has ended. You'll need Open Enrollment or a qualifying life event.

What happens if I guess my income too low?

You'll pay back the extra tax credit when you file your taxes, and there's no longer a cap on how much you might owe. An accurate estimate up front is the best protection.

Can I use a Health Savings Account with a Marketplace plan?

Yes, with any bronze or catastrophic plan, and with other plans that meet IRS high-deductible rules. You open the HSA through a bank or credit union.

Does adult dental come with Marketplace plans?

Not automatically. Some plans include it, and you can add a stand-alone dental plan.

Why do I have to confirm a code when an agent helps me?

It proves you approved the work on your application. It protects you from anyone changing your plan without your permission.

What if the Marketplace asks me for documents?

Respond by the deadline on the notice. If you don't, your financial help could be reduced or stopped. We'll tell you which documents to send.

Does it cost more to enroll through an agent?

No. Marketplace premiums are the same whether you use an agent or enroll on your own.

Book your Open Enrollment review

Call us at 843-509-2642 or 803-920-8827 to set up a time. If you already have a Marketplace plan, the best time to call is early November, before the December rush. New clients should start early too, since identity checks and document requests can take a few days to clear.

Written by Jennifer Mauldin, Licensed Health Insurance Agent, SC License #6422562, Mauldin Insurance Group.

Mauldin Insurance Group is a licensed independent insurance agency. We are not affiliated with or endorsed by HealthCare.gov, the Centers for Medicare & Medicaid Services, or any government agency. Eligibility for premium tax credits and cost-sharing reductions depends on household income, household size, and other factors. This article is general information, not tax advice. Talk with a qualified tax professional about your situation