By Mauldin Insurance Group  ·  Lexington, SC  ·  Published 2026

 

If you buy your own health insurance — or you’ve been uninsured and are thinking about getting covered — ACA Open Enrollment is the window you’ve been waiting for. For 2027 coverage, that window opens November 1, 2026 and closes sooner than most people expect.

This guide covers everything South Carolina residents need to know: the exact deadlines, how to find out if you qualify for subsidies, what plan types are available, and how Mauldin Insurance Group can help you find the right fit — for free.

 

Key ACA Enrollment Deadlines for 2027 Coverage

Missing the open enrollment window means waiting a full year for another chance to enroll — unless you qualify for a Special Enrollment Period. Mark these dates on your calendar now:

 

Date	Coverage Starts	What Happens
November 1, 2026	January 1, 2027	Open enrollment begins. You can enroll or make changes starting now.
December 15, 2026	January 1, 2027	Deadline to enroll for coverage beginning January 1.
January 15, 2027	February 1, 2027	Final deadline of the open enrollment period. Last chance until next year.

 

📅 Don’t Wait Until December Most people procrastinate and scramble in mid-December. If you want January 1 coverage — especially if you’re switching jobs, aging off a parent’s plan, or losing other coverage — start your comparison in October so you’re ready to enroll the moment November 1 arrives.

 

Do You Qualify for a Subsidy? Probably More Than You Think.

One of the most common mistakes South Carolina residents make is assuming they earn too much to get help paying for health insurance. In reality, expanded subsidies under the Inflation Reduction Act have made ACA coverage affordable at income levels that would have disqualified people just a few years ago.

 

Premium Tax Credits (PTCs)

Premium tax credits directly lower your monthly insurance premium. They’re available to individuals and families with income between 100% and 400% of the Federal Poverty Level (FPL) — and in recent years, enhanced subsidies have provided meaningful assistance even above that threshold.

What does that look like in dollars? For 2026 (as a reference point):

• Single individual: 100% FPL is approximately $15,650/year
• Family of 4: 100% FPL is approximately $32,150/year

The subsidy is calculated as a sliding scale — the lower your income relative to the FPL, the more assistance you receive. Your actual monthly premium after tax credits can be significantly lower than the sticker price of the plan.

 

Cost-Sharing Reductions (CSRs)

If your income is between 100% and 250% of FPL and you enroll in a Silver plan, you may also qualify for cost-sharing reductions — which lower your deductibles, copays, and out-of-pocket maximums. This is why Silver plans are often the best value for moderate-income households, even though they’re not the cheapest on paper.

 

💡 You Must Apply During Open Enrollment to Get Subsidies Subsidies are only available for plans purchased through the Health Insurance Marketplace (Healthcare.gov). You cannot get a premium tax credit for an off-marketplace plan. Mauldin Insurance Group helps clients enroll through the Marketplace to make sure you capture every dollar of financial assistance you’re entitled to.

 

ACA Plan Options in South Carolina: Metal Tiers Explained

ACA plans are grouped into four “metal” tiers based on how costs are split between you and the insurance company. None of the tiers affect the quality of care — they just determine how you pay.

 

Plan Tier	Monthly Premium	Out-of-Pocket Costs	Best For
Bronze	Lowest	Highest	Healthy individuals who want a safety net for major medical events and rarely use routine care.
Silver	Moderate	Moderate	Most people — especially those eligible for cost-sharing reductions. Best overall value for moderate incomes.
Gold	Higher	Lower	People who use healthcare frequently and want predictable costs throughout the year.
Platinum	Highest	Lowest	Individuals with significant ongoing medical needs who prefer maximum coverage and minimal surprise bills.

 

Important: If you qualify for cost-sharing reductions (income 100–250% FPL), you must enroll in a Silver plan to access them — the reductions are only built into Silver tier plans.

 

Special Situations: Seniors, Small Businesses & Life Changes

 

Turning 65 or Going on Medicare?

If you’re turning 65 during 2027, you’re transitioning from ACA coverage to Medicare. You generally cannot use an ACA Marketplace plan as primary coverage once you’re enrolled in Medicare Part A. The good news: Medicare has its own enrollment windows, and Mauldin Insurance Group specializes in Medicare planning. We can help you time the transition correctly so you never have a gap in coverage.

 

Special Enrollment Periods (SEPs)

If you miss open enrollment, you may still qualify to enroll outside the window if you experience a qualifying life event, such as:

• Losing job-based coverage (including COBRA expiration)
• Getting married or divorced
• Having or adopting a child
• Moving to a new zip code or county
• Gaining or losing eligibility for Medicaid or CHIP

SEPs typically give you 60 days from the qualifying event to enroll. Don’t wait — the clock starts the day the event occurs.

 

Small Business Owners in South Carolina

If you own a small business and want to offer health coverage to your employees, you have options through the SHOP (Small Business Health Options Program) Marketplace. Key benefits include:

• Access to group HMO, PPO, and EPO plan options
• Potential eligibility for the Small Business Health Care Tax Credit (up to 50% of premium costs for qualifying businesses)
• More flexibility and buying power than purchasing individual plans for each employee

Mauldin Insurance Group can walk you through whether SHOP or a private group plan makes more sense for your business size and budget.

 

How to Enroll: A Simple Step-by-Step

The process is more straightforward than most people expect — especially with help from a licensed agent.

 

1. Gather your information. You’ll need Social Security numbers for everyone enrolling, income information (last year’s tax return or estimated current income), and employer and current coverage details if applicable.
2. Estimate your income for 2027. Subsidies are based on your projected income for the coverage year, not last year’s income. If your income varies, use your best estimate — you can reconcile on your tax return.
3. Compare plan options. Visit Healthcare.gov to see available plans in your zip code, or work with Mauldin Insurance Group to get a side-by-side comparison that accounts for your actual doctors, prescriptions, and expected usage.
4. Check your doctors and prescriptions. Make sure your preferred providers are in-network and your medications are covered before selecting a plan. This step is easy to skip and often leads to expensive surprises.
5. Enroll before your deadline. Submit your application at Healthcare.gov or through a licensed agent by December 15, 2026 for January 1 coverage, or by January 15, 2027 for February 1 coverage.
6. Pay your first premium. Enrollment is not complete until you make your first payment. Your insurer will send payment instructions after you enroll.

 

👋 Work With a Licensed Agent — It’s Free Working with Mauldin Insurance Group to enroll through the Marketplace costs you nothing. We are compensated by the insurance carriers, not by you. And unlike going directly to one insurance company’s website, an independent agent compares options across multiple carriers to find the plan that fits your life — not just the one that’s easiest to sell.

 

 

Ready to Find Your 2027 Health Insurance Plan?

Open enrollment moves fast. Let Mauldin Insurance Group do the comparison work for you — we’ll find the right plan at the right price, make sure you’re capturing every subsidy you qualify for, and have you enrolled before the deadline.

📞 Call or Text: 843-509-2462

🌐 MauldinInsuranceGroup.com

📍 Lexington, SC · Licensed in SC, NC & GA · Serving all of South Carolina