Missed Open Enrollment in South Carolina? Here’s How You Can Still Get Covered in 2026

For a few years, people with lower incomes could enroll in marketplace coverage any month of the year. That option is gone. Federal rules ended the low-income Special Enrollment Period in late 2025, and the ban was made permanent in 2026 — part of the same wave of 2026 ACA changes that reshaped South Carolina premiums. If you’ve heard “you can sign up anytime if you don’t make much” — that was true once, and it isn’t anymore.

Today there is one reliable way to get marketplace coverage outside open enrollment: a qualifying life event.

If any of these happened to you recently, a Special Enrollment Period (SEP) likely applies — generally for 60 days from the date of the event:

• You lost other health coverage. Laid off, quit, hours cut below eligibility, COBRA ran out, aged off a parent’s plan at 26, lost coverage through a spouse.
• You moved — to South Carolina from another state, or within SC to a county with different plan options (and had coverage before the move).
• Your household changed. Marriage, divorce or legal separation that ends your coverage, a new baby, adoption.
• Other, less common triggers: release from incarceration, gaining citizenship or lawful presence, certain errors or misconduct in a prior enrollment.

Miss the 60 days and the window closes — then it really is open enrollment (November 1) or nothing, for most people.

Job loss is the most common SEP we see, and it comes with a fork in the road: COBRA or the marketplace.

COBRA keeps your exact employer plan — but you now pay the full premium your employer was subsidizing, often $700+ per month for an individual and far more for a family. The marketplace, by contrast, prices your coverage on your current income. If your income just dropped because you lost your job, there’s a good chance you qualify for meaningful subsidies — during 2026 open enrollment, subsidized South Carolinians paid an average of about $76/month.

Rules of thumb:

• COBRA makes sense when you’re mid-treatment with doctors you can’t switch, or you’ll be re-employed with benefits within a month or two.
• The marketplace usually wins on price for everyone else — especially single-income households in a gap.
• Careful: if you enroll in COBRA and then change your mind mid-stream, you generally can’t switch to a marketplace plan until COBRA runs out or open enrollment comes around. The fork matters; take an hour (or a free phone call with us) before you pick.

• 1. Document the event. Termination letter, loss-of-coverage notice, lease or closing papers for a move, marriage or birth certificate. Expect healthcare.gov to ask for proof — verification got stricter in 2026.
• 2. Apply within 60 days. Coverage typically starts the first of the month after you pick a plan.
• 3. Estimate your income honestly — this year’s income, not last year’s. That number sets your subsidy.
• 4. Compare plans on network, not just premium. In the Upstate that means checking whether your doctors — Prisma Health or Bon Secours — are in the specific plan’s network. Our Upstate coverage guide explains why this matters more here than almost anywhere.

Or skip the paperwork: this entire process — event documentation, subsidy application, plan comparison, enrollment — is what SimpliCovered does for free. Carriers pay us; you don’t.

No qualifying event and no employer coverage coming? Your honest options until November:

• Mark open enrollment: November 1. Enroll in the first two weeks of December for January 1 coverage.
• Be careful with “alternatives.” Short-term and non-ACA products exist, but they can decline you for pre-existing conditions and cap what they pay. Some people use them as a stopgap; nobody should mistake them for real coverage. If you’re considering one, talk to someone who can show you the exclusions in writing first.
• If your income is low, check Medicaid eligibility year-round — South Carolina’s program (Healthy Connections) has no enrollment window for those who qualify.