At a glance
What South Carolina requires
South Carolina permits fixed indemnity as a supplemental, limited-benefit product, but it sets a minimum-benefit standard on hospital-indemnity coverage. Under S.C. Code Regs R.69-34 G(4), a hospital confinement indemnity plan must pay at least $30 per day for at least 31 days. Notably, this regulation does not contain a "regardless of expenses" format phrase, and it does not require a fixed-indemnity-specific notice about minimum essential coverage or comprehensive coverage — the disclosures it calls for are generic accident-and-health disclosures (R.69-34 H).
Because fixed indemnity is an excepted benefit, it sits outside ACA rules. At the federal level, a 2024 fixed-indemnity consumer-notice requirement was vacated by a court in December 2024, so it is not federally required; an earlier 2014 individual-market notice still applies. South Carolina has not adopted the 2024 federal fixed-indemnity consumer-notice, so that specific federal disclosure is not layered on top of the state's own accident-and-health disclosure rules.
The core thing to understand is how it pays: fixed indemnity pays a predetermined cash amount when a covered event happens — for example, a set amount per day in the hospital — no matter what your treatment actually costs. That's very different from major medical, which pays a share of your actual bills.
How fixed indemnity works in South Carolina
Fixed indemnity and related excepted benefits come in a few forms (described as coverage types, not specific products):
Each pays a fixed cash benefit you can use toward bills, deductibles, or everyday costs during a covered event. Because South Carolina's disclosures for these products are generic accident-and-health disclosures rather than a fixed-indemnity-specific notice, read the policy documents closely so you understand exactly what the plan pays. As an independent, carrier-neutral brokerage, we don't push any single insurer — and we'll be clear that fixed indemnity works best alongside a comprehensive plan, not instead of one.
How to get coverage here
Fixed indemnity isn't sold through the health insurance marketplace, and it isn't tied to Open Enrollment — you can generally apply for it year-round, directly from an insurer or through a broker, subject to the product's terms and South Carolina's requirements.
For the comprehensive coverage that fixed indemnity is meant to supplement, South Carolina uses the federally facilitated marketplace at HealthCare.gov, where ACA plans have an annual Open Enrollment (typically each fall through early winter) and Special Enrollment Periods for qualifying life events like losing job-based coverage, moving, or having a baby. South Carolina has not expanded Medicaid, so eligibility there is limited mostly to specific categories.
What it costs
We don't quote premiums here — prices depend on your situation — but the cost of fixed indemnity in South Carolina is driven by:
Because fixed indemnity pays fixed amounts rather than a share of your bills, the real question is how much cash it pays for the events you're most concerned about — and remember it's supplemental, so weigh it alongside the cost of the comprehensive coverage it's meant to support.
Fixed indemnity insurance is a supplemental, limited-benefit (excepted-benefit) product. It pays fixed cash amounts for covered events regardless of your actual medical costs, is not major medical coverage, and is not minimum essential coverage under the Affordable Care Act. It does not cover the full range of essential health benefits and is not a substitute for a comprehensive health plan.
GetHealthPlans.com is operated by MTG Insurance Agency, an independent, carrier-neutral brokerage. We do not issue insurance and are not a government agency or the health insurance marketplace. Regulatory details on this page reflect South Carolina law and South Carolina Department of Insurance guidance as of the last-reviewed date and can change; confirm current terms and the specific product's approved form before you enroll.