The State Health Plan

Your good health is important to you, your family, and the state of South Carolina. That's why the South Carolina Budget and Control Board's Employee Insurance Program offers several health insurance options to all full-time state employees.

The State Health Plan (SHP) is a comprehensive health plan that provides you and your covered dependents with medical benefits if you become sick or are injured. With the SHP you have freedom of choice. This means you may choose your own healthcare provider, regardless of whether the provider participates in a SHP network. Network providers have agreed to accept the plan’s allowable charges for covered medical services as payment in full and will not balance bill you. Non-network providers, however, are free to charge you any price for their services, so you may pay more. The SHP offers two choices: the Standard Plan, which has higher premiums but lower deductibles, and the Savings Plan, which has higher deductibles but much lower premiums.

Savings Plan subscribers who have no other health coverage (including Medicare) may open a Health Savings Account, which can be used to pay medical expenses now and in the future. Some Standard Plan and Savings Plan benefits require Medi-Call approval before you receive them. This program helps coordinate your medical care and ensure that you and your covered dependents receive appropriate medical care in the most beneficial, cost-effective manner.

Getting your prescriptions filled is easy thanks to the Prescription Drug Program. If you are enrolled in the Standard Plan, there is no annual deductible. Simply show your SHP ID card when you purchase your prescriptions from a participating pharmacy and pay a copayment of either $10 for generic drugs, $25 for preferred brand drugs and $40 for non-preferred brand drugs for up to a 31-day supply. If you are a Savings Plan subscriber you pay the full allowable cost for drugs at a participating pharmacy, and the cost is applied to your annual deductible. If you have met your deductible you will be reimbursed for 80 percent of the allowable cost of the drug. The remaining 20% will be credited to your coinsurance maximum.