South Carolina's marketplace covers 587,567 people — bigger than states with far larger populations — with all six carriers returning and BCBS pairing the cheapest silver with the gentlest increase. Here's what South Carolinians actually pay in 2026, and how to shop a state without Medicaid expansion.
Based on 2026 rate analyses, Blue Cross Blue Shield of South Carolina has the cheapest silver plan at about $550 a month for a 40-year-old — and it took the state's smallest increase (+17.5%). Molina ($584) leads in the Charleston area, Ambetter ($590) posts the lowest out-of-pocket maximum ($5,545), and First Choice Next ($628) has the lowest deductible ($2,190).
Six carriers sell 2026 plans — BCBS SC, Molina, InStil Health, Ambetter (Absolute Total Care), First Choice Next (Select Health), and UnitedHealthcare — and every one of them returned from 2025, making South Carolina one of the most stable lineups we cover.
Cheapest sticker, gentlest repricing, and the state's dominant network — the rare market where the big Blue is also the budget answer. Its ~$4,064 deductible is the trade.
The value leader in Charleston-area counties, with Medicaid-rooted networks that run deep in the coastal metros.
Seventy-eight dollars more than BCBS buys a deductible about $1,900 lower — usually the better whole-year math for anyone with regular care needs.
Figures are approximate, from 2026 rate analyses for a 40-year-old on silver HMO plans. InStil Health (~$587), Ambetter (~$590, lowest MOOP $5,545), and UnitedHealthcare (~$766) also compete. Your rate varies by county, age, household size, tobacco use, and income.
BCBS's $550 sticker versus First Choice's $2,190 deductible versus Molina's Charleston pricing is a genuinely different answer depending on your county and care needs. A licensed agent can run all six carriers for your ZIP code, age, and income — free, in about 10 minutes.
No cost. No obligation to enroll. Licensed in 23 states, including South Carolina.
Before subsidies, silver plans for a 40-year-old South Carolinian average about $611 a month in 2026, from BCBS's $550 to UnitedHealthcare's $766. The average approved increase was 21.0%; 89% of enrollees are subsidized, with 30% paying under $10 a month.
| Carrier | 2026 position | Approved rate increase |
|---|---|---|
| BCBS of South Carolina | Cheapest silver ~$550; dominant network | +17.5% (lowest) |
| InStil Health | ~$587 silver | +20.6% |
| Molina | ~$584; Charleston-area leader | +23.9% |
| Ambetter (Absolute Total Care) | ~$590; lowest MOOP $5,545 | +25.2% |
| First Choice Next (Select Health) | ~$628; lowest deductible $2,190 | +25.2% |
| UnitedHealthcare | ~$766 silver | +25.2% |
Approximate 2026 figures from South Carolina DOI filings and public rate analyses, before premium tax credits. Availability and pricing vary by county.
ACA rates follow the federal age curve — a 64-year-old can be charged up to three times a 21-year-old's rate. Using a ~$610 South Carolina silver average at age 40:
| Age | Approx. monthly premium (silver) | vs. age 21 |
|---|---|---|
| 21 | ~$480 | 1.0× |
| 30 | ~$540 | 1.1× |
| 40 | ~$610 | 1.3× |
| 50 | ~$855 | 1.8× |
| 60 | ~$1,300 | 2.7× |
Illustrative — applies the federal default age factors to an approximate 2026 South Carolina silver average. Subsidies are age-aware, so older enrollees with moderate incomes often receive much larger credits.
South Carolina's 2026 is a big market having a quiet year — which is its own kind of news:
The enhanced premium tax credits that capped marketplace premiums from 2021–2025 ended December 31, 2025 — the single biggest driver of this year's rate jump. The original ACA credits are still in place for households between 100% and 400% of the federal poverty level (roughly up to $62,600 single, $128,600 family of four).
No exits, no entries, and increases clustered between 17.5% and 25.2% — South Carolina avoided both the carrier churn and the extreme repricing its neighbors saw. That makes this a year where the smart move is fine-tuning: the BCBS-versus-First-Choice deductible math, or Molina's Charleston edge, rather than wholesale plan changes.
Enrollment for 2027 coverage runs November 1 to December 15, 2026 — a month shorter than South Carolinians are used to. With 587,000+ enrollees and no expansion backstop, missing the window matters more here than in most states.
Sources: healthinsurance.org South Carolina marketplace guide, MoneyGeek, HealthCare.gov.
South Carolina's price leaders rotate by metro — the statewide cheapest isn't everyone's cheapest:
Six carriers, three regional answers: Molina by the coast, BCBS in the middle and upstate, and a deductible decision everywhere — South Carolina rewards quoting your actual county.
Tell me your ZIP code, ages, and household income — I'll compare every carrier filed in your area (and check what your household qualifies for while we're at it), then show you what you'd actually pay after subsidies.
Free comparison. No pressure, no obligation.
Metal tiers are about how you split costs with the insurer — not the quality of care. In South Carolina the deductible spread inside silver ($2,190 to $4,064) is bigger than most bronze-to-silver gaps:
Lowest premium, ~$10,600 deductible. Pure emergency protection — no subsidy eligibility.
Cheapest subsidized tier. Pair an HSA-eligible bronze plan with tax-free savings if you're healthy.
The sweet spot for most South Carolinians — from ~$550 with BCBS — and the only tier that unlocks cost-sharing reductions under 250% of poverty.
Worth comparing against silver every year — rate-filing quirks sometimes put gold within a few dollars.
Highest premium, lowest out-of-pocket. Rarely offered in South Carolina.
South Carolina's marketplace does the safety-net heavy lifting, because the Medicaid floor stops early:
Turning 65 soon? Marketplace plans stop making sense once Medicare kicks in — see your Medicare options instead.
BCBS saves $78/month on premium; First Choice Next's deductible is about $1,900 lower. If you expect more than a checkup or two, the "pricier" plan often wins the year.
In a non-expansion state, projecting annual income at or above 100% of the poverty level is what unlocks subsidies — and with 30% of South Carolinians paying under $10, the stakes are the whole premium. Worth doing with an agent.
Credits are based on this year's income estimate, and the math changed for 2026. A mid-year income change, a new baby, or a household change can unlock help immediately.
Cost-sharing reductions only attach to silver plans. They can cut a multi-thousand-dollar deductible to a few hundred dollars — a benefit bronze and gold buyers give up.
Open enrollment for 2027 ends December 15, 2026 — a month earlier than before. In a state without expansion, missing it usually means waiting a full year for coverage.
Premiums are regulated: you pay the same whether you enroll alone or with an agent. The difference is having someone who runs all six carriers, does the math on the whole year — premiums plus deductibles — and answers the phone after you enroll.
Based on 2026 rate analyses, Blue Cross Blue Shield of South Carolina has the cheapest silver plan at about $550 a month for a 40-year-old — and it also took the state's smallest increase. Molina leads the Charleston area at about $584, Ambetter posts the lowest out-of-pocket max ($5,545), and First Choice Next has the lowest deductible ($2,190) at about $628.
Before subsidies, silver plans for a 40-year-old South Carolinian average about $611 a month in 2026, ranging from $550 (BCBS) to $766 (UnitedHealthcare). Premiums rose 21% on average — but 89% of enrollees receive subsidies, and 30% pay under $10 a month.
Yes. South Carolina uses the federal marketplace — you shop and enroll at HealthCare.gov, and a licensed agent can quote and enroll you through it at no extra cost. Plans, prices, and subsidies are identical either way.
Yes. The original ACA premium tax credits are still in place for households earning between 100% and 400% of the federal poverty level — roughly up to $62,600 for a single person or $128,600 for a family of four. What expired at the end of 2025 were the enhanced subsidies, which had capped premiums and extended help above 400% of poverty.
If you've had a qualifying life event in the last 60 days — losing other coverage, moving, marriage, a new baby, certain income changes — you may qualify for a Special Enrollment Period on HealthCare.gov and can enroll now. Medicaid and CHIP enrollment (for those who qualify) is open year-round. Otherwise, open enrollment for 2027 coverage begins November 1, 2026.
No. South Carolina has not expanded Medicaid — Healthy Connections covers very low-income parents, pregnant women, seniors, and people with disabilities, leaving roughly 65,000 adults in the coverage gap. Children qualify through Partners for Healthy Children (SC's CHIP) at much higher family incomes. From 100% of the federal poverty level, marketplace subsidies take over.
Below 100% of the federal poverty level, marketplace subsidies aren't available, and without Medicaid expansion many adults fall into the coverage gap. Options worth checking: whether any household change (income, dependents) moves your projected annual income above the line; Healthy Connections eligibility if you're a parent, pregnant, over 65, or disabled; CHIP for your kids regardless of your own status; and community health centers, which charge on a sliding scale. An agent can walk through all four in one call.
No. Premiums are filed with regulators and are identical whether you enroll through HealthCare.gov yourself, directly with the carrier, or with a licensed agent. Agents are paid by the insurance companies, so the guidance costs you nothing extra.
Premium figures on this page are approximate averages drawn from 2026 individual-market rate filings and analyses, including healthinsurance.org, MoneyGeek, and ValuePenguin, checked July 2026. They are illustrations, not quotes: your premium depends on your region, age, household, tobacco use, income, and the plan you choose. Official plan pricing is available at HealthCare.gov or through any licensed agent.
Zuriel is licensed in 23 states. Explore cost guides for other states we serve:
Talk with Zuriel Kinlock, a licensed insurance agent, and get a real comparison of every 2026 plan filed in your South Carolina region — free, with zero obligation.
Important: This page is for general information and reflects approximate 2026 figures from public sources; it is not a quote, and submitting information or speaking with a licensed insurance agent does not guarantee enrollment, eligibility, savings, approval, or specific benefits. There is no obligation to enroll. Smooth Health Solutions is not connected with or endorsed by the U.S. government, the federal Medicare program, CMS, HealthCare.gov, or any government agency. Plan availability, benefits, premiums, and eligibility vary by plan, carrier, location, and individual circumstances.
