Best Health Insurance in South Carolina (2026)


Key Takeaways
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Ambetter and First Choice Next are tied as South Carolina's best health insurance providers, with Ambetter leading on out-of-pocket costs and First Choice Next on deductibles.

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Blue Cross Blue Shield has the most affordable health insurance in South Carolina, though its deductibles are higher than other options in the state.

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When shopping for health insurance in South Carolina, compare multiple insurer quotes, review coverage and deductibles, and confirm your preferred doctors are in-network.

Your best plan in South Carolina depends on how often you use health care. If you use care regularly, First Choice Next's $2,190 deductible makes it the better fit even at $628 per month. If you want the lowest monthly bill, Blue Cross Blue Shield at $576 is the cheapest Silver option. For the best balance of premium and out-of-pocket costs, Ambetter leads at $590 per month. 

South Carolina's ACA marketplace has six carriers writing Silver HMO plans for 2026. Monthly premiums for 40-year-olds range from $576 to $766. The deductible range tells a more useful story: $1,874 separates the lowest ($2,190 at First Choice Next) from the highest ($4,064 at Blue Cross Blue Shield). 

Blue Cross Blue Shield's $4,064 deductible is nearly twice First Choice Next's $2,190. It is the only carrier with all four plan types: HMO, PPO, EPO and POS. Offering those networks pushes its Silver HMO deductible above every competitor in the state. Monthly premium is rarely the deciding number in this market.

Best Health Insurance Companies in South Carolina

Based on pricing, out-of-pocket costs and overall plan value, Ambetter is the best health insurance company in South Carolina. First Choice Next, Blue Cross Blue Shield, Molina Healthcare and Instil Health also score highly statewide, offering competitive alternatives across premiums, deductibles and coverage.

Ambetter$590$5,545$3,2124.6Focused Silver
First Choice Next$628$5,888$2,1904.6First Choice Next Silver Premier
Blue Cross Blue Shield$576$5,578$4,0644.5Blue Pee Dee Silver 2
Molina Healthcare$584$5,800$3,3684.4Molina Silver Standard
Instil Health$587$6,341$3,1214.2Inhealth Basic Standard
UnitedHealthcare$766$6,048$2,5294Uhc Silver Standard-

*Our picks are the best health insurance options for 40-year-olds looking for Silver-tier HMO plans.

Ambetter

Ambetter

MoneyGeek Rating
4.6/ 5
4.9/5Affordability
3.3/5Deductible
5/5MOOP
  • Average Monthly Rate

    $590
  • Average MOOP

    $5,545
  • Average Deductible

    $3,212
First Choice Next

First Choice Next

MoneyGeek Rating
4.6/ 5
4.7/5Affordability
5/5Deductible
3.7/5MOOP
  • Average Monthly Rate

    $628
  • Average MOOP

    $5,888
  • Average Deductible

    $2,190
Blue Cross Blue Shield

Blue Cross Blue Shield

MoneyGeek Rating
4.5/ 5
5/5Affordability
2.5/5Deductible
4.9/5MOOP
  • Average Monthly Rate

    $576
  • Average MOOP

    $5,578
  • Average Deductible

    $4,064

Which Is the Best Health Insurance in South Carolina by Age and Plan Type?

South Carolina's largest age-based premium jump runs from $421 per month for an 18-year-old on Ambetter's Silver HMO to $1,577 for a 60-year-old on Blue Cross Blue Shield's PPO. Both endpoints come from the same 2026 plan year. The nearly 3:1 ratio holds across every carrier and plan type in this market. 
The best health insurance in South Carolina changes by age, plan type and coverage level. Silver-tier premiums range from $421 to $1,577 monthly. The rate varies based on age and plan type.

By Age:

  • Teens (18): For Blue Cross Blue Shield EPO plans, you pay $472 a month, Ambetter HMO plans are $421 and Blue Cross Blue Shield PPO plans cost $531.
  • Young adults (26): Blue Cross Blue Shield EPO plans charge $529 per month, Ambetter HMO plans are $472 and Blue Cross Blue Shield PPO plans charge $595.
  • Adults (40): You pay $660 per month for Blue Cross Blue Shield EPO plans, while your costs for Ambetter HMO plans are $590. Blue Cross Blue Shield PPO plans charge you $743.
  • Seniors (60): Blue Cross Blue Shield EPO plan premiums are $1,402 a month, Ambetter HMO plans cost $1,252 and Blue Cross Blue Shield PPO plans charge $1,577.

The rate difference between 18 and 60 tells the clearest story. A 60-year-old pays $1,252 per month for the same Ambetter Silver HMO plan that costs an 18-year-old $421, an $831 monthly gap. That nearly 3:1 ratio holds across carriers and is the primary reason premium tax credits matter for older South Carolina residents: without subsidies, Silver coverage consumes a large share of a fixed income 

By Plan Type:

  • PPO: Blue Cross Blue Shield is South Carolina's only PPO provider and charges $743 a month for 40-year-olds with a $2,390 deductible and $3,242 MOOP.
  • HMO: You pay $590 per month for Ambetter HMO coverage for 40-year-olds. This is with a $3,212 deductible and $5,545 MOOP.
  • EPO: Blue Cross Blue Shield EPO plans for 40-year-olds costs $660 a month with a $3,483 deductible and $5,786 MOOP.
  • POS: Blue Cross Blue Shield is the only POS provider in South Carolina, at $572 a month with a $3,121 deductible and $6,341 MOOP.

*All these rates are averages based on Silver plans for the category in each case.   

PPO plans cost more than every other plan type in South Carolina's 2026 market. Blue Cross Blue Shield's Silver PPO is $743 per month versus $590 for Ambetter's HMO, a $153 monthly gap with no South Carolina PPO competitor to offset it. That premium pays for out-of-network access and no referral requirement. Residents who rely on out-of-network specialists or want to see any provider without prior authorization should price that trade-off carefully against the added cost.

Compare South Carolina Health Insurance Providers

Health insurance costs in South Carolina change by provider, plan type and coverage level. Compare premiums, deductibles, out-of-pocket maximums, age groups, metal tiers and HSA eligibility.

Data filtered by:
HMO
Silver
40
No
Ambetter$590HMOSilver$5,545$3,21240No
First Choice Next$628HMOSilver$5,888$2,19040No
Blue Cross Blue Shield$576HMOSilver$5,578$4,06440No
Molina Healthcare$584HMOSilver$5,800$3,36840No
Instil Health$587HMOSilver$6,341$3,12140No
UnitedHealthcare$766HMOSilver$6,048$2,52940No

South Carolina's 2026 marketplace draws plans from six carriers. Every carrier except Blue Cross Blue Shield sells HMO plans only, which is why the market has a single PPO source and a single POS source. Blue Cross Blue Shield's higher Silver deductible reflects the cost of running four separate network types across the state.

South Carolina hasn't expanded Medicaid under the ACA. Adults earning below the federal poverty level aren't covered by state Medicaid and don't qualify for marketplace subsidies. That coverage gap is larger here than in most states. Check eligibility at HealthCare.gov for your specific income level. 

South Carolina residents enroll through HealthCare.gov during open enrollment, November 1 through January 15 each year. Premium tax credits apply for residents earning 100% to 400% of the federal poverty level. Cost-sharing reductions on Silver plans apply at 100% to 250% of the poverty level. 
The cheapest carrier in your county may differ from the statewide average. Molina leads in some Charleston-area counties while Blue Cross Blue Shield has the lowest rates in the Columbia and Greenville areas. Filter by ZIP code on HealthCare.gov for your specific county.

How Do I Choose Health Insurance in South Carolina?

All six 2026 marketplace carriers offer different deductible structures and monthly premiums. Your annual medical use determines which carrier saves the most. Your network choice determines which providers are covered.

  1. 1
    Assess Your Health Needs

    Start by estimating your annual health care use rather than guessing at a coverage level. In our South Carolina data, a 40-year-old on an Ambetter Silver plan who hits their $3,212 deductible once pays no more than $5,545 that year, the lowest out-of-pocket ceiling in the state. A 40-year-old who rarely sees a doctor and never meets the deductible pays only the $590 monthly premium, or $7,080 annually. Your expected use determines which of those two totals you're actually buying.

  2. 2
    Compare Multiple Insurer Quotes

    MoneyGeek analyzed every 2026 plan on South Carolina's exchange and found Silver HMO premiums for 40-year-olds ranging from $590 to $766 per month across the six carriers we reviewed. The pattern that surprised us most was how often the lowest-premium carrier is not the lowest-cost carrier. Blue Cross Blue Shield is $14 per month cheaper than Ambetter at the Silver level, but its average deductible is $852 higher. A single hospital visit can erase five years of premium savings. Get quotes from at least three carriers and compare total annual cost, not just monthly premium.

  3. 3
    Check Provider Networks

    Each marketplace carrier in South Carolina runs a separate HMO network. A hospital that accepts Ambetter won't necessarily accept Molina Healthcare or Instil Health. Call your doctor's billing office directly before enrolling. Blue Cross Blue Shield is the only carrier in the state with a PPO plan, at $743 monthly for 40-year-olds.

  4. 4
    Review Cost-Sharing Details

    South Carolina's Silver HMO deductibles for 2026 range from $2,190 to $4,064 among the top five carriers, a $1,874 spread. On a $628 monthly plan, choosing a carrier with a $2,190 deductible instead of a $4,064 deductible saves $1,874 in out-of-pocket costs the first time you meet your deductible, more than two months of premiums. Raise your deductible to lower monthly payments only if you have enough savings to cover that amount when you need care. Your out-of-pocket maximum caps what you'll spend in a year beyond premiums.

  5. 5
    Evaluate Plan Types

    South Carolina's Silver tier has four plan types. POS plans average $572 monthly, the lowest Silver rate in the state, but Blue Cross Blue Shield is the only POS carrier. HMOs from five carriers average $611 monthly. EPO plans skip specialist referrals at $660. The only PPO is Blue Cross Blue Shield at $748 monthly. POS plans require specialist referrals like HMOs.

  6. 6
    Review Federal Programs

    South Carolina residents earning 100% to 400% of the federal poverty level may qualify for premium tax credits through HealthCare.gov. Credit amounts are lower in 2026 than in prior years because federal subsidy enhancements expired at the end of 2025. Residents earning above 400% of the federal poverty level no longer qualify for marketplace credits.

    South Carolina hasn't expanded Medicaid. Residents below the federal poverty level who don't qualify for marketplace plans have limited coverage options. Check eligibility at HealthCare.gov. If you have low income, a qualifying disability or are 65 or older, review Medicare Advantage and Medicare Supplement plans separately.

How Much Does Health Insurance Cost in South Carolina?

HMO plans offer the most affordable Bronze coverage in South Carolina at $426 per month and are the only standard Bronze option available. For Expanded Bronze, POS plans lead with the lowest average rate at $397 monthly, followed by HMO at $461, PPO at $503 and EPO at $476. 

In the Silver tier, POS plans remain the cheapest at $572 per month, while HMO plans cost $611, EPO $660 and PPO $748. For Gold coverage, POS again offers the lowest premiums at $621, with HMO at $653, EPO $701 and PPO $760. HMO plans cost less. PPO and EPO plans cover larger provider networks at higher monthly premiums. South Carolina has no Platinum coverage. 

The most consistent pattern in South Carolina's cost data is the POS tier advantage. POS plans undercut the next cheapest option across Expanded Bronze, Silver and Gold tiers, by $39 per month in Silver alone, but Blue Cross Blue Shield is the only carrier offering POS plans in the state. That means POS shoppers have no competitive alternative if Blue Cross Blue Shield's network or deductibles don't fit their needs. HMO plans give buyers the broadest carrier choice and the lowest average premiums in South Carolina's 2026 market.

EPONo Data$476$660$701
HMO$426$461$611$653
POSNo Data$397$572$621
PPONo Data$503$748$760

*Rates are averages for 40-year-olds in South Carolina. Your rates will vary based on your age and location. 

UnitedHealthcare, the lowest-scoring carrier on this list at 4.0 out of 5, has the second-lowest Silver HMO deductible in the state at $2,529, behind only First Choice Next. That's a finding most shoppers who sort by score alone would miss entirely. UnitedHealthcare's weak score comes from its $766 monthly premium, the most expensive Silver HMO rate in the state by $138. But for a South Carolina resident who expects to use a lot of health care in a given year and can absorb a high monthly cost, UnitedHealthcare's deductible picture is better than three of the five higher-ranked carriers.

Best Health Insurance in South Carolina: Bottom Line

Ambetter and First Choice Next are the strongest choices for most South Carolina residents in 2026. Ambetter wins on the lowest out-of-pocket maximum in the Silver tier at $5,545. First Choice Next wins on the lowest deductibles at $2,190, which matters most for residents who use health care regularly and want cost-sharing to start sooner. 

Blue Cross Blue Shield is the best choice when PPO or POS access matters more than out-of-pocket costs. Its HMO Bronze plans start at $386 per month. The trade-off is higher Silver deductibles than any competing carrier. Compare all three before choosing.

Best South Carolina Health Insurance: FAQ

South Carolina health insurance questions cover enrollment timing, state regulations and coordinating multiple plans:

How do I get health insurance in South Carolina?

Are you required to have health insurance in South Carolina?

Can you have multiple health insurance plans in South Carolina?

Should I choose Ambetter or First Choice Next in South Carolina?

Is Blue Cross Blue Shield worth the higher deductible in South Carolina?

What is the best health insurance plan in South Carolina for someone on a budget?

Our Review Methodology

We ranked the best South Carolina health insurance providers by focusing heavily on monthly premiums since they create the highest ongoing cost. We also examined maximum out-of-pocket limits and deductibles, which impact your total annual spending.

Our Scoring System

We weighted three cost factors:

  • Monthly premium (60%): Premiums carry the most weight because they're the largest recurring annual cost. Lower average monthly premiums earn the highest scores on this dimension.
  • Maximum out-of-pocket (20%): A lower average MOOP limits your worst-case annual spending beyond premiums. Carriers with lower average MOOPs score higher on this factor.
  • Deductible (20%): Your deductible is what you pay before coverage starts. South Carolina's 2026 Silver HMO deductibles range from $2,190 at First Choice Next to $4,064 at Blue Cross Blue Shield, a $1,874 spread. Lower average deductibles earn higher scores.

Sample Consumer Profile

We reviewed all 2026 South Carolina plans for people aged 18, 26, 40, 50 and 60. Prices are shown for 40-year-olds unless otherwise noted. We analyzed every tier: Catastrophic, Bronze, Expanded Bronze, Silver, Gold and Platinum.

Related Pages

About Mark Fitzpatrick


Mark Fitzpatrick, Licensed P&C Insurance Expert, MoneyGeek

Mark Fitzpatrick, a Licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident insurance expert. He has spent nearly a decade analyzing the market, first at LendingTree and now at MoneyGeek, where he produces original research on hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.

He covers economics and insurance at MoneyGeek, and his work has been featured in The Washington Post, The New York Times and NPR, among other outlets.

Like all MoneyGeek analysts, he draws on independent cost and consumer experience data. No insurance company partnership influences his recommendations.

Mark holds a B.A. from Boston College and an M.A. in Economics and International Relations from Johns Hopkins University. He started his career in financial risk management at State Street and is also a five-time “Jeopardy!” champion.


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