Best Health Insurance in South Carolina (2026)

Ambetter is the best health insurance company in South Carolina for 2026, with the lowest average out-of-pocket maximum among the state's marketplace carriers at $5,545. Its Silver plans average $590 per month with a $3,212 deductible.

First Choice Next is a strong option for people who expect regular medical care. Its average deductible is $2,190, which is $1,022 lower than Ambetter's, allowing coverage to kick in sooner.

Blue Cross Blue Shield has the lowest average premium of the three at $576 per month and provides greater plan variety. Its Silver deductible is higher, however, at $4,064.

* Rates shown are statewide averages for 40-year-olds looking with Silver HMO plans.

Ambetter's $5,545 Silver out-of-pocket maximum is the lowest in South Carolina's 2026 marketplace, $33 below the next closest carrier.

First Choice Next's $2,190 Silver deductible is the lowest in South Carolina's 2026 market, $1,022 below Ambetter and $1,874 below Blue Cross Blue Shield. For regular health care users, the lower deductible means your plan starts sharing costs sooner than with any competing carrier.

Blue Cross Blue Shield is the only 2026 marketplace carrier in South Carolina with all four plan types, HMO, PPO, EPO and POS. Its Silver plan at $576 per month is the cheapest among the six carriers we reviewed, $35 below the state average. The trade-off is the state's highest Silver deductible at $4,064.

The table lets you filter South Carolina's 2026 marketplace plans by age, plan type, metal tier and HSA eligibility. Not every carrier serves every county. Filter by your ZIP code on HealthCare.gov to confirm which plans are available where you live before comparing premiums or deductibles here.

South Carolina hasn't expanded Medicaid. Adults earning below the federal poverty level don't qualify for state Medicaid and can't access marketplace subsidies. More South Carolinians fall through this coverage hole than in most states. Enter your household income and size at HealthCare.gov to see whether you qualify for premium tax credits or Medicaid.

Health insurance costs in South Carolina vary by plan type and metal tier. For a 40-year-old, POS plans have the lowest average rates for Expanded Bronze, Silver and Gold metal tiers, ranging from $397 to $621 per month. HMO plans are the only option available at the standard Bronze tier, averaging $426 monthly.

PPO plans cost the most, with Silver coverage averaging $748 per month and Gold averaging $760. The higher costs reflects the greater provider flexibility these plans provide.

* Rates are statewide averages for 40-year-olds in South Carolina. “N/A” indicates that the plan type is not available at that metal tier in the state.

Which carrier costs less over a year depends on how often you use care, not which premium is lowest. Your provider network determines whether your doctors are covered at no additional cost.

South Carolina and federal agencies have free resources for comparing plans, applying for subsidies and resolving coverage disputes. These links are current for 2026.   

• HealthCare.gov: The federal marketplace where South Carolina residents compare ACA health insurance plans, check subsidy eligibility and enroll during open enrollment or a Special Enrollment Period after a qualifying life event.
• South Carolina Department of Insurance: Provides consumer guides on coverage options, helps resolve billing or claims disputes with insurers and handles complaints against carriers doing business in the state.
• South Carolina Department of Health and Human Services: Information on South Carolina Medicaid (Healthy Connections), CHIP and other public health programs, including eligibility requirements and how to apply.
• Find Local Enrollment Assistance: Search for certified enrollment navigators in your county who help you compare plans and complete your marketplace application at no cost.

Medicare covers adults 65 and older and some younger adults with qualifying disabilities. It's a federal program separate from the ACA marketplace, with different enrollment periods and plan types. If you or someone in your household is approaching Medicare age, review both types below before your 65th birthday. Enrollment windows have strict deadlines.

• Best Medicare Supplement Plans in South Carolina: Medicare Supplement plans, also called Medigap, help cover out-of-pocket costs that Original Medicare doesn't pay, such as deductibles, copays and co-insurance.  
• Best Medicare Advantage Plans in South Carolina: Medicare Advantage replaces Original Medicare and often adds prescription drug coverage along with dental, vision and hearing benefits.

My pick for most South Carolina residents is Ambetter. Its $5,545 out-of-pocket maximum is the lowest Silver ceiling in the state and cost-sharing beyond the monthly premium is capped lower than with any competing carrier. 

If you see a doctor more than twice a year, First Choice Next is the stronger pick. Its $2,190 Silver deductible is the lowest in the state. You'll pay $456 more per year in premiums than with Ambetter, but save $1,022 the first time you meet your deductible.   

South Carolina residents who need to see specialists outside a standard network, or who split their time between states, will find plan-type flexibility more valuable than a lower deductible. Blue Cross Blue Shield is the only 2026 carrier with PPO and POS options, and its HMO Bronze at $386 is the state's lowest Bronze entry point. The trade-off is the highest Silver deductible in the state at $4,064.   

If you live in Charleston-area counties, Molina Healthcare is the carrier to compare first. It leads on rates there and averages $584 per month for Silver HMO statewide, $6 below Ambetter and $8 above Blue Cross Blue Shield. Confirm county availability at HealthCare.gov before enrolling.

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

Our Scoring System

We weighted three cost factors:

• Monthly premium (60%): We compared average premium across all plans for ages 18, 26, 40, 50 and 60. Plans with lower average premiums earn higher scores.
• Maximum out-of-pocket (20%): This is the most you'll pay in a year beyond your monthly premium. Among South Carolina's 2026 Silver HMO carriers, out-of-pocket maximums range from $5,545 at Ambetter to $6,341 at Instil Health. Carriers with lower limits score higher.
• Deductible (20%): The deductible is what you pay before your insurer starts sharing costs. 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 difference. 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. An analysis of every available tier includes Catastrophic, Bronze, Expanded Bronze, Silver, and Gold. No Platinum plans are available in South Carolina's 2026 marketplace.