Best Health InsuranceSouth CarolinaBest South Carolina Health Insurance (2023 Plans)
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Best Health InsuranceSouth CarolinaBest Health Insurance in South Carolina
Best Overall in South Carolina - Cigna
Best for Low MOOP - Blue Cross Blue Shield
Best Cheap - Cigna
Best for Low Income - Cigna
Best for Young Adults - Blue Cross Blue Shield
Best for HMO - Cigna
Best for EPO - Blue Cross Blue Shield
Best Short-Term Insurance - National General Accident & Health
Best Overall for Health Insurance in South Carolina
Cigna Healthcare of South Carolina is the best health insurance provider in South Carolina, with a MoneyGeek score of 60 out of 100. Of the providers that we evaluated, it has the most affordable average monthly premium and the lowest claims denial rate. MoneyGeek analyzed approximately 16 Silver EPO and 21 Silver HMO plans to find the best overall health insurance provider in South Carolina.
MoneyGeek Pick: Cigna Healthcare
pros
Rarely, if ever, denies claims
Scored the highest in affordability out of the five insurers in our comparison group
cons
Has a higher average MOOP cost than other insurers
Only offers HMO plans
COMPANY HIGHLIGHTS
Cigna Healthcare of South Carolina offers seven Silver Health Maintenance Organization (HMO) plans for an average cost of $490 per month — the lowest monthly premium among the insurers in our comparison group. While you will pay less per month for health insurance, policyholders with Cigna Healthcare of South Carolina may pay high MOOP costs of $8,929. The provider has an average denial rate of 0%, so you can be confident that your insurance claims will likely be approved.
With an HMO plan, you can only receive services from providers within your insurer’s network, unless it’s a medical emergency. You will also need a referral to see a specialist. That said, HMO plans are a good choice if you want to pay less per month and there are in-network physicians in your area.
Plan Recommendations
Among the plans offered by Cigna Healthcare of South Carolina, MoneyGeek suggests the following three Silver HMO plans:
- Cigna Connect 8100: $493 per month; MOOP $8,100
- Cigna Connect 0B: $484 per month; MOOP $9,100
- Cigna Simple Choice 5800: $489 per month; MOOP $8,900
Best Health Insurance in South Carolina for Low Out-of-Pocket Costs
Blue Cross Blue Shield ranks as the best health insurance provider in South Carolina for low MOOP costs, earning a score of 68 out of 100 from MoneyGeek. Our findings reveal that it's a good choice for those whose primary concern is minimizing out-of-pocket health care expenses.
To find the best providers in this category, we examined 15 Gold HMO and 10 Gold EPO plans.
MoneyGeek Pick: Blue Cross Blue Shield
pros
Has the lowest MOOP cost out of the providers in our comparison group
Offers a variety of plan options
cons
Has a higher claims denial rating than other providers
Has higher average premiums than other providers
COMPANY HIGHLIGHTS
Blue Cross Blue Shield offers 10 Gold EPO plans. EPO plans work similarly to HMOs in that they only cover in-network providers, but they may allow you to see a specialist without a referral from your primary care doctor.
The average cost of a Blue Cross Blue Shield Gold EPO plan is $576 per month — relatively high in comparison to other providers. However, it offers lower MOOP costs, at around $6,580. Its denial rate is approximately 18%. Though not the highest among the insurers that we evaluated, there is still a chance that your claim may be denied.
Plan Recommendations
MoneyGeek recommends the following Gold EPO plans from Blue Cross Blue Shield for those seeking low out-of-pocket health care costs:
- BlueEssentials HD Gold 3: $591 per month; MOOP $3,400
- Blue VirtuConnect Gold 1: $574 per month; MOOP $5,000
- BlueEssentials Gold 1: $595 per month; MOOP $4,900
Best Cheap Health Insurance in South Carolina
Cigna Healthcare of South Carolina is the best affordable health insurance provider in South Carolina, receiving a score of 75 out of 100 for its low monthly premiums.
For this category, MoneyGeek weighted providers’ monthly premiums more heavily to find the cheapest insurer. It’s important to note that a lower monthly premium may translate to a higher MOOP cost.
MoneyGeek reviewed 16 Silver EPO plans and 21 Silver HMO plans to find the most affordable health insurance provider in South Carolina.
MoneyGeek also analyzed the cheapest health insurance in South Carolina for those who just want the cheapest rates.
MoneyGeek Pick: Cigna Healthcare
pros
Has a low claims denial rating (approves claims)
Offers affordable monthly premiums compared to other insurers
cons
Has a high MOOP cost
Offers limited plan types
COMPANY HIGHLIGHTS
Of the insurers that we evaluated, Cigna Healthcare of South Carolina has the lowest average monthly premium at $490 a month. As a trade-off, it comes with a high MOOP cost of around $8,929.
Although this insurer’s plans have one of the highest average MOOP costs, policyholders can rest easy knowing that their claims will likely be approved — the insurer has a denial rate of 0%. Cigna Healthcare of South Carolina offers seven Silver HMO plans.
Plan Recommendations
MoneyGeek recommends the following three Silver HMO plans from Cigna:
- Cigna Connect 0B: $484 per month; MOOP $9,100
- Cigna Connect 7500: $488 per month; MOOP $9,100
- Cigna Simple Choice 5800: $489 per month; MOOP $8,900
Best Health Insurance for Low Income in South Carolina
Cigna Healthcare of South Carolina is the best health insurance provider for those with low incomes in South Carolina. The insurer received a MoneyGeek score of 76 out of 100 for its affordable monthly premiums and low claims denial rate.
For this category, we only reviewed providers and plans that featured cost-sharing reductions (CSRs) and favored those with low monthly premiums. This amounted to 16 Silver EPO plans and 21 Silver HMO plans.
Typically, plans with lower out-of-pocket expenses have higher MOOP costs. CSRs cover some of these out-of-pocket costs, so you may not have to choose between paying a lower premium and having a higher deductible. For example, a standard Silver plan pays about 70% of expected health care costs, but CSR Silver plans pay even more:
- Those who make between $27,180 and $33,975 per year (201%–250% of the federal poverty level) can expect to have 73% of their health costs covered.
- Those who make between $20,385 and $27,180 per year (151% to 200% of the FPL) will likely have 87% of their costs covered.
- Those who make less than $20,385 per year (up to 150% of the FPL) can expect to have 94% of their health care costs covered.
Keep in mind that these brackets may vary based on the number of people living in a household.
MoneyGeek Pick: Cigna Healthcare
pros
Rarely denies claims
Has the most affordable monthly premium among the insurers we evaluated
cons
Has one of the highest MOOP costs of the insurers in our comparison group
Only offers one plan type
COMPANY HIGHLIGHTS
Cigna Healthcare of South Carolina offers seven Silver HMO plans to those whose income falls below 250% of the FPL. On average, its plans for low-income policyholders cost $490 per month and have an average MOOP cost of $7,136.
Though the provider only offers HMO plans, these are a low-cost option for those who don’t mind using in-network providers. Another noteworthy feature of this provider is its claims denial rate of 0%, which may indicate that its claims are almost always approved.
Plan Recommendations
The best plan from Cigna Healthcare of South Carolina is Cigna Connect 0B. The MOOP cost for this plan varies based on income bracket:
- 201%–250% of the FPL: $484 per month; MOOP $7,250
- 151%–200% of the FPL: $484 per month; MOOP $3,000
- Up to 150% of the FPL: $484 per month; MOOP $1,000
Best Health Insurance for Young Adults in South Carolina
Young adults in South Carolina may find the best health plan from Blue Cross Blue Shield. MoneyGeek gave the provider a score of 78 out of 100 for its low average MOOP and monthly premium costs.
For this category, we reviewed Bronze and Catastrophic plans, which tend to have cheaper premiums but higher out-of-pocket costs. Catastrophic plans are only available to those under the age of 30.
Here's a breakdown of the number of plan tiers and types we evaluated:
- Bronze: One EPO plan and five HMO plans
- Expanded Bronze: Ten EPO plans and 14 HMO plans
- Catastrophic: One EPO plan
MoneyGeek Pick: Blue Cross Blue Shield
pros
Has the cheapest monthly premium out of the insurers in our comparison group
Offers more plan types than other insurers
Has the lowest out-of-pocket costs among the insurers in our comparison group
cons
Denies more claims, on average, than other insurers
COMPANY HIGHLIGHTS
Health insurance plans from Blue Cross Blue Shield cost an average of $300 per month and have an average MOOP cost of $8,509 — the lowest premium and MOOP cost among the insurers in our comparison group. While the insurer offers health insurance at a low cost, its claims denial rate of approximately 18% means that your claim may not be approved.
The insurer has one Catastrophic EPO plan, one Bronze EPO plan and ten Expanded Bronze EPO plans. EPO plans are similar to HMO plans in that they only provide coverage for in-network providers. Unlike HMO plans, EPOs may not require a referral to see a specialist.
Plan Recommendations
MoneyGeek recommends the following EPO plans from Blue Cross Blue Shield for young adults in South Carolina:
- BlueEssentials HD Bronze 3: $283 per month for 18-year-olds and $317 per month for 26-year-olds; MOOP $7,000
- BlueEssentials HD Bronze 5: $278 per month for 18-year-olds and $312 per month for 26-year-olds; MOOP $7,500
- BlueEssentials Catastrophic 1: $182 per month for 18-year-olds and $204 per month for 26-year-olds; MOOP $9,100
Best Health Insurance by Plan Type in South Carolina
South Carolina health insurance providers offer a variety of plan types. Here are the best providers for each plan type:
- HMO: Cigna Healthcare of South Carolina (MoneyGeek score of 63 out of 100)
- EPO: Blue Cross Blue Shield (MoneyGeek score of 100 out of 100)
Our recommendations are based on Silver plans, which tend to have a good balance of premiums and out-of-pocket costs. You can choose from 16 EPO plans and 21 HMO plans in South Carolina.
MoneyGeek Pick for HMO: Cigma Healthcare of South Carolina
COMPANY HIGHLIGHTS
Cigna Healthcare of South Carolina sells seven Silver HMO plans. These plans cost around $490 per month and have a MOOP cost of $8,929.
HMO plans are the most common type of health insurance, and for good reason — they’re often the least expensive option. However, it’s not an ideal choice if your preferred physicians are not included in the provider’s network. Furthermore, you will likely need a referral to see a specialist.
Plan Recommendations
We recommend the following two Silver HMO plans from Cigna Healthcare of South Carolina:
- Cigna Connect 8100: $493 per month; MOOP $8,100
- Cigna Connect 0B: $484 per month; MOOP $9,100
MoneyGeek Pick for EPO: Blue Cross Blue Shield
COMPANY HIGHLIGHTS
Blue Cross Blue Shield offers 16 Silver EPO plans at an average monthly cost of $566 and a MOOP cost of $8,370. EPO plans are like HMOs, but with a few key differences. One difference is that with an EPO, you may not always need a referral to see a specialist. This can be useful if you aren’t able to easily get an appointment with your primary physician.
Plan Recommendations
Our review found that the following Silver EPO plans are the best options from Blue Cross Blue Shield:
- BlueEssentials HD Silver 6: $598 per month; MOOP $5,000
- BlueExclusive Cooper Silver 1: $496 per month; MOOP $8,500
Best Short-Term Health Insurance in South Carolina
National General Accident & Health is the overall best company for short-term health insurance in South Carolina. It received a nearly perfect MoneyGeek score of 95 out of 100.
While short-term health insurance may be a good option for some, it is not an adequate substitute for health care coverage under the Affordable Care Act (ACA) since it does not cover essential health benefits.
National General Accident & Health
National General Accident & Health received a MoneyGeek score of 95 out of 100, making it a good choice for those who prioritize customer service and value in South Carolina. Its average MOOP cost is $7,500. Plan options range in length from 30 days to one year and include coverage for prescription drugs, urgent care and online doctor visits. You may also take advantage of several discounts to keep your costs down.
How to Find the Best Health Insurance for You in South Carolina
The best health insurance policy in South Carolina will vary between individuals based on their health care needs and budget. When shopping for health insurance, it’s important to compare insurers’ monthly premiums and out-of-pocket expenses to find the best value.
Understand when a health insurance plan will cover you
The terms "in-network provider" and "out-of-network provider" refer to the insurance company's network of doctors, hospitals and other health care services.
If you go to a doctor or hospital that's an in-network provider, you may not have to pay out of pocket for your visit. You’ll also have lower monthly premiums. But if you need care from an out-of-network provider, you'll have to pay higher copays or co-insurance.
In South Carolina, 21 Silver HMO and 16 Silver EPO plans are available, both of which require you to stay within your provider’s network, although the latter is somewhat less strict when it comes to referrals over seeing specialists.
Weigh the cost of premiums vs. the cost of care
Typically, obtaining a plan with a low monthly premium means you will pay a higher MOOP cost for health care. For example, the Cigna Connect 0B plan from Healthcare of South Carolina has a low average monthly premium of $484 and a high MOOP cost of $9,100.
Consider South Carolina Medicare or Medicaid if You’re Eligible
Medicare is a federal health insurance program for those aged 65 and older, as well as individuals with certain disabilities. It is divided into three parts:
- Part A (Hospital Insurance): Covers the cost of inpatient hospital stays, skilled nursing care and some home health care services.
- Part B (Medical Insurance): Helps cover outpatient care, including doctor’s visits and preventative services.
- Part D (Prescription drug coverage): Offsets the cost of prescription drugs and vaccines.
If you need more coverage, you can look at the best Medicare Advantage and best Medicare Supplement plans in South Carolina.
Although South Carolina is not a Medicaid expansion state, those that meet certain criteria can still qualify for subsidized or free health care. These eligibility requirements include, but aren’t limited to, those who are pregnant, parents of minors, those who have been diagnosed with cervical or breast cancer and individuals who are blind.
Frequently Asked Questions About Health Insurance in South Carolina
People shopping for health insurance often have questions about cost and coverage. Here are the answers to some of the most commonly asked questions.
About Brenna Kelly, Licensed Health Insurance Agent
