Short answer: private health insurance in South Carolina comes in two forms. The marketplace plans are themselves sold by private companies: six insurers file plans on HealthCare.gov for 2026, led by Ambetter from Absolute Total Care in all 46 counties. They come with tax credits and no health questions. Medically underwritten plans are the other form: they ask about your health, can decline you and get no credit, but a healthy buyer can often pay less, and one can start in any month. (Reviewed by Daniel Griffin, licensed independent advisor, NPN #22052447.)
Who Sells Marketplace Plans in South Carolina
| Insurer (2026) | Counties where it sells |
|---|---|
| Ambetter from Absolute Total Care | All 46 |
| BlueCross BlueShield of South Carolina | All 46 |
| Molina Healthcare | 37 of 46 |
| First Choice Next | 20 of 46 |
| UnitedHealthcare | 17 of 46 |
| InStil Health | 5 of 46 |
From the CMS Plan Year 2026 landscape file. Every South Carolina county has at least two marketplace insurers in 2026. Insurers filing under more than one company name are counted once here.
What South Carolina Plans Cost Before a Tax Credit
The average benchmark Silver premium for a 40-year-old in South Carolina was $564 a month in 2026, before any tax credit (KFF). County by county, that benchmark ran from $461 in Abbeville County to $665 in Anderson County. The cheapest Silver plan anywhere in South Carolina cost $374 at age 27, $456 at 40 and $968 at 60; the priciest Silver plan for a 40-year-old cost $931.
Who Should Look Beyond the South Carolina Marketplace
For 2027 coverage the tax credit stops at $63,840 for one person and $132,000 for a family of four. At South Carolina’s 2026 benchmark, a single 40-year-old just over that line pays $6,768 a year, about 11% of income, before the 2027 increase. That is where a healthy household can save with a medically underwritten plan, which is priced on health, not income. It is not ACA coverage: it can decline you and usually excludes pre-existing conditions and maternity care. Leaving a job? See COBRA alternatives.
Networks: What to Check in South Carolina
PPO plans are sold on South Carolina’s marketplace in all 46 counties for 2026, alongside EPO, HMO and POS plans. A PPO pays something out of network, usually at a higher cost to you; the others generally do not.
Healthy, in South Carolina, and paying full price?
Send your ZIP code. A licensed agent checks your tax credit first, then compares your best marketplace plan with the private options for your county.
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2027 in South Carolina
South Carolina’s approved 2027 rates are an average 22.1% higher than 2026 (enrollment-weighted, reported Oct 19, 2026). No insurer has announced it is leaving South Carolina’s marketplace for 2027. Open Enrollment on HealthCare.gov runs November 1, 2026 to January 15, 2027; choose by December 15 for coverage that starts January 1. Medically underwritten plans are not tied to that calendar. health insurance in South Carolina · South Carolina plans compared.
Checking an Agent or a Plan in South Carolina
The South Carolina Department of Insurance licenses agents and insurers in South Carolina: look up anyone selling you a plan, and get the insurer’s name and the list of what is not covered before you pay.
Common Questions
What is private health insurance in South Carolina?
Two things. 6 private insurers sell South Carolina marketplace plans on HealthCare.gov for 2026, with tax credits and no health questions; Ambetter from Absolute Total Care sells in every county. Medically underwritten plans ask health questions, can decline you, get no tax credit and can start in any month.
Who should buy a medically underwritten plan in South Carolina?
A healthy household that gets little or no tax credit: for 2027 coverage there is none above $63,840 for one person or $132,000 for a family of four. Anyone with a real health history, or planning a pregnancy, is usually better protected on the marketplace.
Are there PPO plans on the South Carolina marketplace?
Yes. PPO plans are sold in all 46 South Carolina counties for 2026.
Which insurers are leaving South Carolina’s marketplace for 2027?
No insurer has announced it is leaving South Carolina’s marketplace for 2027.
Sources
- KFF benchmark premiums, South Carolina, 2026.
- CMS plan landscape file, South Carolina, 2026.
- South Carolina 2027 rates and exits (Plans By State, from regulators and ACASignups.net).
- HealthCare.gov: tax credit income limits.
- South Carolina Department of Insurance.
Full-price filed rates before tax credits, not quotes. Underwritten plans are not sold in every state and acceptance depends on health history.