South Carolina Health Insurance: Marketplace, Private Plans & 2027 Rates
Shopping for health insurance in South Carolina? All six Marketplace insurance companies are expected to continue offering coverage for 2027, but the premiums they're requesting vary significantly.
Current proposed average increases range from about 10.7% for one insurer to 45.5% for another. That doesn't mean your own premium will change by the same amount, but it makes comparing coverage especially important before automatically renewing.
We help self-employed workers, individuals, families, early retirees, and small business owners compare HealthCare.gov plans with other available private coverage while looking at premiums, doctors, hospitals, prescriptions, deductibles, networks, and total costs.
Licensed in South Carolina • Free consultation • Phone and video appointments available
South Carolina Health Insurance at a Glance
| Topic | What South Carolina Residents Should Know |
|---|---|
| Marketplace | South Carolina uses the federal Marketplace at HealthCare.gov. |
| 2027 Open Enrollment | November 1, 2026 through January 15, 2027. |
| January 1 Coverage | Select a Marketplace plan by December 15, 2026. |
| 2027 Marketplace Insurers | Six insurers are expected to continue from 2026, with availability varying by county. |
| Proposed 2027 Rates | Carrier proposals currently range from approximately +10.7% to +45.5%. |
| Overall Rate Trend | Current analyses of the filings put the overall proposed increase at roughly 17% before subsidies. |
| Marketplace Financial Help | Premium Tax Credits generally require household income between 100% and 400% of the federal poverty level plus other eligibility requirements. |
| Medicaid Expansion | South Carolina has not adopted the ACA Medicaid expansion for low-income adults. |
| Coverage Gap | Some very low-income adults may qualify for neither Healthy Connections Medicaid nor Marketplace Premium Tax Credits. |
South Carolina Uses HealthCare.gov
South Carolina does not operate a separate state-based health insurance Marketplace.
Individuals and families who want Marketplace coverage use the federal Marketplace at HealthCare.gov.
Qualified Health Plans sold through the Marketplace are ACA-compliant major medical health insurance. They include important consumer protections such as:
- Coverage for pre-existing conditions
- ACA-required essential health benefits
- Preventive care
- Prescription drug coverage
- Hospital and emergency coverage
- Defined annual limits on covered in-network out-of-pocket costs
- No medical underwriting for eligibility
South Carolina Marketplace Insurance Companies for 2027
Six insurance companies are expected to offer Marketplace individual health insurance in South Carolina for 2027. All six also participated in 2026.
Blue Cross Blue Shield of South Carolina
BCBS of South Carolina remains one of the state's individual Marketplace insurers for 2027.
Ambetter / Absolute Total Care
Ambetter plans are offered through Absolute Total Care in South Carolina's Marketplace.
Molina Healthcare
Molina is expected to continue Marketplace participation for 2027.
Select Health of South Carolina
Select Health continues in the individual Marketplace, with its service area varying by county.
UnitedHealthcare
UnitedHealthcare remains a Marketplace carrier, although its South Carolina service area is limited to selected counties.
InStil Health
InStil Health is also expected to continue offering Marketplace plans for 2027.
Proposed South Carolina Health Insurance Rates for 2027
South Carolina's Marketplace insurers have submitted their preliminary individual-market rate filings for 2027.
The proposed average changes vary widely by insurance company:
| Insurance Company | Proposed Average 2027 Change |
|---|---|
| Select Health of South Carolina | +10.7% |
| Molina Healthcare of South Carolina | +14.6% |
| Blue Cross Blue Shield of South Carolina | +15.6% |
| Ambetter / Absolute Total Care | +22.1% |
| InStil Health | +23.4% |
| UnitedHealthcare of South Carolina | +45.5% |
Current analyses of the filings estimate an overall increase of roughly 17% across South Carolina's individual market before Premium Tax Credits, although the exact estimate varies depending on how carrier enrollment is weighted.
Why Comparing Plans Matters in 2027
South Carolina's statewide average doesn't tell the whole story.
One insurer is requesting an average increase of about 10.7%, while another is requesting more than 45%. That creates the possibility that the relative pricing between plans could look very different in 2027 than it did in 2026.
But price isn't the only reason to compare.
Check:
- Your monthly premium after any financial assistance
- Your deductible
- Your annual out-of-pocket maximum
- Primary care and specialist costs
- Hospital and outpatient costs
- Your prescription formulary
- Your doctors and hospitals
- Any changes to the provider network
South Carolina Premiums Also Increased Sharply in 2026
The 2027 increases come after a significant rise in South Carolina individual-market premiums for 2026.
The weighted average full-price individual-market increase for 2026 was approximately 21%.
The temporary enhanced federal Premium Tax Credits that applied from 2021 through 2025 also expired, meaning many households began paying more of the premium themselves in 2026.
Marketplace Financial Help in South Carolina for 2027
Federal Premium Tax Credits are still available to eligible South Carolina households purchasing coverage through HealthCare.gov.
However, the temporary enhanced Premium Tax Credit rules that applied through 2025 have ended.
Under the general federal rules now in effect, Premium Tax Credit eligibility generally requires household income between 100% and 400% of the federal poverty level, along with the other federal eligibility requirements.
For 2027, the federal applicable percentage table ranges from 2.15% at the lowest income band to 10.22% for households between 300% and 400% of the federal poverty level.
Self-Employed Health Insurance in South Carolina
We work with South Carolina contractors, truck drivers, tradespeople, real estate professionals, tourism and hospitality workers, manufacturing contractors, consultants, freelancers, small business owners, and other people who buy their own health insurance.
Self-employed applicants have an additional challenge: estimating annual income for Marketplace financial assistance.
Estimate Net Business Income
Marketplace applications generally use expected net self-employment income after eligible business expenses rather than simply gross business revenue.
Update Significant Changes
Commissions, contract work, seasonal income, business ownership, and tourism-related work can make annual income difficult to predict.
Update meaningful changes during the year instead of waiting until the next Open Enrollment period.
Understand MAGI
Marketplace financial assistance uses Modified Adjusted Gross Income, commonly called MAGI.
Tax Planning Can Matter
Certain eligible retirement, HSA, and other tax adjustments may affect Adjusted Gross Income.
Talk with a qualified tax professional about which deductions actually apply to your situation.
Marketplace Plans vs. Other Private Health Coverage
South Carolina residents may also encounter individual health products sold outside HealthCare.gov.
These products do not necessarily provide the same coverage or consumer protections as Marketplace major medical plans.
HealthCare.gov Marketplace Plans
- ACA-compliant major medical insurance
- Coverage for pre-existing conditions
- ACA-required essential health benefits
- Defined annual out-of-pocket limits
- No medical underwriting for eligibility
- Premium Tax Credits for eligible households
Other Private Coverage
- May be sold outside HealthCare.gov
- Some products may use medical underwriting
- Pre-existing-condition rules may differ
- Benefits and exclusions can differ
- Provider networks may work differently
- Marketplace Premium Tax Credits generally cannot be used
Healthy Connections Medicaid in South Carolina
South Carolina's Medicaid program is called Healthy Connections.
Unlike many states, South Carolina has not adopted the ACA Medicaid expansion for the general adult population.
Instead, Medicaid eligibility depends heavily on the specific category into which a person falls.
Current Healthy Connections categories include coverage for qualifying:
- Children
- Pregnant women
- Parents and caretaker relatives
- People who are aged, blind, or disabled
- People who qualify for certain long-term care programs
- Other specific Medicaid eligibility groups
South Carolina Medicaid Income Limits Vary by Program
Because South Carolina has not expanded Medicaid, the income limit depends heavily on your eligibility category.
For 2026, South Carolina lists examples including:
Parents & Caretaker Relatives
The current income limit is approximately 62% of the federal poverty level, along with the program's other requirements.
Children
Partners for Healthy Children currently covers qualifying children under age 19 at income levels up to approximately 208% of FPL.
Pregnancy Coverage
South Carolina currently lists pregnancy Medicaid eligibility up to approximately 194% of FPL.
Aged, Blind or Disabled
This Medicaid category currently has an income limit at approximately 100% of FPL, along with applicable resource and other eligibility rules.
The South Carolina Medicaid Coverage Gap
South Carolina's decision not to expand Medicaid creates an important health insurance issue for some very low-income adults.
Marketplace Premium Tax Credits generally begin at 100% of the federal poverty level.
But South Carolina Medicaid does not provide a general expansion category for all adults below that income level.
As a result, an adult may have income too low to qualify for Marketplace Premium Tax Credits while also failing to meet one of South Carolina's Medicaid eligibility categories.
If your income is near or below the poverty level, review your household circumstances carefully before assuming you qualify or don't qualify for coverage.
Your South Carolina County Can Change Your Health Insurance Options
Marketplace carrier participation varies considerably across South Carolina.
Someone in Charleston, Greenville, Columbia, Myrtle Beach, or Rock Hill may see a different combination of insurance companies and provider networks.
Before selecting coverage, check:
- Your primary care doctor
- Your specialists
- Your preferred hospital or health system
- Your regular prescriptions
- Your pharmacy
- Nearby urgent care facilities
- Coverage when traveling outside your local area
South Carolina Open Enrollment for 2027
South Carolina follows the federal HealthCare.gov Open Enrollment schedule.
Open Enrollment for 2027 coverage runs from November 1, 2026 through January 15, 2027.
- November 1, 2026: Open Enrollment begins.
- December 15, 2026: Select a plan by this date for coverage beginning January 1, 2027.
- January 15, 2027: Open Enrollment ends. Coverage selected after December 15 generally begins February 1.
Outside Open Enrollment, Marketplace enrollment generally requires a qualifying Special Enrollment Period.
Leaving a Job or Losing Employer Health Insurance?
Losing qualifying employer-sponsored health coverage can create a Special Enrollment Period through HealthCare.gov.
Depending on your circumstances, compare:
- COBRA continuation coverage
- A spouse's employer-sponsored plan
- A HealthCare.gov Marketplace plan
- Healthy Connections Medicaid if eligible
- Other available individual coverage
COBRA can allow you to temporarily keep your existing employer plan, but the premium may increase significantly after the employer stops contributing.
South Carolina Health Insurance for Early Retirees
Retiring before age 65 can leave several years between employer coverage and Medicare eligibility.
Depending on your circumstances, you may compare:
- HealthCare.gov Marketplace coverage
- COBRA
- A spouse's employer plan
- Other available private coverage
Marketplace financial assistance can make income planning particularly important for early retirees because taxable retirement distributions, pensions, investment income, self-employment income, and other income can affect household MAGI.
Small Business Health Insurance in South Carolina
South Carolina small employers have several ways to approach employee health benefits.
Depending on the company, options may include:
Traditional Group Coverage
Employer-sponsored health insurance where eligible employees participate in the company's group plan.
Level-Funded Coverage
Certain employers may qualify for level-funded arrangements that combine employer funding with stop-loss insurance.
Underwriting, refund provisions, and plan structure vary by carrier.
ICHRA
An Individual Coverage HRA can allow an employer to reimburse eligible employees for qualifying individual health insurance under applicable rules.
QSEHRA
Certain qualifying small employers that do not offer group health coverage can reimburse employees for qualifying individual premiums and medical expenses.
How We Help South Carolina Residents
Self-Employed & 1099 Workers
Contractors, real estate professionals, truck drivers, tourism and hospitality workers, tradespeople, manufacturing contractors, consultants, freelancers, and other independent workers.
Individuals & Families
We compare premiums, deductibles, doctors, prescriptions, Marketplace financial assistance, and other available coverage.
People Paying Full Price
If you don't qualify for Marketplace Premium Tax Credits, we can compare full-price Marketplace coverage with other available options.
Low-Income Households
We can help explain the difference between Marketplace eligibility and South Carolina Healthy Connections Medicaid eligibility.
Early Retirees
We help people who need coverage before Medicare compare Marketplace coverage, COBRA, spouse coverage, and other available options.
Small Business Owners
We can discuss traditional group coverage, level-funded arrangements, ICHRAs, QSEHRAs, and additional employee benefits.
Serving Clients Across South Carolina
We work with South Carolina residents by phone and video, so you don't need to live near a local insurance office.
Charleston, North Charleston, Mount Pleasant, Summerville, Goose Creek, Beaufort, Hilton Head Island and surrounding communities
Columbia, Lexington, Irmo, Sumter, Aiken and surrounding communities
Greenville, Spartanburg, Anderson, Greer, Simpsonville and surrounding communities
Myrtle Beach, North Myrtle Beach, Conway and surrounding communities
Florence, Darlington and surrounding communities
Rock Hill, Fort Mill and surrounding communities
Official South Carolina Health Insurance Resources
HealthCare.gov
Marketplace enrollment, Premium Tax Credits,
plan comparison, and Special Enrollment Periods.
Visit HealthCare.gov →
South Carolina Department of Insurance
ACA carrier information, rate filings,
county availability, and insurance consumer resources.
Visit South Carolina DOI →
Healthy Connections Medicaid
Medicaid programs, eligibility categories,
income limits, and application information.
Visit Healthy Connections →
Common Questions About South Carolina Health Insurance
Does South Carolina use HealthCare.gov?
Yes. South Carolina uses the federal Health Insurance Marketplace at HealthCare.gov for individual and family Marketplace coverage.
How many Marketplace insurers will South Carolina have in 2027?
Six insurers are expected to participate: Blue Cross Blue Shield of South Carolina, Ambetter/Absolute Total Care, Molina, Select Health, UnitedHealthcare, and InStil Health.
Not every insurer is available in every county.
How much are South Carolina health insurance premiums increasing in 2027?
Current analyses of the preliminary filings put the overall proposed increase at roughly 17% before Marketplace Premium Tax Credits.
Individual carrier proposals range from about 10.7% to 45.5%.
Which South Carolina insurer has the largest proposed 2027 increase?
UnitedHealthcare's current filing shows a proposed average increase of approximately 45.5%.
That is an insurer-wide average and does not mean every UnitedHealthcare member's premium will increase by exactly that amount.
Which insurer has the smallest proposed increase?
Select Health of South Carolina currently has the smallest proposed Marketplace carrier average at approximately 10.7%.
That does not automatically make it the lowest-cost or most appropriate plan for every household.
When is South Carolina Open Enrollment for 2027?
Open Enrollment runs from November 1, 2026 through January 15, 2027.
Select a plan by December 15, 2026 for coverage beginning January 1, 2027.
Did South Carolina expand Medicaid?
No. South Carolina has not adopted the ACA's Medicaid expansion for the general adult population.
What is the South Carolina Medicaid coverage gap?
Marketplace Premium Tax Credits generally require income of at least 100% of the federal poverty level, but South Carolina has not expanded Medicaid to all adults below that level.
As a result, some very low-income adults may qualify for neither Marketplace Premium Tax Credits nor Healthy Connections Medicaid.
Can children qualify for Healthy Connections even if their parents don't?
Yes. South Carolina's Medicaid income limits differ by eligibility category.
Partners for Healthy Children currently has a higher income limit than the parent/caretaker Medicaid category, so children may qualify even when a parent does not.
Can self-employed people get Marketplace insurance in South Carolina?
Yes. Self-employed South Carolina residents can buy individual coverage through HealthCare.gov and may qualify for Premium Tax Credits if they meet the applicable eligibility requirements.
Can I get health insurance outside Open Enrollment?
Possibly. Marketplace enrollment outside Open Enrollment generally requires a Special Enrollment Period after a qualifying event such as losing coverage, getting married, having a baby, or certain moves.
Healthy Connections accepts Medicaid applications throughout the year for eligible residents. Other health products may have different enrollment rules.
Is private health insurance cheaper than HealthCare.gov?
It depends on the applicant and the type of coverage.
Some non-Marketplace products may have lower premiums for certain eligible applicants, but medical underwriting, benefits, exclusions, provider networks, and pre-existing-condition rules can differ.
Compare what the policy actually covers rather than choosing based only on the monthly premium.
Can you check whether my doctors are in network?
Yes. Give us the names of your doctors, specialists, preferred hospitals, prescriptions, and pharmacy when we compare coverage.
Can you help me if your office is in Arizona?
Yes. We are licensed in South Carolina and work with South Carolina clients remotely by phone and video.
Compare Your South Carolina Health Insurance Options for 2027
All six Marketplace insurers are staying, but proposed premium increases vary dramatically by company. South Carolina's Medicaid coverage gap also makes eligibility particularly important for lower-income households.
We'll help you compare the available options, check your doctors and prescriptions, and understand the costs and coverage before you choose.
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