Best Health Insurance in South Carolina (2026)

Ambetter is the best health insurance in South Carolina for 2026. Its $5,545 out-of-pocket maximum, the most you pay on care in a year beyond your premium, is the lowest in the state. Its $590 monthly premium is the second-lowest among the three carriers in our top picks.   

First Choice Next is the stronger pick for people who use their plan regularly. Its $2,190 Silver deductible is $1,022 below Ambetter's $3,212, so FCN starts sharing your care costs sooner on every visit. A 40-year-old pays $456 more per year in FCN premiums than on Ambetter. Meeting the $2,190 deductible once saves $1,022 in cost-sharing against Ambetter, $566 net after the $456 annual premium cost.     

Blue Cross Blue Shield's main advantage over the other two carriers is plan variety. It's the only carrier in South Carolina's 2026 marketplace with all four plan types. Its PPO is the only plan in South Carolina's 2026 Silver marketplace that lets you see providers outside the network without a referral.

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

At 26, South Carolina premiums range from $462 to $614 per month across the six carriers. The gap between the lowest and highest Silver deductible across those carriers is $1,874. For young adults choosing health insurance, the deductible choice carries more financial impact than the premium choice at this age.

At 60, premiums range from $1,224 at Blue Cross Blue Shield to $1,627 at UnitedHealthcare per month. Adults approaching Medicare at 65 have an additional cost decision about whether to stay on a marketplace plan before switching.

*Rates in both the tables above are for HMO, Silver-tier plans that are not HSA-eligible. HSA stands for Health Savings Account, a tax-advantaged account that lets you set aside pre-tax dollars for qualified medical expenses. Silver-tier plans do not meet the IRS minimum deductible thresholds required to pair with one. Data sourced from CMS Public Use Files.

Plan type determines your cost range as much as metal tier in South Carolina's 2026 marketplace. POS plans, which cover out-of-network care with a referral, average $397 for Expanded Bronze and $621 for Gold, the lowest rates at both tiers. Blue Cross Blue Shield is the only carrier offering them. HMO plans are the only Bronze option in the state, averaging $426 per month.

* 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.   

PPO plans cost the most in every tier where they're available, with Silver at $743 and Gold at $760 per month. The higher price is what you pay for out-of-network access. A PPO plan lets you see any provider without a referral. This includes doctors and hospitals outside the insurer's network.

Which carrier costs less over a year depends on how often you use care. Monthly premium is the most visible cost. Your deductible and out-of-pocket maximum determine what you pay when care is needed. A plan's provider network determines which doctors and hospitals bill at in-network rates.

Not every carrier serves every South Carolina county. Before using the rates in this table, filter by your ZIP code on HealthCare.gov to confirm which plans are available where you live. Rates are for 40-year-olds unless you adjust the age filter.

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.

These South Carolina and federal resources cover plan comparison, subsidies and coverage disputes. All are free and 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.

We scored South Carolina's 2026 marketplace carriers on three cost factors. 
Our Scoring System

• Monthly premium (60%): We compared average premiums across all plans for ages 18, 26, 40, 50 and 60. Carriers with lower average premiums earn higher scores.
• Maximum out-of-pocket (20%): Your out-of-pocket maximum is the most you'll pay in a year beyond your monthly premium. South Carolina's 2026 Silver HMO maximums range from $5,545 at Ambetter to $6,341 at Instil Health. Carriers with lower limits earn higher scores.
• Deductible (20%): The deductible sets when cost-sharing starts. Carriers with lower average deductibles earn higher scores.

Sample Consumer Profile

Rates shown are for 40-year-olds unless noted. Our analysis covers all available tiers, including Catastrophic, Bronze, Expanded Bronze, Silver and Gold. No Platinum plans are available in South Carolina's 2026 marketplace.