Updated: September 5, 2024
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Best Health InsuranceSouth CarolinaBest Health Insurance in South Carolina
Why Trust MoneyGeek? We downloaded plan data for South Carolina directly from the Centers for Medicare & Medicaid Services (CMS). MoneyGeek’s scoring methodology balances costs, claims approval and plan types to find the best providers in the state.
Plan data was updated with the CMS exchange data released in October 2003 for the 2024 enrollment period.
Ambetter provides the best health insurance in South Carolina with a MoneyGeek score of 74 out of 100. The provider offers affordable plan options and has low maximum out-of-pocket costs. Ambetter is also better than average when it comes to not denying claims.
We evaluated a total of 46 Silver health plans in South Carolina for this analysis.
Affordable premium rates
Low out-of-pocket costs
Fewer claims denied
Limited plan types offered
MoneyGeek's top pick for the best health insurance in South Carolina is Ambetter. This provider offers nine Silver HMO plans with an average monthly rate of $488. The average MOOP cost for these plans is $5,400. Ambetter provides Silver HMO plans to its customers. HMO plans usually require choosing a primary care physician and getting referrals to see specialists.
This insurer offers an average plan rate of $488, and the average maximum out-of-pocket cost for these plans is $5,400. Ambetter has a denial rate of about 15%, a rate lower than most competitors.
MoneyGeek recommends the following Silver plans:
Ambetter has the best health insurance in South Carolina for low out-of-pocket costs, with a MoneyGeek score of 71 out of 100. This insurer offers the cheapest plan options in South Carolina. The company also has low out-of-pocket costs and better-than-average claim denial rates.
For this analysis, a total of 31 Gold plans were evaluated in the state, including six EPO plans and 25 HMO plans.
Affordable premium rates
Low out-of-pocket maximum costs
Fewer claim denials
Limited plan types available
MoneyGeek's top pick for the best health insurance in South Carolina for low out-of-pocket costs is Ambetter. It has eight Gold HMO plans. HMO plans like these often require choosing a primary care doctor and getting referrals to see specialists.
Ambetter offers an average plan rate of $548, and the average maximum out-of-pocket cost for these plans is $7,300. The company has a denial rate of 15%, lower than the average overall denial rate of 17%.
MoneyGeek recommends the following Gold and Platinum plans:
Ambetter is the best cheap provider for health insurance in South Carolina, with a score of 85 out of 100. The provider offers the cheapest plan options, has lower-than-average costs when you have to pay out of pocket and denies fewer claims denial compared to other companies.
For our analysis, we looked at 46 Silver plans in South Carolina. This number includes six Silver EPO and 40 Silver HMO plans. MoneyGeek puts more importance on plans with lower monthly costs when deciding the best provider, but remember, plans that cost less each month usually mean you pay more out of pocket when you need to use the insurance.
Excellence in maintaining low premiums
Exceptionally low out-of-pocket costs
Remarkably few claims denied
Limited plan types available
MoneyGeek's top pick for the best cheap health insurance in South Carolina is Ambetter. They offer nine different Silver plans, offering many affordable health care coverage choices.
The Silver plans available are all HMO types. HMO plans often require choosing a primary care physician and getting referrals to see specialists. Ambetter has an average plan rate of $508, and the average maximum out-of-pocket cost for these plans is $7,689. It has a denial rate of 15%, lower than most of the competition.
MoneyGeek recommends the following cheap Silver plans:
Ambetter, scoring 85 out of 100, offers low-income people the best health insurance in South Carolina. It has a lower-than-average rate for plans, low out-of-pocket costs and a lower claims denial percentage than others.
We evaluated six Silver EPO and 40 Silver HMO plans in South Carolina. We gave more weight to plans with low monthly premiums and included only those with cost-sharing reductions (CSRs).
These income brackets change with the number of people in a household.
Low premium rates
Minimized out-of-pocket costs
Few claims denied
Limited variety of plan options available
MoneyGeek's top pick for the best health insurance in South Carolina for those with low income is Ambetter. The provider offers cost-effective plans for people earning below 250% of the Federal Poverty Level (FPL). Ambetter provides nine Silver CSR plans with an average cost of $508 per month and an average MOOP of $6,489.
Ambetter does not offer PPO or POS plans, but EPO plans like theirs can offer lower monthly premiums. The company's denial rate is 15%, meaning it approves claims more frequently than competitors.
Plan Recommendations
Ambetter's top-rated plan offers lower out-of-pocket expenses for the same premium for people in different income brackets. Here are some of the lower overall out-of-pocket costs based on income levels:
With a MoneyGeek score of 75, Blue Cross Blue Shield offers the best health insurance in South Carolina for young adults. The provider has affordable plan options, low out-of-pocket costs and better-than-average claim denial rates, making it a strong choice for young adults.
For South Carolina, we evaluated 28 Expanded Bronze HMO plans, six Expanded Bronze EPO plans, two Bronze HMO plans and one Catastrophic EPO plan. Remember, only young adults under 30 can qualify for a Catastrophic plan.
High score for affordable premium rates
Low out-of-pocket costs
Few claims are denied
Limited plan types available
MoneyGeek's top pick for the best health insurance in South Carolina for young adults is Blue Cross Blue Shield. This insurer provides a selection for young people who often choose lower coverage levels. It offers one Catastrophic plan and six Expanded Bronze plans.
Blue Cross Blue Shield does not have PPO or POS plans in South Carolina but offers EPO plans. EPO plans usually allow you to see specialists without a referral.
It offers an average plan rate of $309, and the average maximum out-of-pocket cost for these plans is $8,829. Blue Cross Blue Shield has a denial rate of about 17%, lower than most of the competition.
MoneyGeek recommends the following plans for young adults:
Health insurance companies have different plan options. The best providers for all plan categories available in the state are:
MoneyGeek's analysis focused on Silver plans. Silver plans often balance your monthly costs and the fees you pay when using medical services. People who go to the doctor usually find Silver plans an intelligent choice.
South Carolina has six Silver EPO plans and 40 Silver HMO plans to choose from.
MoneyGeek's top pick for the best health insurance in South Carolina for Silver EPO plans is Blue Cross Blue Shield, which offers six different plans. It has an average plan rate of $586, and the average maximum out-of-pocket cost for these plans is $9,200. The provider denies 17% of claims, around the average rate compared to others.
Silver EPO plans are popular because they often don't require a referral to see a specialist. Like HMO plans, you need to use doctors in the network unless there's an emergency, which may limit who you can see.
We suggest the following Silver EPO plans from Blue Cross Blue Shield:
MoneyGeek's top pick for the best health insurance in South Carolina for Silver HMO plans is Ambetter. It offers an average plan rate of $508. Silver HMOs average maximum out-of-pocket cost is $7,689. Ambetter has a denial rate of less than 1%, meaning they deny claims less often than many other providers.
Silver HMO plans can be good if you want lower monthly payments and you don't mind having a specific network of doctors. You have to get a referral to see specialists, though, and the plans may not cover out-of-network care except in emergencies. This can be a drawback if you need flexibility or if your preferred doctors are not in-network.
We suggest the following Silver HMO plans from Ambetter:
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 stands out because it offers various plan options to accommodate multiple health care demands. The company offers plans for high-risk patients with modest co-insurance and out-of-pocket expenses. Plans can last three months to three years and offer several options for cost-sharing and prescription drug coverage.
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 essential to compare insurers’ monthly premiums and out-of-pocket expenses to find the best value.
Understand when a health insurance plan will cover you
In health insurance, in-network doctors and hospitals have a deal with the insurance company to charge less. Out-of-network providers do not have this deal, so they usually cost more. Different plans in South Carolina handle these costs in various ways. Some plans let you see any doctor for more money; others cost less, but you can't go out of network.
In South Carolina, there are six EPO plans. These plans are for people who want to save money and will stay in the network. South Carolina also has 40 HMO plans available. Like EPOs, HMO plans also have rules about staying in the network.
Weigh the cost of premiums vs. the cost of care
When you pick health insurance, it's like finding a balance. It helps to determine the monthly price and the most you pay in a year. If you use doctor services a lot, a plan with a lower yearly limit might be better, even if it costs more each month.
For example, with Ambetter, the Clear Silver plan has a $5,400 limit. It costs $488 a month. That's less than what other Silver plans cost, on average, offered by the same company. It could be the best option if you require medical services more often.
Medicare is a federal health insurance program for those aged 65 and older and individuals with certain disabilities. It is divided into three parts:
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 who meet specific 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.
Finding an ideal health insurance plan can be complicated due to concerns about price and availability. MoneyGeek answers some frequently asked questions to help you research options.
The best health insurance in South Carolina for 2024 is provided by Ambetter. However, the best choice for you will depend on your unique circumstances and needs.
A plan with reasonable prices and sufficient coverage is what you should be looking for. Despite offering reduced prices, some plans and companies might only offer a few services that may not suit all your medical needs. Your unique needs will determine what the best health insurance plan for you is.
About Mark Fitzpatrick
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.
Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
