Health insurance in South Carolina is sold through Federal (Healthcare.gov), with an estimated 25-50 plans available for 2026. The average Silver-tier premium is $490/mo before subsidies for a 40-year-old non-smoker. Medicaid status: Not expanded.
Marketplace
Federal HC.gov
Federal (Healthcare.gov)
Avg Silver Premium
$490/mo
Before tax credits, age 40
Medicaid
Not expanded
Affordable Care Act status
| Field | Value | Notes |
|---|---|---|
| Marketplace | Federal (Healthcare.gov) | Apply via Healthcare.gov |
| Open Enrollment 2026 | Nov 1, 2025 – Jan 15, 2026 | Special enrollment for QLEs year-round |
| Plans available | 25-50 | Bronze/Silver/Gold/Platinum tiers |
| Medicaid expansion | Not expanded | Coverage gap may exist |
Premium and plan counts are estimates for 2026 based on prior-year filings and pending rate approvals. Always verify pricing on the marketplace itself before enrolling.
South Carolina's ACA marketplace offers 25–50 plans statewide, with BCBS SC holding a dominant market position. Ambetter and Molina provide limited competition primarily in the Columbia and Charleston markets. Silver premiums average $480–$500/month for a 40-year-old before subsidies. Rural counties in the Pee Dee region and Lowcountry have very limited carrier options and significant network access challenges. South Carolina uses Healthcare.gov for marketplace enrollment.
South Carolina has not expanded Medicaid, leaving an estimated 200,000+ adults in the coverage gap. The Republican-controlled legislature has consistently blocked expansion efforts. South Carolina Medicaid (Healthy Connections) covers primarily children, pregnant women, and severely disabled individuals. South Carolina has one of the higher uninsured rates in the Southeast. There are no state-funded coverage programs or reinsurance mechanisms. The state's high rate of chronic disease, particularly in rural communities, makes the coverage gap especially consequential for public health.
Leading 2026 ACA carriers in South Carolina: BlueCross BlueShield of South Carolina, Ambetter (Centene), Molina Healthcare. Plan selection and network breadth vary widely by ZIP code — use the marketplace's plan-finder tool with your ZIP and household income for accurate availability.
South Carolina is a non-expansion state with one of the highest uninsured rates in the Southeast; BCBS SC dominates the marketplace with limited competition in many counties.
South Carolina has not expanded Medicaid. This creates a "coverage gap" where some adults earn too much for Medicaid but too little to qualify for premium tax credits. Check eligibility for traditional Medicaid (parents, pregnant women, disabled, elderly) separately.
💡 South Carolina Pro Tip
South Carolina uses the federal marketplace at Healthcare.gov. The state does not operate its own exchange.
A 40-year-old non-smoker in South Carolina typically pays about $480–$500/month for a Silver plan before subsidies.
No. South Carolina has not expanded Medicaid under the ACA. Adults without dependent children generally do not qualify for South Carolina Medicaid.
Marketplace data sourced from state and federal exchange filings for South Carolina, April 2026. Premium estimates are 2026-projected.
Jennifer Walsh
Editorial Lead, Health & Medicare
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed April 2026
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