In South Carolina, the average 2026 Marketplace premium after subsidies is about $139 a month, down from a full unsubsidized average that runs $600 to $900 a month depending on age and plan, according to HealthCare.gov enrollment data. Six insurers sell 2026 plans on the federal exchange, average pre-subsidy rates rose about 21% statewide, and more than 89% of the 587,567 South Carolinians who enrolled for 2026 receive a premium tax credit. What changed for 2026 is the size of that credit: the enhanced subsidies that capped premiums at 8.5% of income expired at the end of 2025, so households above 400% of the federal poverty level now pay full price with no assistance at all. This guide breaks down exact costs by metal tier, who still qualifies for help, and how to shop for the lowest net premium available to you.
South Carolina Uses HealthCare.gov
South Carolina did not build its own state-based exchange, so residents shop for Marketplace coverage through the federal platform at HealthCare.gov. Open enrollment for 2026 coverage ran through January 15, 2026, but a Special Enrollment Period is available year-round if you have a qualifying life event such as losing job-based coverage, getting married, having a baby, or moving to a new coverage area. If you missed open enrollment and do not have a qualifying event, you generally have to wait for the next enrollment window, which for 2027 coverage will run through a shortened December 15, 2026 deadline under new federal rules.
2026 South Carolina Marketplace Premiums by Age and Tier
Premiums vary by age, county, tobacco use, and which of the six carriers you choose. These are statewide averages before any subsidy is applied.
| Age | Approximate Monthly Silver Premium (unsubsidized) |
|---|
| 21 | $515 |
| 30 | $580 |
| 40 | $670 |
| 50 | $855 |
| 60 | $1,290 |
Bronze plans typically run 20% to 30% below these Silver figures, and Gold plans run 15% to 25% above them. Actual dollar amounts depend on your county and carrier, so these are directional estimates, not a quote. The only way to get your exact number is to enter your ZIP code, age, and household income at HealthCare.gov or through a licensed broker.
Who Sells Plans in South Carolina for 2026
Six insurers offer coverage on the South Carolina Marketplace for 2026:
- Blue Cross Blue Shield of South Carolina
- Ambetter (Absolute Total Care)
- Molina Healthcare
- Select Health of South Carolina
- UnitedHealthcare
- InStil Health
Not every carrier is available in every county, and rate increases varied by insurer for 2026, ranging from roughly 17.5% to 25.2% depending on the company. Comparing at least two or three plans in the same metal tier before you enroll can meaningfully change your monthly bill, since the benchmark used to calculate your subsidy is the second-lowest-cost Silver plan in your area, not the cheapest plan on the market.
What Your Subsidy Actually Covers in 2026
A premium tax credit, also called an Advance Premium Tax Credit or APTC, is the difference between your area's benchmark Silver plan cost and the amount the government expects you to contribute based on your income. For 2026, that expected contribution rose sharply compared to 2025 because the temporary enhanced-subsidy rules from the American Rescue Plan expired on December 31, 2025.
| Household Size | 100% FPL (subsidy floor) | 400% FPL (subsidy ceiling) |
|---|
| 1 | $15,650 | $62,600 |
| 2 | $21,150 | $84,600 |
| 3 | $26,650 | $106,600 |
| 4 | $32,150 | $128,600 |
| 5 | $37,650 | $150,600 |
| 6 | $43,150 | $172,600 |
If your projected 2026 household income falls inside this range, you likely qualify for at least a partial credit. Fall above 400% FPL and you now pay the sticker price with zero assistance, a return of the "subsidy cliff" that had been paused since 2021. Even a small raise or a bit of extra freelance income near that ceiling can cost you thousands of dollars a year in lost help, so it is worth running your numbers carefully before you enroll or renew.
South Carolina has not expanded Medicaid, so the subsidy floor stays at 100% FPL rather than the 138% FPL used in expansion states. That leaves an estimated 65,000 low-income adults in the coverage gap: they earn too little to qualify for a Marketplace subsidy but too much (or fall outside the category limits) for South Carolina's existing Medicaid program. If your income is below 100% FPL and you do not qualify for Medicaid under South Carolina's current rules, a free eligibility screening can confirm which programs, if any, are still available to you.
Average Net Cost After Subsidies
Even with the subsidy cliff back in place, most South Carolina enrollees are still cushioned by a credit. Across the 89% of 2026 enrollees who qualify:
- Average subsidy savings: about $579 per month
- Average net premium after subsidy: about $139 per month
- Share of enrollees paying under $10 per month: about 30%
The households feeling the biggest hit are those near or above 400% FPL, where subsidies shrink fast or disappear, and unsubsidized shoppers, whose full premiums rose roughly 21% on average for 2026 on top of losing the enhanced-credit cushion. If you are self-employed, retired early, or otherwise estimating income for the year ahead, small changes in projected income can swing your subsidy by hundreds of dollars a month, so update your Marketplace application whenever your income estimate changes.
Deductibles and Out-of-Pocket Costs by Metal Tier
Premium is only half the cost picture. Deductibles vary widely by tier, and Silver is the only tier where South Carolina enrollees earning under 250% of FPL can also get Cost-Sharing Reductions (CSRs), which lower deductibles and copays on top of the premium tax credit.
| Metal Tier | Typical Deductible Range (national average) | Best For |
|---|
| Bronze | $7,000 to $9,000 | Healthy enrollees who mainly want catastrophic protection |
| Silver | $4,500 to $6,000 (much lower with CSR) | Most enrollees, especially those under 250% FPL |
| Gold | $1,500 to $2,500 | People who expect regular medical visits or prescriptions |
| Platinum | Under $500 (limited availability) | High health care users who value low out-of-pocket costs |
If your income qualifies you for CSR, only a Silver plan gives you access to it. Choosing Bronze or Gold instead means giving up that extra discount even if your premium tax credit stays the same. This is the single most common mistake South Carolina shoppers make: picking a cheap-looking Bronze plan when a CSR-enhanced Silver plan would have cost less overall once deductibles and copays are factored in.
How to Apply for South Carolina Marketplace Coverage
- Gather your documents. You will need Social Security numbers for everyone in your household applying for coverage, immigration documents if applicable, and your best estimate of 2026 household income.
- Go to HealthCare.gov. Create an account or log in to your existing Marketplace account.
- Complete your application. Enter household size, income, and current coverage status. The system will calculate your estimated premium tax credit automatically.
- Compare plans by net cost, not just premium. Look at the total picture: premium after subsidy, deductible, copays, and whether your doctors and prescriptions are in-network.
- Enroll and set up payment. Confirm your first premium payment to activate coverage. Coverage generally starts the first of the following month if you enroll by the 15th.
- Report income changes during the year. If your income, household size, or job situation changes, update your application right away so your subsidy stays accurate and you avoid a surprise tax bill when you file.
You can also work with a licensed insurance broker or navigator at no cost to you. Brokers are paid by insurers, not by you, and can help you compare plans across all six carriers side by side.
Frequently Asked Questions
How much does health insurance cost in South Carolina in 2026?
Unsubsidized Silver plan premiums average around $670 a month for a 40-year-old, but most enrollees receive a premium tax credit that brings their actual cost down. The statewide average net premium after subsidies is about $139 a month, and roughly 30% of enrollees pay less than $10 a month.
Why did South Carolina premiums go up so much for 2026?
Two things happened at once. Insurers raised sticker prices by an average of about 21% due to rising medical costs, and the enhanced federal subsidies that had capped premiums at 8.5% of income expired at the end of 2025. Combined, many households saw their net monthly cost rise by hundreds of dollars even though their insurer's rate increase alone was more modest.
What is the income limit for ACA subsidies in South Carolina for 2026?
Subsidies are generally available to households earning between 100% and 400% of the federal poverty level. For a single person, that is roughly $15,650 to $62,600. For a family of four, it is roughly $32,150 to $128,600. Above 400% FPL, there is currently no premium tax credit available.
What happens if I earn just over 400% of the federal poverty level?
You lose access to any premium tax credit and pay the full, unsubsidized premium. This is often called the subsidy cliff. If your income is close to this line, consider whether a retirement account contribution or other income adjustment could keep you under the threshold and preserve thousands of dollars in annual savings.
Can I get help with deductibles and copays, not just my premium?
Yes, if your income is under 250% of the federal poverty level and you choose a Silver plan, you can also receive Cost-Sharing Reductions, which lower your deductible, copays, and out-of-pocket maximum. This benefit is only available on Silver plans, so switching to Bronze or Gold means giving it up.
Which insurers offer Marketplace plans in South Carolina for 2026?
Six carriers sell 2026 Marketplace plans in South Carolina: Blue Cross Blue Shield of South Carolina, Ambetter (Absolute Total Care), Molina Healthcare, Select Health of South Carolina, UnitedHealthcare, and InStil Health. Availability varies by county.
What if my income is too low to qualify for a Marketplace subsidy?
South Carolina has not expanded Medicaid, so adults earning below 100% of the federal poverty level generally do not qualify for a Marketplace subsidy and may also fall outside the state's existing Medicaid income rules. This is known as the coverage gap, and it affects an estimated 65,000 South Carolina adults. A free eligibility screening can help identify any programs you may still qualify for.
Can I still enroll in a South Carolina Marketplace plan outside of open enrollment?
Only if you have a qualifying life event, such as losing other coverage, getting married, having or adopting a child, or moving. Otherwise, you generally need to wait for the next open enrollment period. For 2027 coverage, that window is expected to close earlier than in past years, on December 15, 2026.
Explore more South Carolina benefit programs on the South Carolina state page, including Medicaid, SNAP, and other assistance options that may apply alongside your Marketplace coverage.
