2027 South Carolina Health Insurance Rate Changes by County

South Carolina health insurance rates for 2027 are higher in all 46 counties. The benchmark silver plan, the price that sets Marketplace tax credits, rises from +11.0% in Beaufort County to +46.8% in Lee County, comparing full-price monthly premiums for a 40-year-old before subsidies. Weighted by where people actually enrolled in 2026, the statewide average increase is +24.8%.

Your own increase depends on your county, which carriers still sell there, and whether you get a premium tax credit.

We used the benchmark silver plan in each county. On HealthCare.gov, which South Carolina uses, the benchmark is the second-lowest-cost silver plan available where you live. It is the yardstick for premium tax credits, so it is the single most useful number for comparing counties.

Every price in this report is the full-price monthly premium for a 40-year-old, before subsidies. Older enrollees pay more and younger enrollees pay less, and most people who qualify for a tax credit pay far less than these figures. The statewide average is weighted by each county's 587,567 total 2026 Marketplace plan selections, so Greenville and Charleston count for more than McCormick.

All figures come from Murdock Insurance Group's analysis of PY2027 South Carolina Marketplace plan data.

Carrier changes also shape the 2027 market. Molina, which offered plans in 37 South Carolina counties in 2026, is not offering Marketplace plans anywhere in the state for 2027. UnitedHealthcare leaves eight counties and InStil Health leaves Spartanburg. On the other side, Oscar enters six counties and First Choice Next (Select Health of South Carolina) newly enters seven.

Lee County: +46.8%

Lee County has the steepest increase in the state. The benchmark moves from $536 to $787 a month, an increase of $251. Lee also loses two carriers at once, Molina and UnitedHealthcare, leaving only Ambetter and BlueCross BlueShield of SC. The 2027 benchmark plan in Lee is Ambetter Signature Silver SC.

Greenwood County: +41.6%

Greenwood's benchmark goes from $497 to $704. With Molina gone, Greenwood is one of 11 counties down to two carriers. The new benchmark is a BCBS plan, BlueEssentials Silver 14.

Charleston County: +38.5%

Charleston is the surprise on this list. It is a large, competitive market, and Oscar is entering for 2027, yet the benchmark still rises from $509 to $705. Charleston had 51,103 plan selections in 2026, the second most in the state, so this increase touches a lot of households. Charleston enrollees have four carriers to compare in 2027: Ambetter, BCBS, Oscar and First Choice Next.

Hampton and Marlboro counties

Hampton's benchmark rises from $558 to $765 (+37.0%). Marlboro rises from $588 to $789 (+34.4%), and at $789 it has the highest 2027 benchmark in South Carolina. Marlboro also loses both Molina and UnitedHealthcare.

Beaufort County has the smallest change in South Carolina at +11.0%, or $64 a month. First Choice Next is new to Beaufort for 2027.

Marion County rises +14.0% and gains Oscar, giving Marion residents four carriers.

York County rises +14.1%. York is one of only two counties with five carriers in 2027 (Florence is the other), after Oscar and First Choice Next both entered. York's benchmark is now an Oscar plan, Oscar Silver Simple Diabetes.

There is a loose one. The 11 counties with only two carriers in 2027 averaged a +30.3% benchmark increase, compared with +23.2% across the 35 counties with three or more carriers (simple averages, not weighted by enrollment). Fewer carriers is not the whole story, though. Charleston has four carriers and still landed in the top three, while Jasper, with two, rose +15.8%.

The data cannot tell you your own price change. A benchmark is one plan. The plan you have today may have gone up more or less than that, and if your carrier left your county, your 2026 plan is not available at all.

Our office is in Irmo, on the Richland-Lexington line, so we get a lot of questions about the Midlands.

Richland and Lexington, the two biggest Midlands markets, rose +20.0% and +18.6%, below the statewide average. Kershaw's +16.6% is among the smaller increases in the state. First Choice Next is new to Lexington County this year, and UnitedHealthcare stays in Calhoun, Fairfield, Kershaw, Newberry and Saluda.

Click a county name to see its local guide with plans, carriers and hospital networks.

If you qualify for a premium tax credit, a higher benchmark also means a larger credit. The credit is the difference between the benchmark premium and the amount you are expected to pay, which is a set percentage of your income. For 2027, that expected share ranges from 2.15% of income at the lowest incomes to 10.22% for households between 300% and 400% of the federal poverty level, according to the IRS.

For example, a single 40-year-old earning $55,860 (350% of the 2026 poverty guideline of $15,960) is expected to pay about $476 a month for the benchmark plan in any county. In Lee County, the benchmark rose $251, and for someone whose income and household stay the same, the tax credit grows by roughly the same amount, so the net cost of the benchmark plan changes far less than the full price. Your actual credit depends on your age, household and income.

Two groups feel the full increase:

• People above 400% of the poverty level. The enhanced tax credits that removed this cap expired after 2025. Unless Congress acts, there is generally no credit above 400% FPL in 2027, so these households pay the full prices in the table above.
• People who stay in a plan that rose faster than the benchmark. Your credit is sized to the benchmark, not your plan. If your plan went up more, you pay the difference.

For more on who qualifies, see our 2027 subsidy guide and our explainer on the subsidy cliff at 400% FPL.

1. Open your renewal notice and log in to HealthCare.gov. Look at the 2027 price of your current plan after your tax credit.
2. Update your 2027 income estimate. Your credit is based on what you expect to earn next year. Our guide to estimating 2027 income walks through it.
3. Compare every carrier in your county. Check our list of carriers by county. If you were with Molina, read what Molina members should do.
4. Do not assume auto-renewal is your best price. The benchmark plan comes from a different carrier in 22 counties this year. Our article on why you shouldn't auto-renew explains why.
5. Enroll by December 15 for coverage that starts January 1. Open Enrollment runs November 1, 2026 through January 15, 2027, but enrollments from December 16 on start February 1.

If you would rather have someone run the numbers with you, our agents can compare every plan in your county against your doctors, prescriptions and budget.