BlueCross BlueShield of SC 2027: BlueEssentials vs Regional Blue HMOs Explained

BlueCross BlueShield of South Carolina sells two kinds of individual Marketplace plans for 2027. BlueEssentials and BlueConnect are statewide EPOs sold in all 46 counties, and they are the only non-HMO plans on the SC Marketplace. The five regional Blue HMOs (Blue Reedy, Blue Congaree, Blue Cooper, Blue Pee Dee and Blue Beaufort) are sold in 17 counties and built around a smaller set of hospitals, which is why they hold the lowest-priced bronze plan in 15 of those 17 counties.

The right choice depends on which hospital you actually use. For every carrier, see our 2027 Marketplace guide.

BlueEssentials and BlueConnect: the statewide EPOs

An EPO (exclusive provider organization) covers in-network care only, except emergencies. BlueEssentials uses BlueCross's statewide network. In our 2027 review it includes every South Carolina hospital we track, a few with restrictions. If you see specialists in another part of the state, or split time between the Upstate and the coast, this is usually the simpler fit.

Every county gets the same 14 statewide BlueCross plans, from a catastrophic plan to gold. That includes BlueEssentials Bronze 6, a $0-deductible expanded bronze plan, and BlueConnect plans, which BlueCross positions around no-cost or reduced-cost primary and urgent care telehealth visits.

There are no PPOs on the SC Marketplace. Every plan from every other carrier is an HMO.

The regional Blue HMOs

Each regional HMO pairs BlueCross with specific health systems in specific counties. In those 17 counties you get nine additional regional plans, for 23 BlueCross plans in total. HMOs cover in-network care only (except emergencies), and the network is narrower by design. You trade breadth for a lower price. For more on the plan types, see HMO vs EPO in South Carolina.

The regional HMOs that include MUSC (Congaree, Cooper, Pee Dee and Beaufort) include nearly all MUSC hospitals statewide, not only the ones in their own counties. That helps if you might be referred to MUSC in Charleston.

Networks and drug lists can change; we verify with the carrier before you enroll. Last verified: November 2026.

Start here if you already know your hospital. "Restrictions" means in-network with limits, such as certain services only.

By area:

• Columbia and Irmo: Blue Congaree includes Lexington Medical Center and MUSC, but not Prisma Health. If your doctors are with Prisma Richland or Baptist, BlueEssentials is the BlueCross option that keeps them. See our Lexington Medical Center guide.
• Charleston and Summerville: Blue Cooper is an MUSC plan. Roper St. Francis, Trident and Summerville Medical Center are not in it. Dorchester County's benchmark silver is Blue Cooper Silver 1, so Summerville families should check this carefully (Dorchester County plans). See Roper St. Francis & Bon Secours.
• Greenville and the Upstate: Blue Reedy is a Prisma plan. Bon Secours St. Francis and Pelham patients should compare BlueEssentials. See which plans cover Prisma Health.
• Myrtle Beach and Conway: Blue Pee Dee includes Conway Medical Center but not Grand Strand or McLeod Loris. See our Grand Strand, Conway and Tidelands guide and McLeod guide.
• Hilton Head and Bluffton: Blue Beaufort includes Beaufort Memorial but not Hilton Head Hospital.

York and Lancaster residents who want Charlotte hospitals have very few choices; our Charlotte hospitals guide covers them.

In 15 of the 17 regional counties, the lowest-priced bronze plan from any carrier is that county's regional "Bronze 2" plan (for example, Blue Congaree Bronze 2). The two exceptions are Berkeley and Florence, where First Choice Next has the lowest bronze. In the other 29 counties, BlueCross has the cheapest bronze overall in 15, and in each of those it is the statewide EPO plan BlueConnect Bronze 1.

Before you grab the lowest price, read the design. Every regional Bronze 2 plan has a $10,600 deductible that equals its $10,600 out-of-pocket maximum, and primary care visits are $0 only after the deductible. For most care other than preventive services, you pay the full cost until you hit $10,600. That can work as catastrophe protection for a healthy person. It is a poor fit if you expect regular visits or prescriptions. The regional Bronze 1 plans ($5,900 deductible, $39 primary care) and the standardized expanded bronze plans ($7,500 deductible, $50 primary care) cost a little more but share costs sooner. See what an expanded bronze plan is.

Prices are full-price monthly premiums for a 40-year-old, before subsidies. Actual cost varies by age, income, household and tobacco use.

Kershaw County's $436 Blue Congaree Bronze 2 is the lowest bronze price in any SC county for 2027. The regional HMOs also set the benchmark silver in six counties (Oconee, Pickens, Lexington, Richland, Dorchester and Horry), so they help determine everyone's tax credit there.

Where BlueEssentials sets the benchmark

In three counties without a regional Blue HMO, BlueEssentials Silver 14 ($7,400 deductible, $9,700 out-of-pocket maximum) is the 2027 benchmark, and BlueEssentials Gold 5 ($250 deductible) is the lowest-priced gold:

Greenwood's benchmark rose 41.6% for 2027, the second-largest increase in the state (Greenwood County plans). Edgefield, Greenwood and Sumter are also among the 11 counties with only two carriers, Ambetter and BlueCross.

Say you are 40 and live in Irmo, which straddles the Richland and Lexington county line. Confirm your county first, since it decides your plan list.

In Richland County, the benchmark is Blue Congaree Silver 1 at $685 a month full price, up 20.0% from 2026, and the lowest-priced gold is Blue Congaree Gold 1. In Lexington County, the benchmark is Blue Congaree Standard Silver at $704, up 18.6%.

If your family doctor and nearest ER are with Lexington Medical Center, Blue Congaree fits, and it adds MUSC's Columbia hospitals. If your care runs through Prisma Health Richland or Baptist, Blue Congaree is the wrong network no matter how good the price looks. See our Richland County and Lexington County pages for every carrier.

1. Start with your hospital, not the premium. If your system is in the regional HMO, it is often the lower-cost BlueCross choice. If it is not, the savings disappear the first time you need care.
2. Think about specialists and travel. If you see a specialist in another region, the statewide EPO is easier to live with.
3. Check every doctor. A hospital being in-network does not guarantee every physician group there is.
4. Read the deductible. The cheapest regional bronze has a $10,600 deductible.
5. Compare net cost. Your premium tax credit is tied to your county's benchmark. For 2027 the credit is generally limited to households between 100% and 400% of the federal poverty level, since enhanced credits expired after 2025.
6. Check prescriptions. Wegovy and Zepbound are not on any SC Marketplace carrier's 2027 formulary, BlueCross included.

When these point in different directions, a quick call helps. Our help costs nothing because carriers pay us, and the premium is the same either way.

Open enrollment runs November 1, 2026 through January 15, 2027. Enroll by December 15 for a January 1 start. We will line up BlueEssentials, the Blue HMO in your county and every other carrier you can buy, with your doctors and prescriptions checked.