First Choice Next (Select Health of SC) 2027: Plans, Counties & Network Review

First Choice Next, the Marketplace plan from Select Health of South Carolina, sells HealthCare.gov plans in 27 South Carolina counties for 2027. Seven are new this year: Aiken, Beaufort, Darlington, Florence, Lexington, Orangeburg and York. It offers eight HMO plans. Its full-price monthly premiums for a 40-year-old run from $490 to $832, before subsidies. First Choice Next is the benchmark silver carrier in 11 counties, including Greenville, Spartanburg, Anderson and Lancaster. Its network includes MUSC Health, Roper St. Francis, AnMed, Spartanburg Regional and Self Regional. It does not include Prisma Health or Lexington Medical Center.

The bronze, silver and gold columns show First Choice Next's lowest-priced plan at each metal level.

• It sets the benchmark in 11 counties: Aiken, Anderson, Berkeley, Cherokee, Chester, Florence, Greenville, Lancaster, Laurens, Spartanburg and Union. Your subsidy is calculated from the benchmark plan's price. In nine of those counties (all but Aiken and Florence), First Choice Next Silver Essential is also the county's lowest-priced silver plan, priced below the benchmark. That can mean a lower net premium.
• Its gold plans cost about the same as its silver plans. In every county it serves, its lowest gold plan costs only $6 to $8 a month more than its lowest silver plan. It has the lowest-priced gold plan in 21 of its 27 counties.
• It has the lowest-priced bronze in 12 counties, spread across the Upstate, Midlands and Pee Dee. BCBS has the lowest bronze in the other 15.

All eight plans are HMOs, so you'll use the plan's network and choose a primary care doctor. The price range shows full-price monthly premiums for a 40-year-old across its 27 counties, before subsidies.

Plans worth a closer look:

• Gold Enhanced. It has a $1,000 deductible and $5 generics, at nearly the same premium as Silver Essential. Compare it closely if you aren't eligible for cost-sharing reductions.
• Silver Essential and Silver Signature. If your income qualifies for cost-sharing reductions, your deductible and out-of-pocket costs can drop on these plans. Silver Essential is the benchmark in Aiken and Florence. Silver Signature is the benchmark in the other nine counties.
• Gold Copay Focus. It has no deductible and $0 primary care. ER visits are a $1,000 copay and hospital stays are $1,500 per day.
• Bronze Essential. It has the lowest premium, but almost nothing is covered until you've spent $12,000. Generics are $25.

Which of the hospitals we track are in First Choice Next's 2027 network:

Check this if you live in one of the new counties. Several have a main local hospital that isn't in First Choice Next's network:

• Lexington: Lexington Medical Center is out of network. MUSC Health's two Columbia hospitals are in network.
• Aiken: Aiken Regional Medical Centers is out of network.
• Beaufort: Beaufort Memorial is out of network, but Hilton Head Hospital is in.
• Florence and Darlington: MUSC Health Florence is in network. McLeod Regional, McLeod Darlington and Carolina Pines are not.
• York and Orangeburg: Piedmont Rock Hill and MUSC Health Orangeburg are both in network.

In the Upstate, Prisma Health is the main gap. If your doctors are with Prisma, read Which 2027 Marketplace plans cover Prisma Health? before choosing First Choice Next because of its price. More network detail: MUSC Health, Roper St. Francis and Bon Secours and Lexington Medical Center.

How the drugs we track appear on First Choice Next's 2027 drug list:

• Diabetes: Ozempic, Rybelsus, Mounjaro and Trulicity are preferred brands, with prior authorization and quantity limits. Jardiance is a preferred brand with a quantity limit. Insulin glargine is preferred.
• Heart and blood thinners: Eliquis is preferred, with a quantity limit. Atorvastatin and lisinopril are preferred generics.
• Specialty drugs: Humira, Stelara, Skyrizi, Dupixent and Xolair are on the preferred specialty tier with prior authorization. Biktarvy is a preferred brand.
• Inhalers: Generic Advair (fluticasone-salmeterol) is a non-preferred generic with a quantity limit. Symbicort and Trelegy are preferred.
• Not covered: Wegovy and Zepbound are not on First Choice Next's list, or on any other SC Marketplace carrier's list.

See our diabetes plan comparison for a side-by-side with every carrier.

First Choice Next is worth comparing if you:

• Live in the Upstate, Lancaster or Chester, where it's the benchmark and often the lowest-priced silver and gold plan
• Use MUSC Health, Roper St. Francis, AnMed, Spartanburg Regional, Self Regional, Piedmont, Trident or Conway Medical Center
• Want a low-deductible gold plan for close to the cost of a silver plan

Look elsewhere first if your care is with Prisma Health, Lexington Medical Center, McLeod Health, Aiken Regional or Beaufort Memorial.

If you're renewing a First Choice Next plan, compare again this year. Benchmark carriers changed in many counties, and that changes your net premium. See why not to auto-renew. Our agents can run that comparison for you at no cost.