Retiring Before 65 in South Carolina: 2027 Health Insurance Costs by County
If you're retiring before Medicare, health insurance may be your biggest new bill. For a 60-year-old in 2027, benchmark silver runs $1,276 to $1,677 a month at full price, depending on the county, and your income can change that number a lot.
Reviewed by Lara Heath, ACA Sales Manager, Agent & Broker
Published · Updated
In this guide
In 2027, the benchmark silver plan for a 60-year-old in South Carolina costs from $1,276 a month in Abbeville County to $1,677 a month in Marlboro County, at full price before subsidies. If your household income is between 100% and 400% of the federal poverty level, $15,960 to $63,840 for one person or $21,640 to $86,560 for a couple, a premium tax credit caps what you pay for that plan at no more than 10.22% of your income. Go over 400% and you pay full price.
Why 2027 is different for early retirees
The enhanced premium tax credits expired after 2025. For 2027, the credit is generally limited to households between 100% and 400% FPL, unless Congress acts. That brings back the "subsidy cliff," and it hits people in their 60s hardest because their full-price premiums are the highest.
ACA plans in South Carolina use the federal age curve: a 60-year-old's premium is about 2.1 times a 40-year-old's for the same plan, and a 64-year-old's is three times a 21-year-old's. Benchmark silver premiums also rose in every SC county for 2027, from +11.0% in Beaufort to +46.8% in Lee.
2027 age-60 benchmark silver premium by county
Full-price monthly premium for a 60-year-old, before subsidies. The benchmark is the second-lowest-cost silver plan in each county, and it's the plan your tax credit is based on.
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| Abbeville | Ambetter Signature Silver SC | $979 | $1,276 | +30.4% |
|---|---|---|---|---|
| Aiken | First Choice Next Silver Essential | $1,134 | $1,424 | +25.6% |
| Allendale | Ambetter Signature Silver | $1,182 | $1,422 | +20.3% |
| Anderson | First Choice Next Silver Signature | $1,411 | $1,667 | +18.1% |
| Bamberg | Ambetter Signature Silver | $1,068 | $1,282 | +20.1% |
| Barnwell | Ambetter Signature Silver | $1,095 | $1,391 | +27.1% |
| Beaufort | Ambetter Signature Silver | $1,242 | $1,378 | +11.0% |
| Berkeley | First Choice Next Silver Signature | $1,181 | $1,474 | +24.8% |
| Calhoun | Ambetter Streamlined Silver | $1,182 | $1,410 | +19.2% |
| Charleston | Ambetter Streamlined Silver SC | $1,081 | $1,497 | +38.5% |
| Cherokee | First Choice Next Silver Signature | $1,367 | $1,614 | +18.1% |
| Chester | First Choice Next Silver Signature | $1,266 | $1,610 | +27.2% |
| Chesterfield | InStil InHealth Basic Standard | $1,187 | $1,565 | +31.8% |
| Clarendon | Ambetter Signature Silver | $1,243 | $1,459 | +17.3% |
| Colleton | Ambetter Signature Silver | $1,211 | $1,555 | +28.4% |
| Darlington | InStil InHealth Basic 1 | $1,127 | $1,415 | +25.6% |
| Dillon | Ambetter Signature Silver | $1,186 | $1,450 | +22.2% |
| Dorchester | Blue Cooper Silver 1 | $1,202 | $1,518 | +26.4% |
| Edgefield | BlueEssentials Silver 14 | $1,070 | $1,415 | +32.3% |
| Fairfield | Ambetter Signature Silver | $1,139 | $1,398 | +22.8% |
| Florence | First Choice Next Silver Essential | $1,155 | $1,469 | +27.2% |
| Georgetown | Ambetter Signature Silver | $1,059 | $1,319 | +24.5% |
| Greenville | First Choice Next Silver Signature | $1,257 | $1,574 | +25.2% |
| Greenwood | BlueEssentials Silver 14 | $1,056 | $1,496 | +41.6% |
| Hampton | Ambetter Streamlined Silver | $1,186 | $1,625 | +37.0% |
| Horry | Blue Pee Dee Silver 1 | $1,058 | $1,393 | +31.7% |
| Jasper | Ambetter Signature Silver | $1,160 | $1,343 | +15.8% |
| Kershaw | Ambetter Signature Silver | $1,103 | $1,287 | +16.6% |
| Lancaster | First Choice Next Silver Signature | $1,284 | $1,621 | +26.2% |
| Laurens | First Choice Next Silver Signature | $1,249 | $1,614 | +29.3% |
| Lee | Ambetter Signature Silver SC | $1,139 | $1,672 | +46.8% |
| Lexington | Blue Congaree Standard Silver | $1,260 | $1,495 | +18.6% |
| Marion | Ambetter Signature Silver | $1,171 | $1,335 | +14.0% |
| Marlboro | Ambetter Signature Silver | $1,248 | $1,677 | +34.4% |
| McCormick | Ambetter Signature Silver | $1,061 | $1,330 | +25.4% |
| Newberry | Ambetter Signature Silver | $1,172 | $1,433 | +22.2% |
| Oconee | Blue Reedy Silver 1 | $1,171 | $1,494 | +27.6% |
| Orangeburg | Ambetter Streamlined Silver | $1,125 | $1,372 | +21.9% |
| Pickens | Blue Reedy Standard Silver | $1,243 | $1,599 | +28.6% |
| Richland | Blue Congaree Silver 1 | $1,213 | $1,456 | +20.0% |
| Saluda | Ambetter Signature Silver | $1,212 | $1,457 | +20.2% |
| Spartanburg | First Choice Next Silver Signature | $1,362 | $1,614 | +18.5% |
| Sumter | BlueEssentials Silver 14 | $1,143 | $1,505 | +31.6% |
| Union | First Choice Next Silver Signature | $1,367 | $1,614 | +18.1% |
| Williamsburg | Ambetter Signature Silver | $1,106 | $1,324 | +19.7% |
| York | Oscar Silver Simple Diabetes | $1,305 | $1,489 | +14.1% |
By 64, those same benchmark plans run from about $1,410 a month in Abbeville to $1,853 in Marlboro.
What the subsidy cliff looks like at 60
Take a married couple, both 60, retired in Richland County. Their benchmark, Blue Congaree Silver 1, costs $2,911 a month for the two of them at full price.
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| 2027 household income | % of FPL | What they pay for benchmark silver | Yearly cost |
|---|---|---|---|
| $80,000 | 370% | $681/month | about $8,176 |
| $86,560 | 400% | $737/month | about $8,846 |
| $90,000 | 416% | $2,911/month (full price) | about $34,932 |
Moving from $80,000 to $90,000 of income raises their yearly premium by roughly $26,750. A single 60-year-old in Marlboro County sees the same pattern: at $60,000 of income she pays about $511 a month for benchmark silver, and at $64,000 she pays the full $1,677.
At lower incomes, credits for people in their 60s are large. A single 60-year-old in Kershaw County with $30,000 of income (188% FPL) would get a credit of about $1,132 a month, enough to bring the cheapest bronze plan down to $0. She'd also qualify for a cost-sharing reduction silver plan with a lower deductible.
These are illustrative estimates for a full year on one plan. Our subsidy cliff guide goes deeper.
Managing your income in early retirement
Because the Marketplace looks at modified adjusted gross income (MAGI), how you draw your retirement money can matter as much as how much you draw. HealthCare.gov counts most traditional IRA and 401(k) withdrawals, pensions, capital gains, interest and dividends (including tax-exempt interest), and all of your Social Security, including the non-taxable part. It does not count qualified distributions from a Roth account.
Strategies early retirees often discuss with their CPA or financial advisor:
- Mix your withdrawal sources. Cash savings and qualified Roth withdrawals don't add to MAGI. When you sell investments in a taxable brokerage account, generally only the gain counts as income, not the full sale.
- Time big moves. A Roth conversion or a large IRA withdrawal adds to income in the year you make it. Spreading it out or waiting until Medicare starts can keep you under 400% FPL.
- Think about when to claim Social Security. All of it counts for the Marketplace.
- Use an HSA if you qualify. Since 2026, bronze plans count as HSA-compatible. For 2027, you can contribute up to $4,500 for self-only coverage or $9,000 for family coverage, and contributions reduce MAGI. See our HSA plans guide.
- Report changes. If your income changes mid-year, update your application as soon as possible. Starting with tax year 2026, there's no cap on repaying excess credit.
This is general information, not tax or investment advice. Your CPA or advisor should help you plan withdrawals. Our income estimating guide shows what to include.
Your bridge options until Medicare
COBRA. If you're leaving a job with group coverage, COBRA usually lets you keep that plan for up to 18 months. You'll pay the full cost plus up to 2%, with no tax credit. It can make sense if you're mid-treatment or you've already met your deductible. You can switch to the Marketplace when COBRA runs out, but you can't drop COBRA early outside Open Enrollment and get a Special Enrollment Period.
A Marketplace plan. Losing job-based coverage gives you a Special Enrollment Period. HealthCare.gov lets you apply from 60 days before to 60 days after your separation date. This is the only way to get a premium tax credit.
Retiree coverage from your employer. If you're enrolled in it, you can't get a premium tax credit. If you drop it voluntarily, you don't get a Special Enrollment Period, so compare carefully before you decide.
A spouse's job-based plan. If your spouse is still working, this may be the simplest bridge. Our one spouse turning 65 guide covers couples whose timelines don't line up.
Short-term coverage. Short-term health insurance can fill a brief gap, but it's medically underwritten and generally excludes pre-existing conditions. It isn't a full replacement for a Marketplace plan.
Picking a plan in your early 60s
People in their 60s often use more care, so compare deductibles, copays and networks along with the premium. Some 2027 SC options to look at:
- Gold can be close to silver. In Greenville and Spartanburg, First Choice Next Gold Enhanced costs less than the benchmark silver, with a $1,000 deductible versus $6,400 on the benchmark.
- Oscar's Gold Simple with Early Retirement Benefits is available in Oscar's six counties (Charleston, Colleton, Florence, Horry, Marion and York). It has a $3,000 deductible, an $8,500 out-of-pocket max, $0 primary care visits and $0 generics. See who it's for.
- Check your doctors and hospital. Almost every SC Marketplace plan is an HMO, so a plan that leaves out your specialist can cost you more than it saves. Use our doctor and prescription checklist.
Our agents help early retirees in Irmo, Columbia and across South Carolina put these pieces together every Open Enrollment. Because carriers pay us, there's no cost to you.
When you turn 65
Your Medicare Initial Enrollment Period lasts seven months: it starts three months before the month you turn 65 and ends three months after. If you sign up before your birthday month, coverage starts the month you turn 65.
Your Marketplace plan doesn't end automatically. HealthCare.gov says to end it when Medicare starts, and you can report your Medicare start date up to three months in advance. Once you're eligible for Medicare Part A, you can no longer get a premium tax credit for your Marketplace plan, so if you keep it you'll pay full price or have to pay the credit back. See our turning 65 timeline and our Medicare page.
Frequently asked questions
The full-price benchmark silver premium for a 60-year-old ranges from $1,276 a month in Abbeville County to $1,677 a month in Marlboro County, before subsidies. Your actual cost depends on your income, county and plan.
Yes, if household income is between 100% and 400% of the federal poverty level and you aren't enrolled in employer retiree coverage. For 2027, that's $15,960 to $63,840 for one person and $21,640 to $86,560 for a couple.
Qualified Roth distributions don't count. Most traditional IRA and 401(k) withdrawals do, and a Roth conversion is generally taxable income in the year you convert. Ask your CPA about your situation.
It depends on your income and health care use. COBRA keeps your current plan and network but has no tax credit. A Marketplace plan may cost far less if your income qualifies for a credit.
It doesn't end automatically. End it when Medicare starts. Once you're eligible for Part A, you can no longer get a premium tax credit for the Marketplace plan.
Sources
- HealthCare.gov: Health coverage for retirees
- HealthCare.gov: What to include as income
- HealthCare.gov: Changing from the Marketplace to Medicare
- Medicare.gov: When does Medicare coverage start?
- U.S. Department of Labor: A Worker's Guide to Health Benefits Under COBRA
- IRS Rev. Proc. 2026-26: 2027 applicable percentage table
- Federal Register: 2026 HHS Poverty Guidelines
- CMS: Market rating reforms — state age rating
- CMS/HHS: Guidance regarding age curves and state reporting
- Kansas Health Institute: What's changing on the ACA Marketplace — Part 1: H.R. 1
- IRS: Guidance on new HSA benefits under the One Big Beautiful Bill
- Ascensus: 2027 HSA limits released (Rev. Proc. 2026-24)
- Murdock Insurance Group analysis of PY2027 SC Marketplace rate filings / plan data
This article is general information, not tax or investment advice. Talk with a CPA or financial advisor about your situation. Prices are full-price monthly premiums for the stated age, before subsidies; your actual cost varies by age, income, household and tobacco use. Credit examples are illustrative estimates. Networks and drug lists can change; we verify with the carrier before you enroll. Last verified: November 2026. Murdock Insurance Group is an independent agency and is not affiliated with HealthCare.gov, Medicare or any government agency.
Reviewed by
Lara Heath
ACA Sales Manager, Agent & Broker
I'm a field agent who helps individuals and groups with health and life insurance.
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