Health Insurance in Charleston County, SC: 2027 Plans, Prices & Hospitals (Charleston & Mount Pleasant)

Charleston County has four Marketplace carriers for 2027: Ambetter, BlueCross BlueShield of SC, First Choice Next (Select Health of South Carolina) and Oscar, which is new this year. Molina is leaving. The benchmark silver plan rises from $509 to $705 a month (+38.5%), and it is now Ambetter Streamlined Silver SC. All prices are full-price monthly premiums for a 40-year-old, before subsidies, unless we note otherwise.

That is the third-largest benchmark increase among South Carolina's 46 counties, so 2027 is a year to shop carefully. Open Enrollment runs November 1, 2026 through January 15, 2027. Enroll by December 15 for a January 1 start.

Charleston County had 51,103 Marketplace plan selections for 2026, equal to nearly 12% of residents and the second-highest total in the state after Greenville County. The average full-price premium was $569 a month, and the average enrollee paid $169 after tax credits.

Full-price monthly premiums before subsidies:

Bronze and gold at ages 27 and 60 are calculated from the age-40 price using the same age ratios as the filed benchmark rates.

Lowest full-price premium from each carrier, age 40:

Silver is tightly bunched: First Choice Next's lowest silver is $704 and the Ambetter benchmark is $705. The cheapest gold is only $6 more. For a 60-year-old, the benchmark rises $416 a month, or about $4,994 a year, before subsidies.

Molina is leaving. Molina is not offering Marketplace plans anywhere in South Carolina for 2027. In Charleston County it had 12 plans in 2026, including that year's benchmark (Molina Silver Standard) and the cheapest gold. Molina members need a new plan, and if HealthCare.gov placed you in a replacement, you can still change it through January 15. See Molina is leaving: what members should do and how to switch after an auto-enrollment.

Oscar is new. Oscar brings 14 plans to Charleston County. Its age-40 prices are the highest here at every metal level, but its network includes Roper Hospital, St. Francis Xavier and Trident. Our Oscar 2027 review has the details.

Ambetter grew from 9 plans to 17, and BlueCross went from 31 to 23. With the benchmark moving from Molina to Ambetter, your 2027 tax credit is figured from a different plan.

• Only First Choice Next and BlueEssentials/BlueConnect include all six hospitals. That makes First Choice Next worth a look for most Charleston households, since it also has the cheapest gold and the lowest silver.
• Blue Cooper is an MUSC plan. Of these six hospitals, it includes only MUSC Health University Medical Center.
• Ambetter, the benchmark carrier, includes MUSC, Trident and East Cooper, but no Roper St. Francis hospital.
• Oscar includes Roper, St. Francis Xavier and Trident, but not MUSC.
• Mount Pleasant: Roper St. Francis Mount Pleasant is in BlueEssentials/BlueConnect and First Choice Next only. East Cooper adds Ambetter.

Using Roper St. Francis Berkeley or Summerville Medical Center? See our Berkeley County and Dorchester County pages. Also see which plans cover MUSC Health and our Roper St. Francis and Bon Secours guide.

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

All Charleston County plans are HMOs except BlueCross's BlueEssentials and BlueConnect EPOs. South Carolina's Marketplace has no PPOs.

• Healthy, budget-first and an MUSC patient: Blue Cooper Bronze 2 has the lowest premium, $506. You pay up to its $10,600 deductible, which is also the out-of-pocket maximum; then the plan pays in full.
• Regular care at any Charleston hospital: First Choice Next Gold Enhanced, at $711, has a $1,000 deductible, $35 primary care visits, $5 generics and a $10,000 out-of-pocket maximum, and its network includes all six hospitals above.
• Lower household income: Start with silver. If your household is at or below 250% of the federal poverty level, silver plans add cost-sharing reductions that lower deductibles and copays. Before those reductions, the benchmark Ambetter Streamlined Silver SC has a $4,700 deductible, $20 primary care visits and an $11,300 out-of-pocket maximum. See cost-sharing reductions explained.
• Managing diabetes or retiring early: Oscar offers Silver Simple Diabetes and Gold Simple with Early Retirement Benefits plans. Our early retirement plan review explains who the gold plan suits.

More: our South Carolina Marketplace guide and 2027 rate changes by county.