Health Insurance in Lexington County, SC: 2027 Plans, Prices & Hospitals (Lexington & West Columbia)

Lexington County has three Marketplace carriers for 2027: Ambetter from Absolute Total Care, BlueCross BlueShield of SC and First Choice Next, offering 48 plans in all. The benchmark silver plan for a 40-year-old costs $704 a month at full price before subsidies, up from $593 in 2026 (+18.6%). Molina is leaving the county, and First Choice Next is new.

This is our home county. Our office is on Dutch Fork Road in Irmo, and our agents live in and shop for coverage in Lexington, West Columbia, Cayce, Chapin and around Lake Murray.

The benchmark silver plan sets the size of your tax credit, and it rose 18.6% at every age.

Each carrier's lowest-priced plan at each metal level:

Silver is nearly a three-way tie: each carrier's lowest silver is $703 to $704 at age 40. When prices are that close, let the network and drug list decide.

Molina is leaving. Molina sold 12 plans here in 2026 and has none for 2027, so Molina members need a new plan. Our article on Molina's exit walks through the options.

First Choice Next is new. First Choice Next (Select Health of South Carolina) enters with 8 plans and the county's lowest gold price. Read our First Choice Next 2027 review first, because its local hospital network is narrower (see below).

Ambetter grew and BCBS trimmed. Ambetter went from 9 plans to 17; BCBS went from 31 to 23, keeping its Blue Congaree HMO and statewide EPO plans.

The benchmark plan changed. In 2026 it was BCBS Blue Congaree Silver 2 + Adult Vision. In 2027 it is Blue Congaree Standard Silver. When the benchmark shifts, your tax credit shifts with it, which is why we tell clients not to auto-renew without checking.

The first question we hear is Lexington Medical Center. The second is Prisma Health and MUSC in Columbia.

• Lexington Medical Center is in the BCBS EPO, the BCBS Blue Congaree HMO and Ambetter. It is not in First Choice Next's network in our 2027 data. Our Lexington Medical Center network guide goes deeper.
• Prisma Health Baptist Parkridge, on the Irmo side of the county, is in the BCBS EPO and Ambetter only. Blue Congaree does not include it or Prisma's Richland and Baptist hospitals in Columbia. See which plans cover Prisma Health.
• MUSC Health Columbia (Downtown and Northeast) is the one system all four networks include, and the only option on this list for First Choice Next members in Lexington County.
• Ambetter and the BCBS EPO include all six hospitals on this list.

Every plan here is an HMO except the BCBS BlueEssentials and BlueConnect EPOs; the SC Marketplace has no PPOs. Neither type covers out-of-network care except emergencies. Our HMO vs. EPO explainer covers the details.

You rarely see a doctor and want the lowest premium. The Blue Congaree Bronze 2 plan is the cheapest at $486 for a 40-year-old, but its $10,600 deductible equals its out-of-pocket maximum, so beyond preventive care it pays nothing until you spend $10,600. Expanded bronze plans with office copays often make more sense.

You want Lexington Medical Center and a lower premium. Blue Congaree HMO plans include LMC and MUSC Columbia. The benchmark plan is one of them: a $6,400 deductible, $10,300 out-of-pocket maximum, $40 primary care and $80 specialist visits.

You see Prisma Health doctors. Look at Ambetter (lowest silver $704 at age 40) or the BCBS EPO.

You expect regular care and want a low deductible. First Choice Next Gold Enhanced is $710 at age 40, only $6 more than benchmark silver, with a $1,000 deductible. The tradeoff is the network: no Lexington Medical Center and no Prisma hospitals in our data. If those matter to you, BCBS's lowest gold is $748 and Ambetter's is $753.

Your income is lower. Silver plans can come with cost-sharing reductions that lower your deductible. See why silver can be the best deal under 250% FPL.

Come see us in Irmo or call, and we will compare all three carriers side by side.

With Molina leaving and a new benchmark plan, shop before you renew for 2027. Tell us your ZIP, ages, household and income, and a licensed agent will price every plan against your doctors and drugs. For the statewide picture, start with our 2027 South Carolina health insurance guide or the 2027 rate changes by county. Next door, see Richland County.