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

Richland County has three Marketplace carriers for 2027: Ambetter, BlueCross BlueShield of SC and First Choice Next (Select Health of South Carolina). Molina is leaving. The benchmark silver plan rises from $571 to $685 a month (+20.0%), and it is BlueCross's Blue Congaree Silver 1. We quote full-price monthly premiums for a 40-year-old, before subsidies, unless we say otherwise.

Columbia's increase is smaller than the statewide average, but check your hospital before you pick a plan. The benchmark plan includes MUSC Health's Columbia hospitals but not Prisma Health Richland or Prisma Health Baptist. Our office is in Irmo, at 1410 Dutch Fork Road, so these are the conversations we have with Midlands families every fall. Open Enrollment runs November 1, 2026 through January 15, 2027. Enroll by December 15 for a January 1 start.

Richland County had the fourth-most Marketplace plan selections in South Carolina for 2026, about one for every 10 residents. The average full-price premium was $649 a month, and the average enrollee paid $131 after tax credits. The statewide enrollment-weighted benchmark increase is 24.8%, so Richland's +20.0% is below average.

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:

BlueCross has the lowest price at every metal level, and gold is tightly grouped: just $20 separates the three carriers' cheapest gold plans. For a 60-year-old, the benchmark rises $243 a month, or about $2,912 a year, before subsidies.

Molina is leaving. Molina is not offering Marketplace plans anywhere in South Carolina for 2027. In Richland County it had 12 plans in 2026, and its lowest silver and gold prices at age 40 were second only to BlueCross. The county drops from 60 plans to 48. Molina members need to choose a new plan; if HealthCare.gov already placed you in one, you can change it through January 15. See Molina is leaving: what members should do and how to switch after an auto-enrollment.

No new carriers. Ambetter grew from 9 plans to 17, BlueCross went from 31 to 23, and First Choice Next stays at 8.

The benchmark stayed with Blue Congaree but moved from Blue Congaree Silver 2 + Adult Vision to Blue Congaree Silver 1.

• Ambetter and BlueEssentials/BlueConnect include all four Columbia hospitals. For households that use both Prisma and MUSC, those are the two to compare.
• Blue Congaree, which holds the benchmark, cheapest bronze and cheapest gold, does not include Prisma Health Richland or Baptist.
• First Choice Next includes the two MUSC hospitals but neither Prisma hospital.
• Just across the river: Lexington Medical Center in West Columbia is in BlueEssentials/BlueConnect, Blue Congaree and Ambetter, but not First Choice Next. Prisma Health Baptist Parkridge is in BlueEssentials/BlueConnect and Ambetter. See our Lexington County page.

See which plans cover Prisma Health, which plans cover MUSC Health and our Lexington Medical Center guide.

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

Richland County's plans are all HMOs except BlueCross's BlueEssentials and BlueConnect, which are EPOs. The South Carolina Marketplace has no PPOs.

• Healthy, budget-first and fine with MUSC or Lexington Medical: Blue Congaree Bronze 2 has the lowest premium at $471. Its $10,600 deductible equals its out-of-pocket maximum, so after you pay that, the plan pays in full.
• Frequent care and fine with MUSC or Lexington Medical: Blue Congaree Gold 1, at $725, has a $250 deductible, $25 primary care visits, $12 generics and a $10,000 out-of-pocket maximum.
• Prisma Health patients: Ambetter includes Prisma Health Richland and Baptist along with both MUSC hospitals. Its cheapest silver is $697 and its cheapest gold is $745. BlueEssentials/BlueConnect also includes them, and we can price both side by side.
• Lower household income: Look at silver first. Only silver plans carry cost-sharing reductions, which lower deductibles and copays for households up to 250% of the federal poverty level. Before those reductions, Blue Congaree Silver 1 has a $7,000 deductible, $20 primary care visits and a $10,500 out-of-pocket maximum. See cost-sharing reductions explained.
• USC students and young adults: At 27, the benchmark is $562 at full price and the cheapest bronze is $386, before any tax credit.

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