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Best Health Insurance Plans in South Carolina 2025

Ambetter and BlueCross BlueShield of South Carolina get top marks for health insurance in South Carolina.
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May 29, 2025
Fact Checked
Profile photo of Kate Ashford, CSA®
Lead Writer & Spokesperson
Profile photo of Holly Carey
Edited by Holly Carey
Managing Editor
Profile photo of Kate Ashford, CSA®
Lead Writer & Spokesperson
Profile photo of Holly Carey
Edited by Holly Carey
Managing Editor
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About one in six people in South Carolina ages 19 to 64 buy their own health insurance on the marketplace or directly from an insurance company. NerdWallet crunched the numbers on 109 health insurance plans to find the best and most affordable in South Carolina.

We built our own data-driven marketplace health insurance rating system based on costs, claims denial rates, medical management programs, dental care, complaints, government quality data and more. We scored plans covering more than 95% of all marketplace health insurance enrollees in South Carolina.

Here are the best health insurance companies in South Carolina

Compare the best health insurance plans in South Carolina

Ambetter from Absolute Total Care (South Carolina) logoAmbetter from Absolute Total Care (South Carolina)
Plan types offered
HMO
Claims denial rate
15% (Far fewer than average)
Avg. Silver premium
$436.12

(844) 612-6210

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Company name
NerdWallet rating
Plan types
Claims denial rate
Avg. Silver premium
Learn more
BEST OVERALL
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Ambetter from Absolute Total Care (South Carolina) logoAmbetter from Absolute Total Care (South Carolina)
5.0/5
HMO15% (Far fewer than average)$436.12
MOST AFFORDABLE
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BlueCross BlueShield of South Carolina logoBlueCross BlueShield of South Carolina
5.0/5
HMO, EPO, POS, PPO20.6% (Average)$429.90
BEST FOR OUT-OF-POCKET COSTS
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Molina Healthcare (South Carolina) logoMolina Healthcare (South Carolina)
4.0/5
HMO26.3% (Far more than average)$434.75

How we choose the best health insurance companies

Kate Ashford

👋 I’m Kate Ashford, a lead writer and content strategist covering health insurance. I did the research for this page to identify the best health insurance options in the state. I gathered and analyzed data across four major categories:

  • Plans with lower costs, such as premiums, deductibles, copays, coinsurance and out-of-pocket maximums, score the best.

    We evaluate plans’ costs using marketplace health plan datasets. These enormous spreadsheets include as many as 149 discrete data points for over 100,000 plan offerings in 31 states that use the federal marketplace (other states use their own separate marketplaces).

    It’s not feasible to evaluate every kind of cost in every scenario, so we use these as a sample:

    Premiums

    Premiums have the highest weight in our scoring. We compare each plan’s unsubsidized premium for a 30-year-old individual as a level playing field for comparison. We score plans based on how cheap they are compared to other plans of the same type and metal — Silver HMOs vs. other Silver HMOs, for example.

    Deductibles

    The amount you need to pay out of pocket before your plan starts to pay for its share of covered benefits. The lower the deductible, the better.

    Out-of-pocket costs

    We analyze each plan’s copays, coinsurance and deductibles for primary care visits, specialist appointments, emergency care and several tiers of prescription drugs.

  • Plans score higher if they made covered medical care and prescription drugs more easily accessible.

    We evaluate plans’ coverage using the same marketplace health plan datasets that we use to analyze costs along with additional data from government-provided “public use files.”

    All marketplace plans have to cover the same essential health benefits, but some plans’ coverage is more usable than others. We score them on how coverage works.

    Pre-deductible benefits

    We give a strong scoring preference to plans that cover certain benefits before (and also after) you’ve met the deductible. Plans get lower scores when they don’t start to cover things like doctor’s office visits or prescription drugs until you’ve paid the full deductible.

    Dental coverage

    Plans that cover adult dental care also get more points for coverage than plans that don’t. (Unlike children’s dental care, adult dental care isn’t considered an essential health benefit, so plans may or may not cover it.)

  • Plans score well when they have fewer denials, lower complaint rates and stronger customer satisfaction surveys.

    We use three different data sources to evaluate customer experience:

    Customer complaints

    We collect and analyze customer complaint data from the National Association of Insurance Commissioners. For each company, we calculate a multi-year average complaint rate.

    NerdWallet conducts its data analysis and reaches conclusions independently and without the endorsement of the NAIC.

    Denials

    Based on claims data from the Centers for Medicare & Medicaid Services, we rank companies based on how often they deny in-network claims. The fewer denials, the better.

    Satisfaction scores

    We rate plans based on how well or poorly they score on government surveys evaluating customer satisfaction.

  • Companies earn points based on their medical management programs and rankings on government ratings of medical quality.

    We use two sources to score plans’ quality of care:

    Government ratings

    Marketplace plans get star ratings from the government based on how well they manage members’ health care, monitor conditions and provide certain medical services. We rank plans based on how highly they score on these ratings.

    Medical management programs

    Some plans offer medical management programs to help members with certain conditions, such as asthma, diabetes, depression, pregnancy and pain management. Plans score points based on how many of these programs they offer.

Best overall: Ambetter from Absolute Total Care

Why we picked it: Ambetter from Absolute Total Care has the highest rating of the health insurance companies we reviewed in South Carolina. It offers competitively priced Silver plans and has the lowest claims denial rate of the companies we analyzed. You’ll also find the lowest generic drug prices with Ambetter, on average, and many plans offer dental coverage.

Claims denials are a problem for many people with health insurance: Insurance companies selling plans on Healthcare.gov denied 19% of in-network claims in 2023, according to the most recent data from KFF, a health policy nonprofit. Ambetter’s denial rate falls below this figure.

BEST OVERALL
Ambetter from Absolute Total Care (South Carolina) logoAmbetter from Absolute Total Care (South Carolina)
Ambetter from Absolute Total Care offers competitively priced Silver plans and has the lowest in-network claims denial rate of the companies analyzed. It also offers the lowest generic drug costs, on average, and many plans offer dental.
Plan types offered
HMO
Claims denial rate
15% (Far fewer than average)
Avg. Silver premium
$436.12

(844) 612-6210

Call a consumer advocate at HealthSherpa
Call a consumer advocate at HealthSherpa

Mon–Fri: 6am–4pm PT

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Pros

  • Competitively priced Silver plans.
  • Low generic drug costs.
  • Lowest claims denial rate.
  • Many plans offer dental.

Cons

  • Brand name drug costs aren’t the lowest.
  • Lower government ratings.

Most affordable: BlueCross BlueShield of South Carolina

Why we picked it: NerdWallet’s second-highest rated company in the state, BlueCross BlueShield of South Carolina, offers the lowest-priced Silver plans and Bronze-tier plans of the companies we analyzed, on average, in South Carolina.

Silver plans are often the most affordable because they’re potentially eligible for more subsidies than any other plan type. If you’re not eligible for premium subsidies, you may want to shop for plans other than Silver (like Bronze or Expanded Bronze) to find the lowest premiums overall.

MOST AFFORDABLE
BlueCross BlueShield of South Carolina logoBlueCross BlueShield of South Carolina
BCBS of SC offers the lowest-priced Silver plans and also the cheapest plans overall, on average. The company has the lowest complaint rate of those analyzed, and in addition to HMOs, it offers EPO, POS and PPO plans that may give members more flexibility for out-of-network care.
Plan types offered
HMO, EPO, POS, PPO
Claims denial rate
20.6% (Average)
Avg. Silver premium
$429.9

(844) 612-6210

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Mon–Fri: 6am–4pm PT

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Pros

  • Lowest priced plans overall.
  • Lowest complaint rate.
  • Offers plans that allow out-of-network care.
  • Highest government ratings.

Cons

  • Drug costs aren’t the lowest.
  • Average claims denial rate.
🤓Nerdy Tip

Bronze plans cover about 60% of the cost of care, which means you’re responsible for about 40% out of pocket. Expanded Bronze plans have the same coverage as regular Bronze plans, broadly speaking, but they either pay for at least one major non-preventive service before you meet the plan’s deductible or function as a high-deductible health plan.

Best for out-of-pocket costs: Molina Healthcare

Why we picked it: Molina Healthcare offers plans with lower fees for seeing your primary care physician or specialists, and it offers the second lowest-cost Silver plans, on average, of the companies reviewed.

When you’re weighing the best plan for your needs, make sure you consider all costs, including monthly premiums, deductibles, out-of-pocket charges and the out-of-pocket maximum, which is the most you’d have to spend in a year.

BEST FOR OUT-OF-POCKET COSTS
Molina Healthcare (South Carolina) logoMolina Healthcare (South Carolina)
Molina Healthcare offers plans with lower fees for seeing your primary care physician or specialists, and costs for brand-name drugs are among the lowest in the state, on average. But Molina’s in-network claims denial rate is well above average.
Plan types offered
HMO
Claims denial rate
26.3% (Far more than average)
Avg. Silver premium
$434.75

(844) 612-6210

Call a consumer advocate at HealthSherpa
Call a consumer advocate at HealthSherpa

Mon–Fri: 6am–4pm PT

partnered with HealthSherpa

Pros

  • Lower average fees to see your PCP or specialists.
  • Competitively priced Silver plans, on average.

Cons

  • Claims denial rate is well above average.
  • Lowest government ratings of companies analyzed.
    • Ambetter from Absolute Total Care.

    • BlueCross BlueShield of South Carolina.

    • First Choice Next.

    • InStil Health.

    • Molina Healthcare.

    • UnitedHealthcare.

How to pick a marketplace health insurance plan

There can be a lot of moving parts when shopping for health insurance coverage. Here are a few questions to help you think through your needs and options:

  • How much are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?

  • Are you eligible for subsidies? Whether applying yourself or with an agent/broker, be sure to enter accurate information to check whether you’re eligible for subsidies through the marketplace.

  • Is your doctor in-network? If you have a preferred doctor (or doctors) or hospital, make sure they participate in the plan’s network.

  • Are your prescriptions covered? If you’re on medication, understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?

  • Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?

If you have questions or need help navigating the marketplace, you can get help from a trained assister or an agent/broker at HealthCare.gov.

Off-marketplace health insurance in South Carolina

Some marketplace plans have matching policies that can be bought outside of the marketplace. You can choose to buy an off-marketplace plan rather than a marketplace plan during open enrollment (Nov. 1 through Jan. 15), but subsidies aren’t available if you do so.

You might be able to find other kinds of health insurance plans sold outside of the marketplace (and outside of open enrollment), such as limited, short-term or alternative health plans. These plans might not have the same coverage and/or consumer protections as plans sold on the marketplace.

It’s a good idea to check whether an off-marketplace plan offers “minimum essential coverage.” If not, the plan might be allowed to do things that most health plans can’t, such as deny coverage due to health status, limit coverage of pre-existing conditions and/or not cover essential health benefits.

Best Medicare plans in South Carolina

Medicare is available for people age 65 and older and people living with certain medical conditions. There are many kinds of Medicare coverage, and the best choice for you can depend on your health, finances and preferences. Check out NerdWallet’s reviews of the best Medicare plans:

Health insurance resources in South Carolina

NerdWallet writers are subject matter authorities who use primary, trustworthy sources to inform their work, including peer-reviewed studies, government websites, academic research and interviews with industry experts. All content is fact-checked for accuracy, timeliness and relevance. You can learn more about NerdWallet's high standards for journalism by reading our editorial guidelines.

Marketplace health insurance ratings methodology

NerdWallet evaluates marketplace health insurance plans based on marketplace data about plans’ premiums, out-of-pocket costs and benefits, prescription drug coverage, dental coverage, government quality rating data, complaint data, records about how plans approve and deny claims and more.

We evaluate individual plans and then aggregate scores to the company level. When a plan is missing data for a certain metric, we exclude it from calculations. For example, the federal government calculates official star ratings for marketplace health insurance plans, but many plans are unrated, and others have incomplete ratings. NerdWallet’s analysis incorporates government quality ratings when they’re available, but doesn’t penalize plans that are unrated.

These ratings are a guide, but we encourage you to shop around and compare several insurance quotes to find the best coverage and rate for you. NerdWallet does not receive compensation for any reviews. Read our editorial guidelines for more information.

Insurer complaints methodology

We examined complaints received by state insurance regulators and reported to the National Association of Insurance Commissioners. To assess how insurers compare to one another, the NAIC calculates a complaint index each year for each subsidiary, measuring its share of total complaints relative to its size, or share of total premiums in the industry.

To evaluate a company’s complaint history, we calculated a similar index for each insurance company, weighted by market shares of each subsidiary. We score companies based on this index of how many complaints the company receives relative to its market share.

NerdWallet conducts its data analysis and reaches conclusions independently and without the endorsement of the NAIC.