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How South Carolina Realtors Should Compare Health Insurance Plans

By Martin Elefant · Licensed insurance agent · Updated October 2026 · 5 min read

Agents compare premiums and stop. Here's the order that actually protects you.

1. Out-of-pocket maximum

The most you can spend in a year on covered care. This is the number that matters in a bad year. Marketplace plans in South Carolina cap around $9,200 individual; private PPOs commonly $6,000–$9,000.

2. Network — and where it works

Is your doctor in it? Is the hospital you'd actually go to in Charleston County in it? Does it work in another state? HMO vs. PPO decides this. Cigna, Aetna and PHCS PPO PPOs are national.

3. Deductible

How much you pay before the plan pays. Healthy agents usually do best with a mid-range deductible and lower premium, plus an HSA.

4. Premium

Only now. And compare net of subsidy if you qualify, net of the self-employed deduction either way. South Carolina has a state income tax, so the self-employed health premium deduction reduces both federal and state taxable income.

5. Enrollment flexibility

Marketplace: once a year. Private: any month. If your income is volatile, flexibility has value.

South Carolina didn't expand Medicaid, and most marketplace plans here are narrow-network HMOs — which is why a national PPO is the thing self-employed buyers ask about first.

Our quoting tool shows every private plan in South Carolina with deductible and out-of-pocket max side by side. Or check your options and we'll compare both markets for you.

ME
Martin Elefant
Licensed insurance agent · NPN 20765405 · Lyons Life LLC · South Carolina Private Health

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