How health insurance works in South Carolina
South Carolinians buying their own coverage have two markets: HealthCare.gov (healthcare.gov), where plans from BlueCross BlueShield of South Carolina, Ambetter, Molina, and Aetna CVS Health are guaranteed-issue and priced on income, and the private shared-network market, where PPO plans on Cigna, Aetna and PHCS PPO are underwritten and priced on age and health.
Medicaid is not expanded in South Carolina. South Carolina has no state individual mandate.
What it costs
Full-price marketplace plans for a 40-year-old in Charleston commonly run $550–$850 a month in 2026; with a subsidy, often under $300. Private PPOs for the same healthy person run roughly $320–$480. South Carolina has a state income tax, so the self-employed health premium deduction reduces both federal and state taxable income.
The South Carolina picture
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.