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Rare Cases for Out of State Blue Essentials

If your job doesn't offer health insurance or if you're not eligible for Medicare or Medicaid through the government, you can find a suitable insurance plan through South Carolina's private insurance exchange.

Finding a health insurance plan that's affordable and provides good coverage can be challenging. If you go for a low-cost plan, your deductibles and out-of-pocket maximums will be high, while your coverage will be low. On the other hand, plans offering more coverage will come with higher premiums. Those who choose a low-cost policy due to its lower premiums may end up paying more out of their pockets before the insurer starts covering their medical costs.

MoneyGeek analyzed the health insurance exchange to find the cheapest and best health insurance plans in South Carolina for various plan types and age groups. The study can help those who are looking for the best coverage at the lowest possible cost.

The Cheapest Health Insurance in South Carolina by Metal Tier

Insurance policies in the health insurance market are frequently classified into various metal tiers. The tiers offered in South Carolina are Catastrophic, Bronze, Expanded Bronze, Silver and Gold. The premiums and cost-sharing for each plan vary based on the tier the policy belongs to. Gold plans have the highest insurer cost-sharing, while Catastrophic plans have the lowest. As a result, premiums for a Gold plan will be high, while premiums for a Catastrophic plan will be the lowest.

For plans with lower monthly premiums, deductibles and out-of-pocket maximums are higher. And plans with higher premiums provide wider coverage with lower deductibles and out-of-pocket maximums.

The following are the average monthly health insurance rates for the five tiers:

  • Catastrophic: $228 per month
  • Bronze: $344 per month
  • Expanded Bronze: $367 per month
  • Silver: $520 per month
  • Gold: $542 per month

Individuals in good health may have fewer medical costs. Therefore, a low-cost insurance plan, such as a Bronze plan, will likely be sufficient to cover their medical expenses. However, individuals with higher medical costs will be at an advantage by choosing a Gold health insurance plan in South Carolina. Although these plans charge you high monthly premiums, you will get more coverage and low deductibles.

Rates, deductibles and out-of-pocket maximums for policies in the South Carolina insurance market might vary by metal tier. The table below provides the lowest available average monthly premium for each metal tier.

If you have a low income, you may be eligible for cost-sharing reductions (CSR) under a Silver plan. These insurance plans have cheaper premiums, lower deductibles and better coverage than the lower-tier policies.

Based on a sample profile of a 40-year-old man, MoneyGeek gathered pricing data for all types of plans available in South Carolina. The prices are for HMO or EPO policies, with HMO being the most prevalent type of insurance plan in the state.

Cheapest Health Insurance in South Carolina by Metal Tier

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  • Metal Tier

    Plan

    Company

    Monthly Cost

    OOP Max

  • Catastrophic

    BlueEssentials Catastrophic 1

    BlueCross BlueShield of South Carolina

    $227

    $8,550

  • Bronze

    Core Care Bronze 2

    Molina Healthcare

    $331

    $8,550

  • Expanded Bronze

    BlueExclusive Cooper Bronze 1

    BlueCross BlueShield of South Carolina

    $302

    $8,550

  • Silver

    BlueExclusive Cooper Silver 2

    BlueCross BlueShield of South Carolina

    $456

    $8,550

  • Gold

    Confident Care Gold 1

    Molina Healthcare

    $512

    $6,500

The Cheapest Health Insurance in South Carolina by Age and Metal Tier

When evaluating the South Carolina health exchange plans, we discovered that age had a significant influence on the cost of health insurance. Insurance prices rise as you age. For a 26-year-old male in South Carolina, a Silver plan will cost around $417 per month, but a 60-year-old male will spend about $1,105 per month for the same policy.

Health Insurance Costs in South Carolina by Age and Metal Tier

The South Carolina insurance marketplace data on health insurance rates are just averages based on sample ages. Besides your age, your income also affects the cost. Seniors in South Carolina may obtain rates lower than the sample rates since insurers consider tax premiums and other factors. Still, you won't know your exact premium until you apply for a health insurance plan.

The table below shows how prices differ based on metal tier plans and age groups. See our detailed guide on South Carolina health insurance for more information about the insurance metal tiers.

Cheapest Health Insurance in South Carolina by Age And Metal Tier

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  • BlueCross BlueShield of South Carolina

  • BlueCross BlueShield of South Carolina

  • Ambetter from Absolute Total Care

  • Ambetter from Absolute Total Care

  • BlueCross BlueShield of South Carolina

  • BlueCross BlueShield of South Carolina

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The Cheapest Health Insurance in South Carolina by County

The cost of health insurance in South Carolina also changes depending on your location. Every state in the United States is divided into rating areas made up of one or more counties. Health insurance companies examine which rating area your county belongs to in order to calculate your monthly insurance costs. Insurers compute premiums for counties in the same rating region in the same manner.

South Carolina's 46 counties are divided into 46 rating regions, each containing only one county. Constant Care Silver 4 from Molina Healthcare is the cheapest Silver health insurance plan in Greenville, the most populous county in South Carolina. The policy costs an average of $430 per month.

To find the cheapest plan in your county for each metal tier, use the table below as a guide.

The average premiums across all metal tiers were calculated using a 40-year-old male's profile.

Cheapest Health Insurance Plans in South Carolina by County

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  • BlueCross BlueShield of South Carolina

    BlueEssentials Catastrophic 1

  • BlueCross BlueShield of South Carolina

    BlueEssentials Catastrophic 1

  • BlueCross BlueShield of South Carolina

    BlueEssentials Catastrophic 1

  • Catastrophic 3 $0 PCP Visits

  • BlueCross BlueShield of South Carolina

    BlueEssentials Catastrophic 1

  • BlueCross BlueShield of South Carolina

    BlueEssentials Catastrophic 1

  • BlueCross BlueShield of South Carolina

    BlueEssentials Catastrophic 1

  • BlueCross BlueShield of South Carolina

    BlueEssentials Catastrophic 1

  • BlueCross BlueShield of South Carolina

    BlueEssentials Catastrophic 1

  • BlueCross BlueShield of South Carolina

    BlueEssentials Catastrophic 1

The Cheapest Health Insurance in South Carolina With High Out-of-Pocket Maxes

Healthy young people in South Carolina may prefer a low-cost health insurance plan because their medical expenditures are usually low. Although the premiums for these plans are minimal, they will have higher out-of-pocket maximums. Therefore, you may have to pay more out of your pocket if you want the insurance to cover a medical emergency or if you make frequent doctor visits.

BlueCross BlueShield of South Carolina's BlueEssentials Catastrophic 1 plan is the cheapest in South Carolina with a high out-of-pocket maximum. For a 26-year-old male, the plan will cost around $182 a month.

MoneyGeek defined a high out-of-pocket maximum as a plan with a yearly maximum cost of $8,250 or higher.

BlueEssentials Catastrophic 1, the cheapest health insurance plan in South Carolina with the highest out-of-pocket limit, is a Catastrophic plan and isn't available for all. Anyone under the age of 30 or who qualifies for a hardship or affordability exemption can enroll in these plans. Individuals who cannot purchase health insurance due to personal or financial reasons are eligible for these hardship or affordability exemptions.

The Cheapest Health Insurance in South Carolina With Low Out-of-Pocket Maximums

If you have more medical expenses than the average person, a health insurance plan with a low out-of-pocket maximum and higher premiums will be your best option. Although such plans have higher monthly premiums, the cost of regular medical visits and prescription medication will quickly cause you to exhaust the plan's low out-of-pocket limit. Your insurance company will then start covering your medical bills.

BlueEssentials HD Gold 3 from BlueCross BlueShield of South Carolina is the cheapest health insurance plan in South Carolina with a low out-of-pocket limit. For a 40-year-old male, this plan will cost around $543 per month.

MoneyGeek defined a low out-of-pocket maximum as a plan with a yearly maximum cost of less than $4,250. In the case of BlueEssentials HD Gold 3, the maximum out-of-pocket rate is $3,000.

BlueEssentials HD Gold 3 is a Gold plan from BlueCross BlueShield of South Carolina. Thus, monthly premiums will be high. However, because the out-of-pocket maximum is low, you'll quickly reach it if you have extensive medical costs, and the insurance provider will start covering your expenses.

Cheapest EPO / HMO Health Insurance Plan in South Carolina

To find the best health insurance plan in South Carolina, you must first assess your healthcare needs and preferences. The majority of plans available in the South Carolina insurance market are Health Maintenance Organization (HMO) plans. In addition, the state provides Exclusive Provider Organization (EPO) plans.

Except in an emergency, South Carolina's HMO plans cover medical services obtained through in-network health providers. Your primary care physician will refer you to specialist doctors. These insurance policies are less expensive than other types of insurance. EMO plans are similar to HMOs. However, unlike an HMO plan, you can see specialists within the network without a referral from your primary physician.

  • Cheapest HMOSilver Plan: Constant Care Silver 4 provided by Molina Healthcare, costing an average of $457 per month for a 40-year-old male
  • Cheapest EPO Silver Plan: BlueExclusive Cooper Silver 2 offered by BlueCross BlueShield of South Carolina, costing around $456 a month for an average 40-year-old man

Cheapest Plan in South Carolina With an HSA

A Health Savings Account, or HSA, is paired with some health insurance plans in South Carolina. HSAs are tax-free accounts that you can use to pay for deductibles, copayments or other expenses. Many people use HSAs in conjunction with high-deductible policies. HSAs are ideal for those who are in good health and rarely need to pay for medical expenditures. These plans are cheaper and offer higher pre-tax contributions for medical benefits. If you don't require the funds for healthcare bills, you can add them to your savings.

As per MoneyGeek's data, the following three are the cheapest healthcare plans with a Health Savings Account (HSA) in South Carolina, in each available tier:

  • Cheapest HSA Expanded Bronze Plan: BlueEssentials HD Bronze 3 provided by BlueCross BlueShield of South Carolina. This EPO plan costs an average of $357 per month for a 40-year-old male.
  • Cheapest HSA Silver Plan: Ambetter Balanced Care 25 HSA offered by Ambetter from Absolute Total Care. This HMO plan is available at around $492 per month for an average 40-year-old man.
  • Cheapest HSA Gold Plan: BlueEssentials HD Gold 3 by BlueCross BlueShield of South Carolina. This EPO plan is available for $543 per month for a 40-year-old man, on average.

As previously stated, higher deductibles are typical with HSA plans. If you experience an unforeseen medical emergency that results in huge medical bills, you must be prepared to spend a large percentage of your savings to cover the costs.

What to Know About Health Insurance in South Carolina

MoneyGeek's study used data from South Carolina's insurance marketplace to determine sample health insurance premiums. The rates shown in our study are not necessarily the cheapest. Residents from low-income households or seniors may be eligible for Medicaid or Medicare, which are often far less expensive than the bulk of marketplace plans.

Private Health Insurance on the South Carolina Marketplace

Healthcare plans in South Carolina are classified into various metal tiers by the state's insurance exchange. Although the Catastrophic and Bronze plans have the lowest premiums, they also have the highest out-of-pocket maximums. The monthly premiums for Gold plans will be higher, but the overall cost to you for choosing this plan will be lower if you have extensive medical expenses.

All the tiers mentioned below meet the state and federal health insurance standards. They do, however, differ in several ways.

  • Catastrophic: Catastrophic plans are the cheapest of the metal tiers, but they are not for everyone. You must be under the age of 30 or qualify for a financial hardship exemption to apply for a catastrophic insurance plan. Their monthly premiums are low, but they come with limited coverage and high deductibles. However, they provide the same essential health coverage as the vast majority of other insurance policies.
  • Bronze: Bronze plans are slightly more expensive than Catastrophic policies but far less expensive than higher-tier insurance. These plans feature cheap monthly premiums, but you'll have to spend more money out of your pocket for medical expenses. Every year, their deductibles might reach thousands of dollars. These policies are perfect for healthy people who seldom have medical costs and are just looking for low-cost health insurance coverage that will protect them in a medical emergency.
  • Expanded Bronze: These plans are for those who do not expect significant medical expenses every year, but want to get the most of their insurance plan from the outset. The plan provides at least one of the essential health benefits before you hit the deductible threshold. Expandable Bronze plans have a higher actuarial value than Bronze plans. The actuarial value of a health insurance plan is simply the percentage of expenditures that it covers. While Bronze plans have an actuarial value of no more than 60%, Expanded Bronze plans have an actuarial value of up to 65%.
  • Silver: Select a Silver plan if you want your insurance to cover more of your usual medical expenses. They have lower deductibles and premiums than Catastrophic, Bronze and Expanded Bronze policies. They are great for those who are eligible for cost-sharing reductions. If you have a lot of medical expenses, these plans can help you save hundreds or even thousands of dollars each year compared to policies from lower tiers.
  • Gold: Gold plans feature higher monthly premiums, lower out-of-pocket maximums and lower deductibles than Catastrophic, Bronze or Silver plans. These plans are intended for those who need regular medical care and are ready to pay higher premiums to cover the majority of their medical expenses. If you require frequent medical care, the overall expenditures of selecting a Gold plan can be substantially cheaper than those of selecting a lower-tier plan.

MoneyGeek's data only shows sample rates; you may be eligible for cheaper plans or more coverage. The income level of your family has a major influence on insurance prices. If your monthly family income is between 100% and 400% of the federal poverty level, you may be eligible for premium tax credits. These tax credits are available in South Carolina to two-person households earning between $17,420 and $69,680 yearly. More information regarding this will be available through the HealthCare.gov calculator.

Open enrollment refers to the specific time period during which a person can enroll in a new health insurance plan through the health insurance exchange. Although the enrollment period usually falls between November and December, the government extended it due to the COVID-19 epidemic. Certain life events like getting married, losing health insurance, having a baby or moving may qualify you for a special enrollment period. Job-based insurance plans may have different enrollment periods. And, for Medicaid or the Children's Health Insurance Program (CHIP), there's no set time limit for applying.

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If your family income is between 138% and 250% of the federal poverty level, you may be eligible for cost-sharing reductions (CSR) under a Silver plan. Qualifying residents may be able to obtain the coverage of a Gold plan for the cost of a Silver plan. These reductions will considerably lower the plan's deductible, copayments or coinsurance and out-of-pocket maximums. In 2021, a two-person household earning $24,040–43,550 in South Carolina may be eligible for these reduced rates.

Medicaid in South Carolina

Medicaid is free, making it the most affordable choice for eligible South Carolinians. However, the state is not a Medicaid expansion state, so not everyone is eligible for Medicaid based on income. In South Carolina, those with very low family income, low-income children, disabilities or pregnancies are generally deemed eligible.

Medicare in South Carolina

Medicare, a federal healthcare program, may be accessible to South Carolina residents 65 and older, as well as those younger than 65 who have a qualifying disability or sickness. Unlike Medicaid, which is often free, you may need to pay for certain Medicare plan services. Regardless, Medicare programs are much cheaper than private insurance plans.

Medicare is divided into three sections, each of which covers a distinct service:

  • Part A: Part A, often known as hospital insurance, covers hospital stays, skilled nursing facility care, hospice care and some home health care services.
  • Part B: Part B is your medical insurance, and it covers some doctors' services, outpatient treatments, medical supplies and preventive care services.
  • Part D: This includes your prescription medicines as well as some necessary vaccinations. You can also find it as prescription drug insurance.

Methodology

MoneyGeek's research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in South Carolina for you

MoneyGeek collected plans and premiums for health insurance in

South Carolina

from the Health Insurance Exchange Public Use Files (Exchange PUFs) for all available metal tiers and across several age groups.

Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.

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Source: https://www.moneygeek.com/insurance/health/best-cheap-health-insurance-south-carolina/

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