Ranked 3 of 15 states · median $636/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old general contractor in South Carolina pays a median $636/month for a Silver plan before subsidies — 3th of 15 on cost. The cheapest plan in the state is $456 from Ambetter from Absolute Total Care in Abbeville. On highest out-of-pocket maximum, South Carolina ranks 11 of 15 for this occupation.
Trade work concentrates cost into rare, expensive events rather than spreading it across the year. That inverts the usual shopping logic: a lower premium with a $9,200 ceiling is a worse deal than a higher premium with a $6,000 one, because the ceiling is what you actually hit. These rankings follow the ceiling.
Occupational context: Falls, struck-by injuries, and heavy-equipment exposure.
None of that changes your price. ACA plans in South Carolina are community rated — premium varies by age, ZIP code, tobacco use and household size only. Your occupation cannot be used to rate you, decline you, or exclude a condition. What it changes is which plan design is the right bet.
Premium is set by rating area, so a general contractor in one South Carolina county can pay materially more than one an hour away. Six counties from across the state, cheapest Silver plan for a 40-year-old:
| County | Cheapest Silver @40 | Issuer | Deductible | Carriers |
|---|---|---|---|---|
| Bamberg | $498 | Ambetter from Absolute Total Care | $6,000 | 3 |
| Darlington | $529 | InStil Health | $6,500 | 4 |
| Marion | $545 | Ambetter from Absolute Total Care | $6,000 | 4 |
| Hampton | $555 | Molina Healthcare | $7,000 | 4 |
| Laurens | $582 | Ambetter from Absolute Total Care | $6,000 | 4 |
| Lancaster | $601 | Molina Healthcare | $7,000 | 5 |
The spread across just these six is $103/month — $1,241 a year for the same metal tier. Statewide the range runs $456 to $931. Coverage by County publishes all 46 South Carolina counties individually.
| South Carolina — worst-case exposure | 2026 |
|---|---|
| Lowest annual out-of-pocket maximum | $0 |
| Highest annual out-of-pocket maximum | $0 |
| Cheapest Gold plan @40 | $476 — Ambetter from Absolute Total Care |
| Gold deductible | $2,000 |
| Cheapest Silver @40 | $456 — Ambetter from Absolute Total Care |
| Cheapest Silver @50 | $637 |
For a general contractor, the gap between $0 and $0 in annual out-of-pocket maximum is worth more than any premium difference on this page. One serious injury reaches that ceiling regardless of which plan you picked.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. 2,518 plan records across 46 South Carolina counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: Indiana ($558), Ohio ($625). More expensive: Alabama ($680), Wisconsin ($687), Michigan ($708).
Side-by-side: South Carolina vs Indiana · South Carolina vs Ohio · South Carolina vs Alabama · South Carolina vs Wisconsin
Read the comparison as context, not as a shopping list. Your county of residence determines what you can buy, and for a general contractor that is fixed unless you relocate. Where it is actionable is a move already in progress — that is a qualifying life event, and you have 60 days on either side of it.
Expense categories that typically apply to this trade: Tools, truck, liability insurance, bonding, licensing. Premiums are generally deductible above the line under IRC §162(l) when no employer plan is available to you or your spouse — a question for your CPA, not your agent.
If your household income is above the subsidy range, ACA is not automatically the answer. There are other categories of coverage that may fit, and they work very differently. That is a conversation, not a web page.
The cheapest Silver plan for a 40-year-old in South Carolina is $456 per month from Ambetter from Absolute Total Care, with a state median of $636. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
No. Under the ACA, carriers cannot rate, decline, or exclude based on occupation or health history. Rates vary only by age, ZIP code, tobacco use and household size.
Yes. Plan types filed for 2026: EPO, HMO, POS, PPO.
South Carolina ranks 3 of 15 states covered here, at a median $636 per month. Indiana is cheapest at $558 and Nebraska is most expensive at $875.
This page compares states. For South Carolina specifically — county-by-county carriers, plan data and enrollment help — I publish that on Coverage by County, including a page written for General Contractors in South Carolina and a blog covering deductibles, subsidies and special enrollment.