Ranked 3 of 15 states · median $636/mo · CMS PY2026
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A 40-year-old nurse practitioner 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 median Silver premium, South Carolina ranks 3 of 15 for this occupation.
Patient-facing and on-your-feet work produces steady, predictable claims — routine visits, refills, physical therapy, the occasional urgent care. That profile is decided by copay design and by whether your providers are in network, not by the sticker premium, so carrier count sits alongside cost below.
Occupational context: Needlestick and infectious exposure; standing strain.
This is background for choosing a plan, not for pricing one. Since 2014 every South Carolina exchange plan has been guaranteed issue and community rated: same age, same ZIP, same tobacco status means the same filed premium whether you are a nurse practitioner or an accountant. Occupation changes the shopping criteria, nothing else.
Premium is set by rating area, so a nurse practitioner 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 |
|---|---|---|---|---|
| Colleton | $567 | Molina Healthcare | $7,000 | 4 |
| Chester | $590 | Ambetter from Absolute Total Care | $6,000 | 5 |
| Union | $641 | First Choice Next | $6,000 | 5 |
| 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 |
The spread across just these six is $143/month — $1,718 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 — network and cost | 2026 |
|---|---|
| Median Silver premium @40 | $636 |
| Cheapest Silver @40 | $456 — Ambetter from Absolute Total Care (Abbeville) |
| Most expensive Silver @40 | $931 |
| Carriers filing in the state | 6 — Ambetter from Absolute Total Care, BlueCross BlueShield of South Carolina, First Choice Next, InStil Health |
| Plan types available | EPO, HMO, POS, PPO |
| Counties with only one carrier | 0 of 46 |
South Carolina has 6 carriers filing and 0 of 46 counties served by a single issuer. For a nurse practitioner with an established provider relationship, that carrier count is the number that decides whether you keep your doctor.
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
Cross-state numbers are useful for understanding whether South Carolina is treating you well, not for arbitrage. You cannot buy an out-of-state exchange plan. If you are a nurse practitioner weighing a relocation for other reasons, the premium difference is a real line item worth putting in the decision.
Deduction categories that generally fit this trade: Malpractice insurance, licensing, DEA registration, CE. Note the ordering problem with health premiums: the §162(l) deduction lowers your AGI, and your AGI is what sets your premium tax credit, so the two calculate against each other. That is a CPA conversation and worth having before you enroll, not after.
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. South Carolina exchange plans are guaranteed issue and community rated, so a nurse practitioner pays exactly what anyone else of the same age in the same ZIP pays. Occupation is not on the application as a rating factor.
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.
Above the cliff. At this income a single-person household receives no premium tax credit for 2026 and pays the full premium.
This occupation is above the cliff in all 20 states reported.
What this figure is. It is the median annual wage BLS reports for Nurse Practitioners (SOC 29-1171) in South Carolina. BLS surveys wage and salary workers and excludes the self-employed, so it is a benchmark for the occupation in this state — not the income of a self-employed nurse practitioner. Premium tax credit eligibility is set by household modified adjusted gross income and household size, not by occupation, so treat this as a reference point rather than a determination of what you qualify for.
Why the cliff is back. The enhanced premium tax credits expired on 31 December 2025. For plan year 2026 the 400% FPL limit applies again, so household income above $62,600 ends premium tax credit eligibility outright.
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 Nurse Practitioners in South Carolina and a blog covering deductibles, subsidies and special enrollment.
Right now 6 carriers file plans across the 46 counties of South Carolina. Participation is reset annually, which is why Nurse Practitioners should check the roster in November rather than assume this year’s options carry over.
Rate filings for 2027 point to roughly a 15% median increase nationally, from −1% at one end to 54% at the other. South Carolina has not finalised, so treat exact local 2027 pricing as unavailable rather than unknown.
Enrollment opens November 1, 2026. Treat December 15 as the deadline: it guarantees January 1 cover on every marketplace, South Carolina included. Conflicting end dates get quoted because a 2025 rule shortened the window and a court vacated it in June 2026, appeal pending — enrol by the 15th and the argument is irrelevant to you.
In your favour: PPOs are sold in all 46 South Carolina counties. That is the type most likely to pay toward out-of-network care, and worth defending at renewal if your work as a nurse practitioner takes you around.
Nothing about 2027 is urgent yet, which is exactly why it is worth ten minutes now. Come November you will be choosing between South Carolina’s carriers under a deadline; today you can do it without one.
Give me a ZIP and I will tell you three things:
Most Nurse Practitioners here are buying their own coverage without an employer. One ZIP is all I need to show you what is available in your part of South Carolina.