Ranked 3 of 15 states · median $636/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old roofer 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.
For work with real injury exposure the premium is the wrong headline number. What decides a bad year is the annual out-of-pocket maximum — the ceiling you stop paying at. A fall, a fracture, an imaging series and a course of physical therapy will reach that ceiling on any metal tier, so the states below are ordered by worst-case exposure.
Occupational context: One of the highest fall-fatality rates of any US trade; heat illness.
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 roofer or an accountant. Occupation changes the shopping criteria, nothing else.
Premium is set by rating area, so a roofer 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 |
|---|---|---|---|---|
| Kershaw | $518 | BlueCross BlueShield of South Carolina | $7,900 | 5 |
| Jasper | $540 | Ambetter from Absolute Total Care | $6,000 | 3 |
| Berkeley | $553 | Molina Healthcare | $7,000 | 4 |
| Richland | $569 | BlueCross BlueShield of South Carolina | $7,900 | 4 |
| Greenville | $590 | BlueCross BlueShield of South Carolina | $7,900 | 3 |
| Anderson | $662 | First Choice Next | $6,000 | 3 |
The spread across just these six is $144/month — $1,725 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 roofer, 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 roofer 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.
Deduction categories that generally fit this trade: Tools, truck, fall-protection gear, liability insurance. 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. 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 Roofers in South Carolina and a blog covering deductibles, subsidies and special enrollment.