Ranked 3 of 15 states · median $636/mo · CMS PY2026
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A 40-year-old therapist 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 standing work means steady, predictable utilization — regular visits, prescriptions, physical therapy. Copay structure and network breadth drive real annual cost more than the headline premium, so these pages rank states on median premium and carrier count together.
Occupational context: Emotional load and burnout; sedentary strain.
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 therapist 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 |
|---|---|---|---|---|
| Florence | $542 | InStil Health | $6,500 | 4 |
| Allendale | $553 | Molina Healthcare | $7,000 | 4 |
| Beaufort | $578 | Ambetter from Absolute Total Care | $6,000 | 3 |
| Lexington | $592 | BlueCross BlueShield of South Carolina | $7,900 | 3 |
| Abbeville | $456 | Ambetter from Absolute Total Care | $6,000 | 3 |
| Charleston | $506 | Molina Healthcare | $7,000 | 4 |
The spread across just these six is $136/month — $1,630 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 therapist 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 therapist 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: Licensing, malpractice insurance, EHR software, supervision. 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 therapist 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.
Below the cliff. At this income a single-person household remains eligible for a premium tax credit in 2026.
This occupation sits above the cliff in 7 of the 20 states reported and below it in the other 13, so the answer changes with the state.
What this figure is. It is the median annual wage BLS reports for Marriage and Family Therapists (SOC 21-1013) 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 therapist. 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 Therapists 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 Therapists should check the roster in November rather than assume this year’s options carry over.
On price the only honest number today is national: the Peterson-KFF read of 2027 filings puts the median proposed rise near 15%, spanning −1% to 54%. Final South Carolina rates are not approved, so any precise 2027 figure quoted for this state is guesswork.
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.
All 46 counties in South Carolina sell a PPO, which is unusual and useful. For a therapist covering ground, it is the plan type that travels best.
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:
The sticker price is rarely what Therapists in South Carolina end up paying. Start with a ZIP and I will work out your actual number.