Health Insurance Charleston, SC: 2027 Plans for Lowcountry Families

Updated for the 2027 plan year (October 2026)

Health insurance Charleston starting point for 2027

Charleston residents who don’t have coverage through work, Medicare, Medicaid or the military buy a plan on HealthCare.gov. You can enroll on your own or with a licensed agent; a plan’s price is the same either way.

South Carolina has not expanded Medicaid. Healthy Connections Medicaid covers non-disabled parents only up to 67% of poverty, so for most adults the Marketplace is the main option, and premium tax credits begin at 100% of poverty. The South Carolina health insurance guide explains statewide rules and the pending Palmetto Pathways waiver.

Military families at Joint Base Charleston are usually covered by TRICARE and don’t need a Marketplace plan. Spouses who leave the military system, contractors and veterans without other coverage should compare Marketplace options.

MUSC, Roper St. Francis and Trident networks

When you compare health insurance in Charleston, check networks first. Plans at similar prices can include very different hospitals, and an out-of-network stay can cost far more than any premium difference.

• MUSC Health is the Medical University of South Carolina’s academic health system. U.S. News ranked MUSC Health University Medical Center the No. 1 hospital in South Carolina for 2026–2027, per MUSC Health.
• Roper St. Francis Healthcare is Charleston’s other major nonprofit hospital system.
• Trident Health, part of HCA, runs Trident and Summerville hospitals in the area (Trident Health).

Before you enroll, search each plan’s 2027 provider directory for your primary doctor, specialists and preferred hospital. Call the doctor’s office to confirm, since directories can lag.

MUSC financial assistance

MUSC Health offers a sliding-scale discount for patients with household income up to 300% of the federal poverty level, according to its financial assistance page. Call 843-792-2311 to request an application. It helps with MUSC bills; it is not insurance.

Hospitality, port and seasonal workers

Charleston’s economy runs on tourism, restaurants and the port. SC Ports says the state’s ports support 1 in 9 South Carolina jobs. Many of these jobs are hourly, seasonal or part-time, and not all of them offer health benefits.

If your hours or tips vary, estimate your 2027 income as carefully as you can and update HealthCare.gov when it changes. A slow winter and a busy summer average out over the year; the credit is based on the full-year total.

Who sells health insurance in Charleston County

For 2026, the South Carolina Department of Insurance listed four Marketplace insurers in Charleston County: Absolute Total Care (Ambetter), BlueCross BlueShield of South Carolina, Molina and Select Health of South Carolina.

The department had not published its 2027 county list as of mid-October 2026, and preliminary filings point to double-digit average rate increases statewide. Don’t assume your 2026 plan is still the best value. When window shopping opens on HealthCare.gov, compare every 2027 health insurance Charleston option side by side.

2027 savings by income in Charleston

Your premium tax credit depends on your household’s expected 2027 income. For 2027, the IRS caps your share of the benchmark Silver plan between 2.15% and 10.22% of income for households from 100% to 400% of poverty. Above 400%, there is no credit.

Households up to 250% of poverty also get cost-sharing reductions on Silver plans. The 2027 out-of-pocket maximum is $12,000 for one person. Read the 2027 subsidies guide and our affordable health insurance South Carolina hub for full tables.

Hurricane season and your Charleston plan

The Lowcountry faces hurricanes and frequent flooding. Charleston County Emergency Management publishes hurricane, evacuation and flooding guidance and a Hurricane Guide; its number is (843) 746-3800.

Add your insurance card, member ID and pharmacy information to your phone and your evacuation kit. Most plans cover emergency care anywhere in the U.S., but check how your plan handles prescriptions and non-emergency care while you’re away from home.

If a storm forces you to move or you lose job coverage afterward, you may qualify for a Special Enrollment Period, generally for 60 days, to enroll or change plans.

If you’re uninsured in Charleston right now

Several local options can help while you get coverage in place, or if you fall into the coverage gap.

• Fetter Health Care Network is a federally qualified health center with sites in Charleston, Berkeley, Colleton and Dorchester counties and a sliding-fee program. Main office: 51 Nassau Street; 843-722-4112.
• Barrier Islands Free Medical Clinic, 3226 Maybank Highway on Johns Island, provides free care to income-qualifying uninsured adults who live or work in Charleston, Berkeley or Dorchester counties.
• Charleston County Health Department, run by the SC Department of Public Health, is at 3685 Rivers Avenue, Suite 201, North Charleston; (843) 953-4713. See DPH public health clinics for services.

Children in families up to 213% of poverty may qualify for Healthy Connections Medicaid or CHIP even when parents don’t. Apply at apply.scdhhs.gov.

Students, new graduates and newcomers

Charleston draws students to the College of Charleston, The Citadel and MUSC, plus a steady stream of people relocating for jobs. Each group has its own coverage path.

• Under 26: you can usually stay on a parent’s plan, even if you live on your own or are married. Check whether that plan’s network actually reaches the Lowcountry.
• Under 30: catastrophic plans are an option. They have lower premiums but cover little until you hit a high deductible, and premium tax credits can’t be used on them.
• Just moved here: a permanent move to Charleston opens a 60-day Special Enrollment Period if you had qualifying coverage in the 60 days before the move.

For health insurance, Charleston newcomers also need to rebuild a care team. Pick a plan that includes a primary-care practice near home or work, so routine visits don’t mean a drive across the bridges.

2027 deadlines and enrollment help in Charleston

Open Enrollment runs November 1, 2026 to January 15, 2027. Enroll by December 15 for January 1 coverage; by January 15 for February 1. Full details are in our Open Enrollment 2027 guide.

Charleston is one of 15 counties where South Carolina’s CMS Navigator, Choose Healthy Life, offers in-person help for 2026–2027 (CMS). Book through localhelp.healthcare.gov.

Prefer to skip the drive? Honesty® Insurance Services, LLC is licensed in South Carolina and helps by chat, voice or text. See how Honesty.AI works, or compare with our Greenville health insurance guide if you’re moving upstate.

Frequently asked questions

Keep learning: read the South Carolina health insurance guide, the affordable health insurance South Carolina hub, our Greenville guide, and the 2027 subsidies guide.