SC Plan Benefits – 2016

As your #1 source for 2016 South Carolina Health Plan information, has compiled plan benefits and benefit summaries for Qualified Health Plans on the Federal Marketplace Exchange. Feel free to browse the benefit summaries below and contact us to get enrolled or to answer any questions you may have.


2014 SC Plan Benefits

2016 SC Plan Benefits: QHP Benefits Summaries

BlueCross Blueshield of South Carolina:

Gold Plans

Silver Plans

Bronze Plans

Bluechoice Healthplan of South Carolina:  Stay Tuned!

Aetna/CoventryOne: CLICK HERE



Nationwide, the average premium for a middle-of-the-road plan purchased through a health care marketplace/exchange will be approximately $328 a month, according to the report from the Department of Health and Human Services. In South Carolina, it will be $339.

When shopping for a 2016 South Carolina Qualified Health Plan, it is important to compare options. Using a brochure of 2016 SC plan benefits from each insurer is a great way to compare options. The plan benefits guides are a basic outline of coverage. As always, you should refer to the full policy for additional information on plan benefits and exclusions. In addition to using your 2014 SC plan benefits brochure, you should also refer to you provider directory for each Qualified Health Plan (QHP) that you consider.

Although all qualified health plans must provide a minimum standard of SC Plan Benefits, it is very important to pay close attention to the fine print. Details such as out of network benefits, prescription deductibles, copays and coinsurance are very important when comparing SC plan benefits.


SC Plan Benefits 2016 Coverage Options

Plans sold in the new marketplace fall into one of four categories: bronze, silver, gold or platinum. Insurers who participate in the federal exchange/marketplace must offer at least one silver and one gold plan.  The different benefit categories represent what an average enrollee would pay out-of-pocket when he/she receives care. If you purchase a bronze plan, you will have to pay a higher portion of the total cost of the care you receive than you would if you
had a gold plan. Of course, bronze plans will have lower premiums, they will have higher deductibles, co-pays and coinsurance levels that will increase your costs if you need medical care. The levels of coverage are:
• Bronze: the plan pays, on average, 60%; consumer pays 40%
• Silver: the plan pays, on average, 70%; consumer pays 30%
• Gold: the plan pays, on average, 80%; consumer pays 20%
• Platinum: the plan pays, on average, 90%; consumer pays 10%

All plans must cover 10 essential health benefits (EHBs): outpatient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services. Your state may require plans to offer additional benefits on top of the EHB.

For more info: