South Carolina · FIPS 45085
Sumter County, SC — ACA coverage
Marketplace plans, premium tax credit eligibility, and Medicaid options for residents of Sumter County, South Carolina. Updated 2026-06-08.
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Enrollee count is an estimate derived by evenly distributing the state's CMS plan-select total across counties; actual county enrollment varies with population.
How the Sumter County estimate is calculated
Methodology: ACA Beacon does not have county-level enrollment dashboards for every U.S. county. To give you a directional sense of marketplace activity in Sumter County, we take the most recent state-wide Open Enrollment Period (OEP) plan-selection total reported by CMSi (or the state-based marketplace) and divide it evenly by the number of counties in South Carolina.
Formula used here: 631,948 total state signupsi ÷ 46 South Carolina countiesi = ~13,738 estimated enrollees for Sumter County.
Uncertainty & limitations: Counties vary widely in population, income, and insurer participation. Urban counties typically enroll far more residents than rural ones. This number is a simple average, not a forecast or official CMS county report. Use it as a rough indicator of statewide penetration, not a precise local count.
Last updated 2026-06-08. Data source: CMS OEP state-level plan-selection reports.
ACA marketplace in Sumter County
Residents of Sumter County shop and enroll in ACA marketplace plans at www.healthcare.gov. Plans are rated by county, so available carriers and prices in Sumter may differ from elsewhere in South Carolina.
Carriers currently selling in South Carolina include: Ambetter from Absolute Total Care, BlueCross BlueShield of South Carolina, First Choice Next, InStil Health, Molina Healthcare, UnitedHealthcare. The final 2027 carrier list for Sumter County is confirmed when South Carolina filings finalize in summer 2026.
Premium tax credit eligibility
Premium tax credits (APTC) cap your monthly premium for a benchmark Silver plan at a percentage of household income — currently 0% at 150% FPL up to 8.5% at 400%+ FPL while Inflation Reduction Act enhancements remain in effect. Cost-sharing reduction (CSR) Silver plans further reduce deductibles for households under 250% FPL.
Use our free subsidy calculator or see the full South Carolina subsidy & income tables.
Medicaid & CHIP in Sumter County
South Carolina has not adopted ACA Medicaid expansion, so adults without dependents in Sumter County may fall into the coverage gap below 100% FPL. Premium tax credits on the marketplace begin at 100% FPL.
Healthy Connections (Medicaid for Kids) covers children up to 213% FPL; pregnancy Medicaid covers up to 199% FPL. Apply year-round at www.scdhhs.gov/program/healthy-connections-medicaid · 1-888-549-0820.
Open Enrollment & SEP
2026 OEP in South Carolina: November 1, 2026 – December 15, 2026. Missed it? You may still enroll within 60 days of a qualifying life event (job loss, marriage, birth, move, income change). See South Carolina OEP & SEP details.
Other South Carolina counties
Sources
- South Carolina marketplace(opens in a new tab)
- HealthCare.gov subsidies(opens in a new tab)
- KFF Medicaid expansion tracker(opens in a new tab)
- U.S. Census county FIPS reference(opens in a new tab)
- CMS CHIP & Medicaid(opens in a new tab)
- CMS OEP state-level plan-selection reports(opens in a new tab)
- CMS 2026 Star Ratings(opens in a new tab)
The information contained on this website is for educational purposes only. We are not responsible for missing or inaccurate information. Please consult a licensed insurance broker in your state and area for insurance advice. Please consult a CPA for tax or legal advice.