South Carolina health plan · 2025

UHC Gold Advantage · 33764SC0030001

UnitedHealthcare of South Carolina, Inc. offers this marketplace health insurance plan (Plan ID 33764SC0030001) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Gold Plan type: HMO CSR: Limited Cost Sharing Plan Variation Issuer: UnitedHealthcare of South Carolina, Inc.
Telehealth Data pending HSA eligible No Dental Child Vision Child

Issuer actuarial value: 78.38%. Expect to pay roughly 21.62% of covered costs out of pocket, based on issuer reporting.

2025 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$295 – $1766

Before subsidies

Estimate after subsidies

Deductible

$1,200

$2400 per group

See deductible details

Max out-of-pocket

$7,500

$15000 per group

Review MOOP rules

Office visits

Primary care $15.00
Specialist $50.00
HSA Not eligible

Drug tiers

Generic $1.00
Preferred brand $50.00

View formulary tiers

$612 / mo before subsidies

≈ $7343 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$1586 / mo before subsidies

≈ $19035 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1849 / mo before subsidies

≈ $22182 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1292 / mo before subsidies

≈ $15499 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

20.00% Coinsurance after deductible

Durable Medical Equipment

20.00% Coinsurance after deductible

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Enrollment guidance

Stay on top of 2025 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in South Carolina). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Limited Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

20.00% Coinsurance after deductible

Durable Medical Equipment

20.00% Coinsurance after deductible

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 33764SC0030001
Coverage year 2025
State South Carolina
Issuer UnitedHealthcare of South Carolina, Inc.
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 33764SC0030001-03
Available variants

Standard Off Exchange Plan · 33764SC0030001-00

Standard On Exchange Plan · 33764SC0030001-01

Open to Indians below 300% FPL · 33764SC0030001-02

Open to Indians above 300% FPL · 33764SC0030001-03

Last plan update Fri, 13 Sep 2024 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in South Carolina 8973
PCPs in South Carolina 1299
Telehealth support Data pending
Nationwide providers 20372
8,973 doctors statewide 1,299 PCPs 50 OB/GYN
Providers South Carolina All US states
All 8973 20372
PCP 1299 1549
Allergy 5 6
OB/GYN 50 69
Dentists 13 18

Drug coverage overview

3,711 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
PREFERRED-GENERIC 1,439
NON-PREFERRED-BRAND 1,429
SPECIALTY 422
ZERO-COST-SHARE-PREVENTIVE 421
Prior authorization Drugs
Required 662
Not Required 3,049
Step therapy Drugs
Required 51
Not Required 3,660
Quantity limits Drugs
Has Limit 1,713
No Limit 1,998

Customer highlights

What stands out for members

  • Issuer: UnitedHealthcare of South Carolina, Inc. · Plan ID 33764SC0030001 · 2025 filing.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 33764SC0030001-03 (Open to Indians above 300% FPL) currently displayed.
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Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

20.00% Coinsurance after deductible

Diabetes Education

20.00% Coinsurance after deductible

Home Health Care Services

20.00% Coinsurance after deductible

Laboratory Outpatient and Professional Services

$10.00

Other Practitioner Office Visit (Nurse, Physician Assistant)

20.00% Coinsurance after deductible

Preventive Care/Screening/Immunization

No Charge

Primary Care Visit to Treat an Injury or Illness

$15.00

Rehabilitative Occupational and Rehabilitative Physical Therapy

$50.00

Rehabilitative Speech Therapy

$50.00

Specialist Visit

$50.00

Urgent Care Centers or Facilities

$50.00

X-rays and Diagnostic Imaging

$35.00

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

$500.00 Copay after deductible

Delivery and All Inpatient Services for Maternity Care

20.00% Coinsurance after deductible

Dialysis

$500.00 Copay after deductible

Durable Medical Equipment

20.00% Coinsurance after deductible

Emergency Room Services

20.00% Coinsurance after deductible

Emergency Transportation/Ambulance

20.00% Coinsurance after deductible

Hospice Services

20.00% Coinsurance after deductible

Inpatient Hospital Services (e.g., Hospital Stay)

20.00% Coinsurance after deductible

Inpatient Physician and Surgical Services

20.00% Coinsurance after deductible

Mental/Behavioral Health Inpatient Services

20.00% Coinsurance after deductible

Mental/Behavioral Health Outpatient Services

$35.00

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

$300.00

Outpatient Rehabilitation Services

$50.00

Outpatient Surgery Physician/Surgical Services

$300.00

Radiation

$75.00 Copay after deductible

Skilled Nursing Facility

20.00% Coinsurance after deductible

Substance Abuse Disorder Inpatient Services

20.00% Coinsurance after deductible

Substance Abuse Disorder Outpatient Services

$35.00

Transplant

20.00% Coinsurance after deductible

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

20.00% Coinsurance after deductible

Hearing Aids

Coverage details pending

Major Dental Care - Child

20.00% Coinsurance after deductible

Prenatal and Postnatal Care

No Charge

Routine Eye Exam for Children

No Charge

Well Baby Visits and Care

No Charge

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$1.00

Non-Preferred Brand Drugs

30.00% Coinsurance after deductible

Preferred Brand Drugs

$50.00

Specialty Drugs

40.00% Coinsurance after deductible

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

20.00% Coinsurance after deductible

Basic Dental Care - Adult

Coverage details pending

Dental Check-Up for Children

No Charge

Infusion Therapy

$75.00 Copay after deductible

Major Dental Care - Adult

Coverage details pending

Nutritional Counseling

20.00% Coinsurance after deductible

Orthodontia - Adult

Coverage details pending

Orthodontia - Child

50.00% Coinsurance after deductible

Prosthetic Devices

20.00% Coinsurance after deductible

Routine Dental Services (Adult)

Coverage details pending

Weight Loss Programs

Coverage details pending

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Acupuncture

Coverage details pending

Allergy Testing

$50.00

Bariatric Surgery

Coverage details pending

Cosmetic Surgery

Coverage details pending

Eye Glasses for Children

20.00% Coinsurance after deductible

Gender Affirming Care

$300.00

Habilitation Services

$50.00

Imaging (CT/PET Scans, MRIs)

$200.00 Copay after deductible

Infertility Treatment

Coverage details pending

Long-Term/Custodial Nursing Home Care

Coverage details pending

Private-Duty Nursing

Coverage details pending

Reconstructive Surgery

$300.00

Routine Eye Exam (Adult)

Coverage details pending

Routine Foot Care

Coverage details pending

Treatment for Temporomandibular Joint Disorders

Coverage details pending

Variant attributes

UHC Gold Advantage · Variant 33764SC0030001-03

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2025

CSR Variation Type

Limited Cost Sharing Plan Variation

HIOS Product ID

33764SC003

Metal Level

Gold

Plan ID (Standard Component ID with Variant)

33764SC0030001-03

Plan Marketing Name

UHC Gold Advantage

Plan Variant Marketing Name

UHC Gold Limited Advantage

Issuer & service area

Issuer-provided metadata for this variant.

Issuer Actuarial Value

78.38%

Issuer ID

33764

Issuer Marketplace Marketing Name

UnitedHealthcare

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

SCN011

Out of Country Coverage

No

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Plan covers eligible expenses provided by a Network Physician or other provider or facility within the Network Area. The Network Area may include select Network providers located in a neighboring state. The plan also covers emergency health care services received outside the service area.

Service Area ID

SCS011

State Code

SC

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$0

SBC Scenario, Having a Baby, Copayment

$0

SBC Scenario, Having a Baby, Deductible

$0

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$0

SBC Scenario, Having Diabetes, Deductible

$0

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$0

SBC Scenario, Treatment of a Simple Fracture, Deductible

$0

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

20.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$15000 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$7500 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$7,500

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

Not Applicable

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

SCF032

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$0

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Not Applicable

EHB Percent of Total Premium

1.0

First Tier Utilization

100%

Import Date

2024-09-13 01:01:48

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

No

New/Existing Plan

Existing

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

No

Plan Effective Date

2025-01-01

Plan Level Exclusions

Some exclusions may apply. See the applicable Certificate of Coverage for details.

Plan Type

HMO

QHP/Non QHP

Both

Source Name

HIOS

Plan ID

33764SC0030001

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group

$2400 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person

$1200 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$1,200

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Individual

Not Applicable

Unique Plan Design

Yes

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in South Carolina?

UHC Gold Advantage (33764SC0030001) is a Gold HMO from UnitedHealthcare of South Carolina, Inc. in South Carolina for the 2025 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does UHC Gold Advantage support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is UHC Gold Advantage HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental add-ons: Child.

Vision add-ons: Child.

Does UHC Gold Advantage support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Is there out-of-country coverage for UHC Gold Advantage?

No, out-of-country services are not covered for this plan.

Does UHC Gold Advantage cover care outside the service area?

Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Plan covers eligible expenses provided by a Network Physician or other provider or facility within the Network Area. The Network Area may include select Network providers located in a neighboring state. The plan also covers emergency health care services received outside the service area.

How do I enroll in or manage payments for UHC Gold Advantage?

Use the issuer portal https://sso.uhc.com/ext/sp/ACS.saml2 to pay premiums or start enrollment, then return to HealthPorta for benefit comparisons.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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