14.1% of under-65 residents in Horry County were uninsured in 2024 — about 41,090 people — which is modestly above the South Carolina average of 11.2% and makes it the 5th highest of the 46 counties in South Carolina. Close enough to the state figure that the county is not an outlier; far enough that coverage gaps here are a real feature rather than a rounding artifact.
Horry County against South Carolina, and against the counties we cover
| Horry County | South Carolina | Covered counties | |
|---|---|---|---|
| Uninsured, under 65 | 14.1% | 11.2% | 13.0% |
| Marketplace enrollees per 1,000 | 175 | — | 127 |
| Insurers selling here | 3 | 4 (median) | 5 |
| Individual plans offered | 48 | — | 84 |
State uninsured rate from the Census SAHIE series; the final column is the median across the 104 counties covered on this site. Enrollment density is CMS plan selections per 1,000 under-65 residents.
What you can actually buy here
3 insurers compete here. That is thin enough that switching carrier usually means switching hospital system too, and wide enough that the premiums genuinely differ. Both things are worth checking before either is dismissed. Between them they offer 48 plans, about 16 for each insurer, a short list by national standards. Short lists are easier to compare properly, which is a real advantage as long as one of them fits your doctors. The count is up from 2 last year. Insurers entering a county usually means they like what they see in the risk pool, and it tends to show up as more aggressive pricing the following year rather than immediately.
50,985 marketplace plan selections were recorded in Horry County for 2026, or 175 per thousand under-65 residents — above the 127 typical of the counties covered here. Enough people locally have done this that the process is not unfamiliar territory. Only 7,075 were new consumers against 43,910 renewals — a 14% new share. A settled, returning population like that means the plans on offer have been chosen by the same people repeatedly, which is a reasonable signal that the networks hold up.
Nearest counties on coverage
The counties we cover in South Carolina whose uninsured rate sits closest to Horry County. Worth a look if you are comparing across a county line or moving.
| County | Uninsured | Insurers | Enrollees |
|---|---|---|---|
| Spartanburg County | 12.4% | 4 | 34,501 |
| Greenville County | 11.5% | 3 | 60,999 |
| Anderson County | 11.4% | 3 | 22,487 |
| Lexington County | 10.8% | 3 | 30,689 |
| Aiken County | 10.4% | 3 | 17,741 |
| Richland County | 10.3% | 4 | 46,217 |
Everything that applies in South Carolina · How COBRA works · Work out your COBRA premium · After a job ends
Common questions
How many people are uninsured in Horry County?
About 41,090 people under 65, out of 291,194 in that age group — 14.1%, the 5th highest of the 46 counties in South Carolina. The South Carolina average is 11.2%. Census Bureau estimates for 2024, the most recent published.
How many health insurers sell in Horry County?
3 insurers offer individual marketplace plans in Horry County for 2026, up from 2 the year before, and between them they sell 48 individual medical plans. The median across the counties covered on this site is 5 insurers and 84 plans.
How many people in Horry County buy marketplace coverage?
50,985 plan selections for 2026 — 7,075 new consumers and 43,910 renewals. That works out at 175 per thousand under-65 residents, against a median of 127 across the counties covered here. New consumers are the group most likely to have lost a job during the year.
Talk it through with a licensed agent
Which option is right depends on your state, your income and which doctors you need to keep. A licensed agent can walk through it with you in about eight minutes.
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Sources
- U.S. Census Bureau, Small Area Health Insurance Estimates, 2024 (released August 2026)
- Centers for Medicare & Medicaid Services, 2026 Marketplace Open Enrollment County-Level Public Use File
- Centers for Medicare & Medicaid Services, 2026 Service Area Public Use File
- Centers for Medicare & Medicaid Services, 2026 Plan Attributes Public Use File
- U.S. Department of Labor, FAQs on COBRA Continuation Health Coverage for Workers