From the Lowcountry charm of Charleston to the Upstate energy of Greenville and the resilient heart of Columbia, South Carolina’s Palmetto State blends coastal beauty with inland industry—but healthcare access remains a challenge for low-income families amid rising premiums. If you’re a parent in Myrtle Beach covering kids’ check-ups or a senior in Spartanburg managing medications on a fixed budget, the South Carolina Medicaid application—known as Healthy Connections—provides vital support with coverage for doctor visits, prescriptions, and long-term care.
In 2025, Medicaid serves over 1.2 million South Carolinians through programs like ABD for seniors and the Community Choices Waiver, managed by the Department of Health and Human Services (SCDHHS). With the “One Big Beautiful Bill” (signed July 4, 2025) ushering in $1 trillion in federal cuts through 2034, including work requirements and frequent eligibility checks, launching your South Carolina Medicaid application now is a wise move.
This detailed guide covers eligibility, income limits, required documents, and the full process—tailored for South Carolina’s coastal clinics, rural waivers, and urban hubs. Ready to take control? Start by estimating your benefits with the Medicaid Eligibility Calculator.
Eligibility for the South Carolina Medicaid Application
Before diving into the South Carolina Medicaid application, let’s clarify who qualifies. Medicaid isn’t just for the unemployed—it’s for working parents in Rock Hill, college students in Clemson, and retirees in Beaufort whose income fits state-federal guidelines. South Carolina, an expansion state, covers adults up to 138% FPL but limits childless adults without disabilities.
Core Eligibility Factors
- Household Composition: Your household includes everyone who lives with you, claimed on taxes, or sharing finances—spouses, kids, and dependents.
- Income Thresholds: Varies by program. Adults up to 138% FPL ($21,597/year for one). Children up to 200% FPL ($31,380/year for one). Pregnant women up to 199% FPL ($31,204/year for one). Seniors/disabled for long-term care up to $2,901/month. See Income for Medicaid Eligibility for details.
- Asset Rules: $2,000 for singles ($3,000 for couples) in most programs; exempt home equity under $713,000, one car, and personal items. No asset limit for children/pregnant women.
- Citizenship and Residency: U.S. citizens or qualified non-citizens living in South Carolina.
- Medical Need: For waivers like Community Choices, require nursing home level of care.
South Carolina’s expansion covers childless adults up to 138% FPL. The OBBBA adds work requirements (80 hours/month for adults 19–64 starting 2027) and 6-month eligibility checks from December 2026. Overlap with SNAP? Curious about costs? See Is Medicaid Free?.
South Carolina Medicaid Income Limits for 2025: Know Your Numbers
South Carolina’s Medicaid income limits vary by program and adjust annually (effective January 1, 2025). Expansion boosts adult access, but long-term care has caps.
Key Income Limits (Annual, 48 States/D.C.)
| Program/Group | Household Size 1 | Household Size 4 | Notes |
|---|---|---|---|
| Adults (Expansion) | $21,597 (138% FPL) | $43,194 (138% FPL) | Up to 138% FPL; no asset test. |
| Children | $31,380 (200% FPL) | $62,760 (200% FPL) | Up to age 19; CHIP up to 300%. |
| Pregnant Women | $31,204 (199% FPL) | $62,408 (199% FPL) | Covers prenatal/postpartum for 12 months. |
| Seniors/Disabled (Regular) | $11,604 (74% FPL) | $23,208 (74% FPL) | SSI-linked; $967/month single. |
| Nursing Home/Long-Term Care | $34,812 (300% SSI, $2,901/month single) | $69,624 (300% SSI, $5,802/month couple) | Income cap; spend-down available. |
Quick Math Tip: Use Modified Adjusted Gross Income (MAGI) for most; SSI methodology for seniors/disabled. Asset limit $2,000 single/$3,000 couple (exempt home under $713,000 equity). For SNAP overlap, see SNAP Benefits by State.
Essential Documents for Your South Carolina Medicaid Application
Streamline your South Carolina Medicaid application with these must-haves:
- Identification: Driver’s license, state ID, birth certificate, or Social Security card.
- Income Verification: Pay stubs (30 days), W-2s, tax returns, SSI/unemployment letters.
- Residency Proof: Utility bill, lease, or mail with South Carolina address.
- Household Info: Names, ages, relationships, SSNs for all members.
- Medical Proof: Doctor’s letter for disability/elderly waiver; pregnancy verification.
- Assets: Bank statements, property deeds for long-term care.
Digital uploads preferred; originals for in-person.
How to Apply for Medicaid in South Carolina: Step by Step
SCDHHS targets 30–45 day processing (10 days expedited for pregnant/children). Here’s the roadmap:
Step 1: Pre-Screen Your Odds
Test waters at scdhhs.gov/members/getting-started or the Medicaid Eligibility Calculator.
Step 2: Pick Your Path
- Online (Recommended): scdhhs.gov/apply. Sign up, fill digitally, upload—routed to your county office.
- Mail/Fax: Download from scdhhs.gov/forms. Send to your local SCDHHS office (list at scdhhs.gov/county-offices).
- In-Person: Visit a county SCDHHS office for guided help.
- Phone: Call 1-888-549-0820 or local county lines.
Elderly/disabled? Use Form 90 for waivers.
Step 3: Fill and Submit
Detail household, income, assets, medical needs. Sign it—e-sign or print.
Step 4: Interview Time
Phone or in-person within 30 days to chat details. Have docs ready.
Step 5: Decision Awaits
- Approved: Healthy Connections card mails 7–30 days; provider setup.
- Denied: Appeal notice—challenge in 90 days (coverage during for some).
- Expedited: 10-day fast lane for kids/pregnant.
Step 6: Activate and Track
Annual renewals; changes in 10 days. Track via scdhhs.gov/myaccount.
Pro Tips for a Seamless South Carolina Medicaid Application
- CHIP Focus: Children qualify up to 200% FPL—include school records.
- Waiver Perks: Community Choices Waiver covers home care—get doctor’s note early.
- Help Hotlines: South Carolina Legal Services (1-888-346-5592) or county offices.
- OBBBA Heads-Up: Work expansions 2027—document hours if applicable.
- Renewals: Use SCDHHS reminders—delays happen, appeals fix retroactively.
Frequently Asked Questions About the South Carolina Medicaid Application
How do I qualify for expedited Medicaid benefits in South Carolina?
To qualify for expedited Medicaid benefits in South Carolina, pregnant women and children under 21 get priority processing within 10 days, while emergencies (like labor or acute illness) can fast-track to 5 days. For the South Carolina Medicaid application, submit via scdhhs.gov/apply with proof like a doctor’s note for pregnancy or hospital records for urgent needs. This is crucial in rural areas like the Pee Dee, where access lags—county offices can assist with same-day intake.
What is the maximum Medicaid income limit in South Carolina for children?
The maximum Medicaid income limit in South Carolina for children through Healthy Connections is 200% of the Federal Poverty Level (FPL)—$31,380 annually ($2,615/month) for a single-parent household or $62,760 ($5,230/month) for a family of four in 2025. This covers kids up to age 19 with no asset test, making the South Carolina Medicaid application family-friendly. Include immunization records for faster approval, and it’s a lifeline for working parents in Charleston suburbs.
Can pregnant women apply for Medicaid in South Carolina without income proof?
Pregnant women in South Carolina can apply for Medicaid with presumptive eligibility, covering prenatal care immediately upon application—even without full income proof—up to 199% FPL ($31,204/year for one). The South Carolina Medicaid application via scdhhs.gov allows provisional approval based on self-attestation, with verification later. This ensures timely services in high-risk areas like the Lowcountry, where clinics partner with county offices for walk-in support.
Does South Carolina Medicaid cover long-term care for seniors?
South Carolina Medicaid covers long-term care for seniors through the Community Choices Waiver, with income up to $2,901/month ($34,812/year) for singles and assets under $2,000. The South Carolina Medicaid application requires a nursing home level of care assessment via Form 90—apply through your county office for home-based services like in-home aides, avoiding institutionalization. It’s vital for rural elders in the Upstate, where transportation to facilities is tough.
How often do I need to renew South Carolina Medicaid coverage?
South Carolina Medicaid renewal is annual for most programs, but the “One Big Beautiful Bill” mandates 6-month checks for expansion adults starting December 2026, requiring updated income proof via scdhhs.gov/myaccount. For children and pregnant women, it’s yearly—set reminders to avoid gaps. The South Carolina Medicaid application process includes auto-renewal notices, but respond within 30 days to keep coverage seamless, especially post-hurricane in coastal counties.
Final Thoughts: Take the First Step Today
The South Carolina Medicaid application is your accessible route to healthcare stability—eligibility varies by program (up to 200% FPL for kids), docs like ID/pay stubs, and apply via scdhhs.gov/apply or county offices. With OBBBA cuts on the horizon, seize the moment.
Plug your numbers into the Medicaid Eligibility Calculator for a quick estimate, dive deeper on Income for Medicaid Eligibility, or learn Is Medicaid Free?. Reach SCDHHS at 1-888-549-0820 or scdhhs.gov. Protect your health, South Carolina—you deserve it.