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If you are not sure if you’re eligible for Medicaid programs using the guidelines below, we urge you to apply for Medicaid anyway OR apply for federally subsidized healthcare at Healthcare.gov . If you apply through Healthcare.gov and are eligible for Medicaid, they will automatically send us your application.
Apply for SC Medicaid
If you need help, please call our Member Help Center at (888) 549-0820. You can also visit SC Thrive for help filling out your application!
People who have Medicaid qualify for the program in one or more different eligibility categories. The Medicaid category or categories that you are in will determine the level of benefits and services you are eligible to receive and whether you need to choose a Managed Care Organization (MCO) to help manage your health care.
When you are approved for Medicaid, we will mail you a notice telling you which Medicaid category or categories you qualified for. You will also be informed whether you need to pick an MCO or not, and provided with instructions and next steps for how to proceed.
An applicant must be at least 65 years of age or blind or living with a disability.
If the Social Security Administration has not established disability, it will need to be determined before Medicaid eligibility can be established.
(At or below 100% of the Federal Poverty Level (FPL))
Family Size Monthly Income (Eff. 03/01/2026) Annual Income (Eff. 03/01/2026) Resources (Eff. 01/01/2026) 1 $1,330 $15,960 $9,950 2 $1,804 $21,640 $14,910
Individuals who are eligible will receive all Medicaid covered services.
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
Additional Information for Select Medicaid Programs (PDF) Authorization to Disclose Health Information – FM 921 (PDF) Adult Disability Report – FM 3218 ME (PDF) Disability Application Cover Letter – FM 3213-F ME (PDF) Adult Application Checklist – FM 3218-G ME (PDF)
Healthy Connections provides full Medicaid benefits to uninsured individuals who are found in need of treatment for breast or cervical cancer or pre-cancerous lesions (CIN 2/3 or atypical hyperplasia).
A person who may qualify for the Breast and Cervical Cancer program must:
Be under age 65
Be screened by a physician or through the South Carolina Breast and Cervical Cancer Early Detection Program-Best Chance Network (BCN) and found in need of treatment for one of the following: Breast cancer Cervical cancer Pre-cancerous lesions (CIN 2/3 or atypical hyperplasia)
Not have other insurance coverage that would cover treatment for breast or cervical cancer or pre-cancerous lesions (CIN 2/3 or atypical hyperplasia), including Medicare Part A or B
Be at or below 200% of the Federal Poverty Level (FPL) (BCN family income guideline)
Not be eligible for another Medicaid eligibility group
Family Size Monthly Income (Eff. 03/01/2026) Annual Income (Eff. 03/01/2026) 1 $2,660.00 $31,920.00 2 $3,607.00 $43,280.00 3 $4,554.00 $54,640.00 4 $5,500.00 $66,000.00 5 $6,447.00 $77,360.00 6 $7,394.00 $88,720.00 7 $8,340.00 $100,080.00 8 $9,287.00 $111,440.00 Each Additional Member $947.00 $11,360.00
Individuals who are eligible will receive all Medicaid covered services.
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
Additional Information for Select Medicaid Programs (PDF) Breast and Cervical Cancer Program Application Addendum 913-A (PDF)
Healthy Connections provides benefits to certain children with disabilities who would not ordinarily be eligible because their parents’ income and/or resources exceed the limit.
In 1981, the federal government created the Katie Beckett waiver, named after the child who inspired it, which allowed children to receive institutional care at home while retaining their Medicaid coverage, regardless of parents’ income. In 1982, the Tax Equity and Fiscal Responsibility Act (TEFRA) expanded the waiver.
A child who may be eligible for this program must:
Be age 18 or under
Be a U.S. Citizen or a Lawful Permanent Resident Alien
Be resident of South Carolina
Live at home
Meet the Supplemental Security Income (SSI) definition of disability
Have gross monthly income below $2,982 and countable resources at or below $2,000 (only the child's income and resources are counted)
Meet an institutional level of care. The three levels of care are: Intermediate care for the intellectually disabled (ICF-IID) Nursing facility (skilled or intermediate care) Hospital care
Meeting a level of care does not mean a child must be institutionalized.
In addition, it must be appropriate to provide care to the child at home. The estimated cost of caring for the child outside the institution does not exceed the estimated cost of treating the child in the institution.
(300% of the Federal Benefit Rate-FBR) January 1, 2026
Family Size Monthly Income Limit Individual $2,982
A child who meets these requirements is eligible for the full range of Medicaid covered services. If the child needs special services, which are available only under the home and community based waiver, they must apply for and be accepted into one of the waiver programs to receive these special services.
If you have a child with a disability or special health care need, Family Connection of South Carolina can provide you with information, support and hope for the future.
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
TEFRA Application Form
TEFRA Fact Sheet Child Under Age 19 Disability Report Disability Application Cover Letter FM 3218-F ME Childhood Application Checklist FM 3218-H ME Authorization to Disclose Health Information
Family Planning is available to individuals (men and women) whose annual family income is at or below 194% of the Federal Poverty Level (FPL).
Individuals who may be eligible for Family Planning must:
Be a South Carolina resident
Be a U.S. citizen or Lawful Permanent Resident Alien
Have a Social Security Number or verify an application for one
Be ineligible for full Medicaid coverage under any other eligibility category
Family Size Eff. 03/01/2026 Monthly Income Annual Income 1 $2,580.20 $30,962.40 2 $3,498.46 $41,981.60 3 $4,416.73 $53,000.80 4 $5,335.00 $64,020.00 5 $6,253.26 $75,039.20 6 $7,171.53 $86,058.40 7 $8,089.80 $97,077.60 8 $9,008.06 $108,096.80 Each Additional Member $918.26 $11,019.20
Family Planning is a limited-benefit program, which provides coverage for preventive health care, family planning services and family planning-related services. This program does not meet the standard for Minimum Essential Coverage under the Affordable Care Act. You may, however, still be eligible for federal programs that will help you pay for insurance through tax subsidies. To learn more about health insurance coverage options or qualifying for an exemption, visit www.healthcare.gov or call 1-800-318-2596.
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Family Planning Application Form
Healthy Connections provides benefits to individuals up to the age of 26 who were formerly in foster care.
A person who may qualify for the Former Foster Care program must:
Have been a Medicaid recipient at the time they aged out of foster care.
The individual is eligible through the end of the month of their 26th birthday as long as they are a resident of South Carolina.
Income is not considered for this coverage group.
Individuals who are eligible will receive all Medicaid covered services.
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
Authorized under Title XXI of the Social Security Act
Healthy Connections sponsors the payment of long-term care for individuals who reside in licensed and certified nursing facilities. The program also pays for special services for those individuals who participate in Home and Community-Based Services (HCBS) waivers and the Program for All-Inclusive Care of the Elderly (PACE). The same eligibility requirements apply for both programs. The difference is that the individuals who need nursing home care but who choose to stay at home rather than going to an institution, can receive special services through a waiver to help them remain at home.
Generally, an individual must be age 65 or older or blind or disabled. Disability is determined by using the Supplemental Security Income (SSI) guidelines. An individual who receives assistance through the Parent/Caretaker Relative program may also be eligible to participate in the home and community-based waiver.
Descriptions of these waiver programs, who is eligible and how you can apply are available on the waiver overview chart. A listing of what services are offered through each waiver is listed on the waiver comparison chart. Both documents are available on the Waivers page of SCDHHS' website .
A person who may qualify for these benefits must:
Be a South Carolina resident.
Be a U.S. citizen or Lawful Permanent Resident Alien.
Require nursing facility level of care either in the home or in a facility. If receiving care in the home, contact Healthy Connections for information about obtaining a Community Long Term Care (CLTC) determination prior to completing your application.
Reside in a medical institution or receive home and community-based waiver services or a combination of these services for a period of 30 consecutive days.
Have a Social Security number or verify an application for one.
Individuals may be eligible if they meet an income limit less than or equal to 300% of the current SSI Federal Benefit Rate (FBR). January 1, 2026.
Family Size Monthly Income Limit 1 (Individual) $ 2,982 Spousal Allocation $4,066.50
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
Application for Nursing Home, Residential or In-Home Care Additional Information for Nursing Home and In-Home Care
This Healthy Connections program sponsors inpatient hospital care for individuals meeting eligibility criteria.
A person who may qualify for the MIAP must:
Be a South Carolina resident
Be a U.S. citizen or Lawful Permanent Resident Alien
Inmates or residents of other governmental institutions are not eligible
Family income cannot exceed 200% of the Federal Poverty Level (FPL)
Additionally, an applicant’s resources and assets cannot exceed the following thresholds:
$35,000 limit on equity value
A family farm of 50 acres or less on which the applicant or his family has lived for at least 25 years is excluded from resources.
Equity interest in real property and taxable personal property (such as motor vehicles) cannot exceed a combined total value of $6,000
Assets in cash cannot exceed $500
An applicant with excess liquid assets may establish eligibility by spending the family's excess liquid assets on valid debts such as rent/mortgage, utilities and medical expenses.
Individuals who are eligible will receive all Medicaid covered services.
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
You can also contact your hospital's social services department for help.
Form 207
The OSS program is for individuals residing in approved, licensed Community Residential Care Facilities (CRCF) who meet Supplemental Security Income (SSI) eligibility requirements, except for income.
A person who may qualify for the OSS program must:
Be at least 65 years old or blind or disabled
Be a resident of a facility that is enrolled with SCDHHS to participate in the OSS program
Be a resident of South Carolina
Be a U.S. citizen or Lawful Permanent Resident Alien
Monthly Net Income Limit may not exceed $1,804 per month. The individual’s resources must not exceed $2,000. January 1, 2026.
Individuals receive full Medicaid benefits. In addition, state-funded cash assistance payment is provided to the facility.
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
Application for Nursing Home, Residential or In-Home Care Additional Information for Select Medicaid Programs
The Parent/Caretaker Relatives program (formally known as Low Income Families (LIF)) is established for parents or other caretaker relatives who meet financial eligibility criteria.
A person who may qualify for the Parent/Caretaker Relatives program must:
Have a dependent child living in the home
Show a specified degree of relationship to the child (Example: relative by blood, adoption or marriage)
Be a South Carolina resident
Be a U.S. citizen or a Lawful Permanent Resident Alien
Have a Social Security number or verify an application for one
(At or below 62% of the Federal Poverty Level (FPL))
Family Size Monthly Income (Eff. 03/01/2026) 1 $824.60 2 $1,118.06 3 $1,411.53 4 $1,705.00 5 $1,998.46 6 $2,291.93 7 $2,585.40 8 $2,878.86 Each Additional Member $293.46
Individuals who are eligible will receive all Medicaid covered services.
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
Healthy Connections provides health insurance plans for children who live in families that meet certain eligibility criteria.
A person who may qualify for the PHC program must:
Be under 19 years of age
Be resident of South Carolina
Be a U.S. citizen or a Lawful Permanent Resident Alien
Have a Social Security number or verify an application for one
(At or below 208% of the Federal Poverty Level (FPL))
Family Size Monthly Income (Effective 03/01/2026) 1 $2,766.40 2 $3,750.93 3 $4,735.46 4 $5,720.00 5 $6,704.53 6 $7,689.06 7 $8,673.60 8 $9,658.13 Each Additional Member $984.53
Individuals who are eligible will receive all Medicaid covered services.
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
The Partners for Healthy Children program was authorized under Title XXI of the Social Security Act. This program provides Medicaid coverage for children who live in families with income at or below 208% of the Federal Poverty Level. The available plans include Medicaid and the Children’s Health Insurance Program (CHIP).
Healthy Connections provides coverage to pregnant women with low income. This coverage for the mother continues for 12 months after the baby's birth. The infant is covered up to age one.
A woman who may qualify for this program must:
Be pregnant
Be a South Carolina resident
Be a U.S. citizen or Lawful Permanent Resident Alien
Have a Social Security number or verify an application for one
(At or below 194% of the Federal Poverty Level (FPL))
Family Size Eff. 03/01/2026 Monthly Income Annual Income 1 $2,580.20 $30,962.40 2 $3,498.46 $41,981.60 3 $4,416.73 $53,000.80 4 $5,335.00 $64,020.00 5 $6,253.26 $75,039.20 6 $7,171.53 $86,058.40 7 $8,089.80 $97,077.60 8 $9,008.06 $108,096.80 Each Additional Member $918.26 $11,019.20
Individuals who are eligible will receive all Medicaid covered services.
Apply Online Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
Provider Form FM 1716 – Request for Medicaid ID of Newborn
The Omnibus Budget Reconciliation Act of 1986 (OBRA 86) gave states the option to provide Medicaid coverage to pregnant women with low income.
This program may help pay your Medicare Part "B" Premiums. Healthy Connections will make a QMB determination for a Medicaid-eligible individual in any full benefits category if that individual is covered under Medicare Part A.
To be eligible as a QMB, an individual must be entitled to Medicare Part A and:
Be aged 65 or over or
Blind or
Disabled
QMB coverage offers payment of Medicare premiums, co-pays and deductibles.
(At or below 100% of the Federal Poverty Level (FPL))
FAMILY SIZE MONTHLY INCOME (Eff. 03/01/2026) ANNUAL INCOME (Eff. 03/01/2026) Resources (Eff. 01/01/2026) 1 $1,330 $15,960 $9,950 2 $1,804 $21,640 $14,910
Apply Online
Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
Additional Information for Select Medicaid Programs (PDF)
Section 303 of the Medicare Catastrophic Coverage Act of 1988 (MCCA) required the State Medicaid program to pay the premiums (Part A and/or B) and cost sharing for individuals/couples with limited resources and incomes at or below 100% of the Federal Poverty Level.
These programs may help pay your Medicare Part "B" Premiums.
Is entitled to Medicare Part A hospital insurance
Has countable resources below the limit ($9,950 for an individual and $14,910 for a couple)
Is not otherwise eligible for full Medicaid benefits
SLMB—(Above 100% or at or below 120% of the Federal Poverty Level (FPL))
QI—(Above 120% or at or below 135% of the Federal Poverty Level (FPL))
Family Size SLMB 120% (Eff. 03/01/2026) QI 135% (Eff. 03/01/2026) Resources (Eff. 01/01/2025) 1 (Individual) $1,596 $1,796 $9,950 2 (Couple) $2,164 $2,435 $14,910
For a SLMB or a QI, Healthy Connections is required to pay the Medicare Part B premium only. These individuals are not entitled to any other Medicaid benefits; therefore, they do not receive a Medicaid card.
Apply Online
Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
Additional Information for Select Medicaid Programs (PDF)
Section 4733 of the Balanced Budget Act of 1997 created an optional coverage group for working disabled individuals with family income below 250% of the Federal Poverty Level (FPL). This provision enabled states to provide the full range of Medicaid services to working disabled individuals with relatively high income. South Carolina adopted this option in its 1998 Appropriations Act. The South Carolina Medicaid program began covering these individuals effective October 1, 1998.
A person who may qualify for the Working Disabled program must:
Be under age 65
Be totally and permanently disabled according to the Supplemental Security Income (SSI) definition of disability
Be a South Carolina resident
Be a United States citizen or Lawful Permanent Resident Alien
Have a Social Security number or verify one has been applied for
Assign rights to medical support
Be working--have earned income
The income eligibility determination is a two-step process.
1. The first step determines if the family's total net income, after certain deductions, is at or must be less than 250% of the FPL for a family of that size.
2. The second step determines if the individual's unearned income is equal to or less than 100% of the FPL for an individual.
The applicant's countable resources must be below the $9,950 Aged, Blind or Disabled resource limit for an individual.
Family Size Monthly Income (Eff. 03/01/2026) Annual Income (Eff. 03/01/2026) 1 $3,325.00 $39,900.00 2 $4,509.00 $54,100.00 3 $5,692.00 $68,300.00 4 $6,875.00 $82,500.00 5 $8,059.00 $96,700.00 6 $9,242.00 $110,900.00 7 $10,425.00 $125,100.00 8 $11,609.00 $139,300.00 Each Additional Member $1,184.00 $14,200.00
For family sizes over 8 eight, add the amount shown for each additional person to income limit for 8 eight.
If applicant's household meets income requirement of 250% FPL, it must also be determined whether the applicant has unearned income equal to or less than 100% FPL.
Applicant's Unearned Income (Eff. 03/01/2025) Monthly Income Annual Income $1,330 $15,960
Individuals who meet these requirements are eligible for the full range of Medicaid covered services.
Apply Online
Or complete the following form(s) and submit it electronically to 8888201204@fax.scdhhs.gov , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or to your local county office .
Download Healthy Connections Application Form (PDF)
Additional Information for Select Medicaid Programs (PDF)
BabyNet is South Carolina's Individuals with Disabilities Education Act (IDEA) Part C program for infants and toddlers with disabilities and special needs.
Eligibility
An infant or toddler is determined eligible for BabyNet if they meet either of the following criteria:
Has a delay of 40% in one or more areas of development or has a delay of 25% in two or more areas of development
Has a diagnosed physical or mental condition (verified by a physician) that has a high probability of resulting in developmental delay and includes conditions such as chromosomal abnormalities; genetic or congenital disorders; sensory impairments; inborn errors of metabolism; disorders reflecting disturbance of the development of the nervous system; congenital infections; severe attachment disorders; complications of prematurity; and disorders secondary to exposure to toxic substances, including fetal alcohol syndrome
Income Limit
Income is not considered for BabyNet eligibility
Benefits
Children eligible for BabyNet will receive service coordination and other Part C services recommended by the Individualized Family Service Plan (IFSP) team. BabyNet also provides transition planning for families and toddlers with the local education agency (LEA) and other preschool options prior to the child's departure from Part C services.
Refer a Child to BabyNet