South Carolina Medicaid Income Limits 2026: Eligibility Guide & Charts

South Carolina Medicaid — called Healthy Connections — has income limits that vary by program and household size.

For most families in 2026, the limits range from $824.60/month for a single parent to $2,982/month for nursing home care.

This guide covers every Healthy Connections program, income limit, and step to apply.

Quick Summary:

• What Medicaid covers: Doctor visits, hospital care, prescriptions, mental health, and more
• Who qualifies: Families, pregnant women, seniors, people with disabilities, and children
• Income limits: Range from 62% to 250% of the Federal Poverty Level (FPL), depending on your program
• No expansion: SC has not adopted ACA Medicaid expansion — childless adults without a disability may not qualify
• How to apply: Online at scdhhs.gov, by phone, or in person
• 👉 Use our free Medicaid Eligibility Calculator 2026 to check your status in minutes

What Is Medicaid?

Medicaid is a free or low-cost health insurance program run by the federal and state governments together. It pays for medical care for people with limited income and resources.

In South Carolina, the program is called Healthy Connections Medicaid and is managed by the SC Department of Health and Human Services (SCDHHS).

Medicaid is different from Medicare. Medicare is for people 65+ or with certain disabilities. Medicaid is based on your income and family size.

Learn more at Medicaid.gov or the ACA and Medicaid overview at Healthcare.gov.

Who Qualifies for Medicaid in South Carolina 2026?

South Carolina Medicaid covers several specific groups of people. You generally must be a SC resident and a U.S. citizen or Lawful Permanent Resident. Income and sometimes asset limits apply to each group.

Here is a quick overview of who may qualify:

Important: South Carolina has not expanded Medicaid under the ACA. If you are a low-income adult without children and are not elderly or disabled, you likely do not qualify for Healthy Connections at this time.

Medicaid Income Limits in South Carolina 2026

Income limits in South Carolina are based on the Federal Poverty Level (FPL) or the SSI Federal Benefit Rate (FBR), depending on your program.

The limits below are effective March 1, 2026 (FPL-based) or January 1, 2026 (FBR-based), as published by SCDHHS.

To compare how South Carolina stacks up nationally, see the full Medicaid income limits by state 2026 breakdown on our site.

Aged, Blind, or Disabled (ABD) — 100% FPL

Applicants must be 65+, blind, or have a disability verified by the Social Security Administration.

Parent/Caretaker Relatives — 62% FPL

For parents or caretaker relatives living with a dependent child. South Carolina’s limit here is one of the lowest in the country.

Resource limit: $3,000

Pregnant Women and Infants — 194% FPL

Coverage extends to the mother for 12 months postpartum. The infant is covered up to age one.

Partners for Healthy Children (CHIP) — 208% FPL

For children under age 19 who do not qualify for regular Medicaid.

Breast and Cervical Cancer Program — 200% FPL

For women under 65 screened through SC’s Best Chance Network who need cancer treatment.

Family Planning — 194% FPL

For men and women who do not qualify for full Medicaid. This is a limited-benefit program covering family planning services only.

Working Disabled Program — 250% FPL (Step 1) + 100% FPL (Step 2)

For disabled adults under 65 who are employed. This program uses a two-step income test.

Step 1 — Household Net Income at or below 250% FPL:

Step 2 — Individual Unearned Income at or below 100% FPL: $1,330/month ($15,960/year) Resource limit: $9,950

Disabled Children (Katie Beckett / TEFRA) — 300% FBR

For children age 18 or under living at home. Only the child’s income and resources are counted — parents’ income is excluded.

Resource limit: $2,000

Nursing Home / HCBS Waivers — 300% FBR

For adults who need nursing-facility level of care, either in a facility or through a home and community-based services (HCBS) waiver.

Spousal income protection: The non-applicant spouse is protected at $4,066.50/month minimum. Home equity limit: $752,000 (if no qualifying dependent lives in the home).

Optional State Supplementation (OSS)

For people 65+, blind, or disabled who live in a SCDHHS-enrolled residential care facility.

• Monthly Net Income Limit: $1,804 (effective January 1, 2026)
• Resource Limit: $2,000

Medicare Savings Programs (for Dual-Eligibles)

These programs help pay Medicare costs for people who have both Medicare and low income.

Qualified Medicare Beneficiaries (QMB) — 100% FPL

Covers Medicare premiums, co-pays, and deductibles.

Specified Low Income Medicare Beneficiaries (SLMB) — 120% FPL

Qualifying Individuals (QI) — 135% FPL

SLMB and QI cover Medicare Part B premium only — no full Medicaid card.

Medically Indigent Assistance Program (MIAP) — 200% FPL

For SC residents who need inpatient hospital care and do not qualify for other Medicaid.

• Income limit: 200% FPL (varies by family size — see Breast & Cervical Cancer table above for matching figures)
• Asset limits: Primary residence equity ≤ $35,000 | Personal property equity ≤ $6,000 | Cash ≤ $500

Former Foster Care (up to Age 26)

If you received Medicaid when you aged out of foster care in SC, you may keep coverage through the end of the month of your 26th birthday. Income is not counted.

BabyNet — Early Intervention

For infants and toddlers under age 3 with a developmental delay of 40%+ in one area (or 25%+ in two or more areas). Income is not counted.

Section 1619(b) — Working SSI Beneficiaries

SSI recipients who work and earn too much for a cash SSI payment may still keep Medicaid. South Carolina’s 2026 threshold is $44,963/year in gross earnings — up from $41,539 in 2025. This is verified by the Social Security Administration.

Summary: All SC Medicaid Income Limits at a Glance (2026)

Sources: SCDHHS Program Eligibility and Income Limits page, effective 03/01/2026 and 01/01/2026. SSA Section 1619(b) Threshold Table, 2026.

What Does Medicaid Cover in South Carolina?

Healthy Connections Medicaid pays for a wide range of health services. Most full-benefit programs cover the same core set of services.

Here is what is typically covered:

• Doctor visits — primary care, specialist visits, and preventive care
• Hospital care — inpatient and outpatient services
• Prescription drugs — covered medications through the Healthy Connections pharmacy benefit
• Mental health and substance use treatment — counseling, therapy, and crisis services
• Pregnancy and delivery — prenatal care, labor and delivery, postpartum care
• Dental care — limited dental services for adults; more comprehensive for children
• Vision care — eye exams and eyeglasses (especially for children)
• Home health services — skilled nursing, therapy at home
• Long-term care — nursing home care and HCBS waiver services
• Transportation — non-emergency medical transportation to appointments

Understanding what services are billed to Medicaid is also important. You can review the Medicaid fee schedule 2026 to see how providers are reimbursed for covered services in South Carolina.

How to Apply for Medicaid in South Carolina 2026

Applying for Healthy Connections is free. There are four ways to apply.

Step-by-Step: How to Apply Online

1. Go to scdhhs.gov — Click “Apply for Benefits”
2. Create an account or log in if you already have one
3. Fill out the application — include your household size, income, and personal information
4. Upload documents — proof of identity, income, residency, and citizenship
5. Submit your application — you will receive a confirmation number
6. Wait for a decision — SCDHHS must notify you within 45 days of a completed application

Other Ways to Apply

• By phone: Call SC Healthy Connections Resource Center at 1-888-549-0820
• By mail or fax: SCDHHS Central Mail, P.O. Box 100101, Columbia, SC 29202-3101
• In person: Visit any SCDHHS county office, a federally qualified rural health center, or most hospitals in SC

What Documents Do You Need?

Gather these items before you apply:

• Photo ID (driver’s license, state ID, or passport)
• Proof of income (pay stubs, tax returns, or benefit award letters)
• Proof of SC residency (utility bill, lease, or mail)
• Social Security Number for each household member applying
• Proof of citizenship or immigration status
• Proof of pregnancy if applying for the pregnant women’s program

What Happens After You Apply?

After you submit your Healthy Connections application, SCDHHS will review it and send you a written notice. The standard decision timeline is within 45 days. For disability-based programs, it may take longer.

What to Expect

• You may get a call or letter asking for more documents — respond quickly to avoid delays
• If approved, you will receive a Healthy Connections Medicaid card in the mail
• Your coverage start date is usually the first day of the month you applied, in some cases even earlier
• If denied, you have the right to appeal the decision — your notice will explain how

Renewals and Redeterminations

Your Medicaid coverage must be renewed each year. SCDHHS will send you a renewal notice before your coverage ends. You must update your income, household size, and contact information. If you miss the renewal, your coverage may stop.

About the Medicaid Expansion Gap in South Carolina

South Carolina has not expanded Medicaid under the Affordable Care Act (ACA). As of April 2026, it remains one of 10 states that have not adopted expansion. This creates a coverage gap for certain adults.

• Adults earning between 0–100% FPL who are not elderly, disabled, pregnant, or a parent of a minor child have no pathway to full Medicaid in SC
• Expansion bills (H3109, H4383) were introduced in the 2025–2026 SC legislative session but have not been enacted
• SC remains a non-expansion state per KFF’s March 2026 tracking

If you fall into this coverage gap, you may want to explore other options such as free community health centers or charity care programs at local hospitals.

2026 Policy Updates for SC Medicaid

Several changes took effect in 2026 for Healthy Connections members:

• Dual Special Needs Plans (D-SNPs): Starting January 2026, SC Medicaid members who also have Medicare can enroll in managed care through D-SNPs. This includes both HIDE D-SNPs (for long-term services and behavioral health) and Coordination Only (CO) D-SNPs.
• Governor’s FY 2026–2027 Budget: Governor McMaster proposed $102.6 million to maintain current Medicaid services, $53.1 million for Medicare premiums for elderly and disabled members, and $47.3 million to expand home and community-based services.
• Federal Medicaid Legislation: Proposed federal changes (“One Big Beautiful Bill Act”) include new Medicaid work requirements. However, because SC has not expanded Medicaid, these requirements apply mainly to the expansion population — most current SC Medicaid recipients will not be directly affected.

Frequently Asked Questions (FAQ)

Sources & Disclaimer

Sources:

• SC Department of Health and Human Services — Program Eligibility and Income Limits: scdhhs.gov (effective 03/01/2026 and 01/01/2026)
• Social Security Administration — Section 1619(b) Threshold Table 2026: ssa.gov
• Medicaid.gov — Federal Medicaid Program Information: medicaid.gov
• KFF — Medicaid Expansion Status, March 2026: kff.org
• Healthcare.gov — Medicaid and CHIP Overview: healthcare.gov/medicaid-chip

Last Updated: April 2026

Disclaimer: CheckMedicaid.com is not affiliated with any government agency. This content is for educational purposes only. For official eligibility determinations, contact SCDHHS at 1-888-549-0820 or visit Medicaid.gov.