Health care costs can feel overwhelming in South Carolina, but Medicaid is there to help if you qualify. Called Healthy Connections Medicaid, this program gives medical coverage to low-income people.
Income limits matter a lot; they decide who gets in, and they shift each year with federal poverty levels. For 2025, it includes children, pregnant women, parents with kids, seniors, and folks who are aged, blind, or disabled.
South Carolina hasn’t expanded Medicaid, so adults without children or disabilities have fewer options.
What Is South Carolina Medicaid? (2025 Overview)
South Carolina’s Medicaid, known as Healthy Connections Medicaid, is handled by the South Carolina Department of Health and Human Services (SCDHHS).
It offers health care to low-income residents, such as kids, pregnant women, parents and caregivers, seniors over 64, and people who are aged, blind, or disabled. You can get doctor check-ups, hospital care, prescriptions, mental health support, dental for children, vision, and long-term help like nursing homes or home aides.
The state did not expand Medicaid under the Affordable Care Act, which means working adults without kids or disabilities usually can’t join. Services often have low or no out-of-pocket costs, making it easier for families to get the care they need.
South Carolina Medicaid Eligibility Requirements 2025
To join Healthy Connections Medicaid in South Carolina in 2025, you need to meet these key rules:
– Residency: You must live in South Carolina and plan to stay.
– Citizenship/Immigration: Be a U.S. citizen, national, or qualified immigrant, like a green card holder after five years. Some non-citizens can get emergency services.
– Income Requirements: Your earnings must be under the limits for your group, based on federal poverty level (FPL). It uses modified adjusted gross income for most people.
– Household Size: This includes you, your spouse, and tax dependents. For pregnant women, the unborn child counts too.
– Pregnant Women: Get higher limits and must show proof of pregnancy.
– Children & Teens: Cover up to age 18 with higher income cutoffs than adults.
– Aged, Blind, and Disabled (ABD): Prove your condition with Social Security or a doctor. Assets are checked.
– No Expansion for Low-Income Adults Without Kids: No coverage unless you have a disability or fit another special rule.
South Carolina Medicaid Income Limits 2025 (Overview)
In South Carolina, income is figured using modified adjusted gross income (MAGI) for groups like children and pregnant women.
For seniors or disabled people (non-MAGI), almost all income counts. Limits are based on federal poverty level percentages, without a 5% extra allowance in many cases.
Adults have lower limits since the state didn’t expand Medicaid, and parents max out near 100% FPL. This makes it harder for working families without children to qualify.
South Carolina Medicaid Income Limits Charts 2025
Adults (Parents/Caretaker Relatives) SC Medicaid Income Limits
For parents with children under 18: Up to 100% FPL.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $1,305 | $15,660 |
| 2 | $1,763 | $21,156 |
| 3 | $2,221 | $26,652 |
| 4 | $2,679 | $32,148 |
| 5 | $3,138 | $37,656 |
| 6 | $3,596 | $43,152 |
| 7 | $4,054 | $48,648 |
| 8 | $4,513 | $54,156 |
Pregnant Women Medicaid Income Limit in South Carolina
Up to 199% FPL; the unborn child counts in household size.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $2,597 | $31,164 |
| 2 | $3,508 | $42,096 |
| 3 | $4,420 | $53,040 |
| 4 | $5,331 | $63,972 |
| 5 | $6,244 | $74,928 |
| 6 | $7,156 | $85,872 |
| 7 | $8,067 | $96,804 |
| 8 | $8,980 | $107,760 |
Children’s Medicaid (South Carolina Healthy Connections Kids)
Up to 213% FPL for ages 0-18.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $2,780 | $33,360 |
| 2 | $3,755 | $45,060 |
| 3 | $4,731 | $56,772 |
| 4 | $5,706 | $68,472 |
| 5 | $6,683 | $80,196 |
| 6 | $7,659 | $91,908 |
| 7 | $8,635 | $103,620 |
| 8 | $9,612 | $115,344 |
Aged, Blind, Disabled Medicaid Income Limits SC 2025
Tied to 100% FPL or SSI levels.
| Household Size | Monthly Income Limit | Annual Income Limit | Asset Limit |
| 1 (Single) | $1,305 | $15,660 | $9,660 |
| 2 (Couple) | $1,763 | $21,156 | $14,470 |
South Carolina Long-Term Care Medicaid Income Limits 2025
For nursing homes or HCBS waivers: Up to 300% SSI.
| Category | Monthly Income Limit (Single) | Asset Limit (Single) | Spousal Income Allowance (Min–Max) | Spousal Asset Allowance (Min–Max) |
| Nursing Home | $2,901 | $2,000 | $2,644 – $3,948 | $31,584 – $157,920 |
| HCBS Waiver | $2,901 | $2,000 | $2,644 – $3,948 | $31,584 – $157,920 |
What Counts as Income for SC Medicaid in 2025?
South Carolina uses MAGI for most groups. It counts:
– Earned income like wages, tips, bonuses, and self-employment profits after deductions.
– Unearned income like interest, dividends, alimony, pensions, and taxable Social Security.
Things that don’t count:
– Child support.
– Tax refunds.
– Gifts or loans.
– SNAP benefits.
– Some scholarships.
– Holocaust payments.
– VA Aid & Attendance.
For ABD or long-term care, there are fewer things left out.
South Carolina Medicaid Household Size Rules 2025
South Carolina goes by tax rules for household size. Count yourself, your spouse, and anyone you claim as a dependent. If you don’t file taxes, include people you support more than half. For example, a married couple with no children is size two. A single mom with one kid is size two. A pregnant woman living alone is size two because the unborn child counts. In shared custody, the parent who claims the child on taxes usually counts them. If it’s confusing, use SCDHHS online tools to sort it out.
How to Apply for South Carolina Medicaid in 2025
1. Collect your papers: ID, Social Security number, pay stubs, tax returns, proof of where you live, and immigration docs if needed.
2. Apply online at apply.scdhhs.gov or scdhhs.gov.
3. Call 888-549-0820 if you want phone support.
4. Go to your county SCDHHS office for face-to-face help.
5. Send it in and wait. Most get an answer in 45 days, but disability cases take up to 90.
Community groups can assist if you need extra guidance.
South Carolina Medicaid Renewal Rules
You renew every year to hold onto your coverage. SCDHHS mails forms 45 days before your renewal date.
Update things like income, address, or family size with proof, such as recent pay stubs.
Tell them about any changes right away. If you skip renewal, your benefits end, but you can reapply fast.
Some get renewed automatically if your info lines up with their records.
Why South Carolina Medicaid Applications Get Denied
- Your income is too high for the group.
- Household size is listed wrong.
- Verification papers are missing.
- Issues with citizenship or immigration.
- You didn’t reply to SCDHHS questions.
FAQs
What are the South Carolina Medicaid income limits for 2025?
They differ by group: Parents up to $1,305 monthly for one person; pregnant $2,597; kids $2,780; ABD $1,305.
What is the income limit for a family of 3 for SC Medicaid in 2025?
Parents: $2,221 monthly; pregnant: $4,420; kids: $4,731; ABD isn’t based on household size that way.
Do pregnant women get higher Medicaid income limits in South Carolina in 2025?
Yes, they go up to 199% FPL, way above the parent limits.
Does SC Medicaid count rent or bills in 2025?
No, it looks at gross income after deductions, without subtracting living costs.
What is the SC Medicaid asset limit for 2025?
Most groups skip asset checks; ABD is $9,660 for singles; long-term is $2,000 for singles.
Do adults without children qualify for Medicaid in South Carolina in 2025?
No, not unless they’re disabled or aged, there’s no expansion.
How does South Carolina calculate Medicaid income in 2025?
It uses MAGI from your taxes, leaving out child support and refunds.
Does SC Medicaid offer a spend-down program in 2025?
Yes, for those who are medically needy: Spend extra income on medical bills to qualify.
What happens if my income goes slightly over the SC Medicaid limit in 2025?
Try the spend-down option or look into Marketplace health plans.
Does South Carolina Medicaid cover dental and vision in 2025?
It’s limited: Full dental for kids, emergencies for adults; vision mostly for children.
Final thoughts
South Carolina Medicaid lets you in if your income matches limits like 100% FPL for parents ($1,305 monthly for one) or 213% for kids ($2,780). Pregnant women hit 199% ($2,597), and ABD tops at $1,305 monthly. Apply online at scdhhs.gov or dial 888-549-0820. Limits update each year, so check back, reach out to SCDHHS for personal advice.
