How to Get South Carolina Medicaid Benefits | Best Answers

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We have scoured the internet to provide all you need to know about the South Carolina Medicaid Benefits.

Medicaid is a joint federal-state program that provides health insurance to low-income individuals who meet certain requirements, including kids, pregnant women, the elderly, and individuals with disabilities. Applying for Medicaid in person, via telephone, or online is simple.

This post will teach you all you need to learn about Medicaid in South Carolina.

What is the South Carolina Medical Program?

South Carolina Medicaid is a service for people and families with income and resources that fall within certain parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.

Who is eligible for the South Carolina Medical Program?

South Carolina Medicaid offers certain limited Medicare beneficiaries who are not eligible for the full Medicaid benefit package some partial financial help with Medicare premiums and copayments or coinsurance through the Medicare Savings Plan.

  • Expectant mothers
  • People who are blind or disabled or who have a spouse who is blind or disabled; 
  • People whom someone adopts;
  • People whom someone adopted; 
  • People who are blind or disabled or have a spouse who is disabled.

The Annual Household Income Limits (before taxes)

Household Size*The Maximum Income Level (Per Year)

*For households with more than eight people, add $4,720 per additional person.

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How do I contact Medicaid in South Carolina?


(888) 549-0820

Mailing Address

Department of Social Services 

P.O. Box 1520. Columbia, SC 29202-1520.


What are the Medicaid plans in South Carolina?

Managed care organizations (MCOs)

In South Carolina, all Medicaid recipients South Carolina Medicaid covers others. 

Since 1996, South Carolina has operated a robust managed care organization (MCO) program that provides acute, primary, specialty care services and outpatient behavioral health for select children, pregnant women, and non-dual eligible adults with disabilities.

Medical Homes Network (MHN)

The majority of Medicaid recipients in the state who are qualified for voluntary enrollment can get acute, primary, and specialty care as well as behavioral health treatments through the Medical Homes Network (MHN) program. 

This county-wide augmented primary care case management program (PCCM) makes these arrangements through networks of primary care clinicians.

The state switched over to an MCO system of service delivery from the PCCM program. 

Before the introduction of the Healthy Interconnection Choices program in 2006, enrollment counselors were not available to assist beneficiaries who needed to select one of the three Medicaid delivery models available in the state.

Delivery models include an MCO, the new PCCM program, or the conventional fee-for-service (FFS) option.

For more details regarding Medicaid plans in South Carolina, visit here.

How do I apply for South Carolina Medicaid?

Call (888) 549-0820 to enroll. 

Apply in person at the Barbara Roberts Human Services Building.

Online:  Download and print the application.

Department: Department of Social Services 

Mail: To P.O. Box 1520. Columbia, SC 29202-1520.


What does South Carolina Medicaid cover?

South Carolina Medicaid covers the following services:

Ambulatory surgeryHospital stays
Audiology servicesLaboratory tests
Behavioral health servicesVision care
Women’s health careNon-emergency transportation
DialysisOrthotic and prosthetic devices
Doctor visitsOccupational therapy
Smoking cessation servicesPharmacy (medications)
Emergency carePhysical rehabilitation
Family planning servicesPreventive care
Hearing aidsHospital outpatient care
Home health careX-rays and other radiology services

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Can I have both South Carolina Medicaid and Medicare?

In certain situations, a person may be eligible for both Medicaid and Medicare. The Social Security Administration’s Supplemental Security Income (SSI) makes you eligible for Medicaid, and you frequently get Medicare.

The South Carolina Waiver

  • Medically Complex Children;
  • Community Supports;
  • Mechanical Ventilator Dependent;
  • Head and Spinal Cord Injury;
  • Pervasive Developmental Disorder;
  • MR and Related Disabilities;
  • Community Choices


They do not have to pay a copayment. When a member is 

  • under 21 years old; 
  • pregnant; 
  • Held by the state
  • Placed under government supervision
  • Native American participants who qualify for Contract Health funding
  • Services or Tribal Union of Indian Health Services
  • The hospital (inpatient)
  • A facility for skilled nursing
  • A nursing home

What is not covered by South Carolina Medicaid?

In South Carolina, Medicaid is not mandated to offer in-home caregiving services or private nursing coverage. Bandages, adult diapers, and other disposable items are frequently excluded from insurance coverage, as are cosmetic surgery and other elective procedures.

What is the highest income limit for South Carolina Medicaid?

The highest income limit for Pennsylvania Medicaid is $13,590 for an individual and $18,310 for a family of two per year.

What if a person’s income is too high to qualify for regular Medicaid benefits?

If your income is too high, you may still be eligible for South Carolina Medicaid, thanks to the asset spend down option.    

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What documents do I need to apply for Medicaid?

The following documents are required with the application:

  • The Social Security Number;
  • Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
  • Evidence of all income sources, both legal and illegal 
  • Proof of origin 
  • Proof of residency 
  • Including the Medicare card, any insurance cards
  • Pregnancy;
  • When non-parents apply for Medicaid on their behalf, they must provide proof of their financial position.

What is the best Medicaid in South Carolina?

According to the National Committee for Quality Assurance’s (NCQA) Medicaid Health Insurance Plan Ratings, First Choice by Select Health is South Carolina’s top-rated Medicaid health plan.

Where do I find the letter showing the reason(s) for denial or discontinuance from South Carolina Medicaid?

By signing into your account at Portal, you can see the progress of your South Carolina Medicaid application.

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Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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