South Carolina's Medicaid program, called Healthy Connections, sets different income limits depending on who you are and what kind of coverage you need. The limits below reflect the thresholds effective March 1, 2026, updated annually based on the Federal Poverty Level (FPL). Whether you are a parent, pregnant, disabled, elderly, or caring for a child, your qualifying income threshold will vary significantly. This guide breaks down every major category with current dollar figures so you can quickly see where you stand.
South Carolina has not expanded Medicaid under the Affordable Care Act. That means adults aged 19 to 64 who do not have dependent children and are not disabled generally cannot qualify, even if their income is very low. If you fall into that group, you may still be eligible for marketplace coverage with subsidies. Use the Benefits Navigator screener to check your full range of options.
Who Qualifies for Healthy Connections in 2026
Eligibility is based on residency, citizenship or immigration status, a Social Security number, and income. The income limits below are organized by program category.
Income Limits by Category
| Category | Income Limit | FPL Percentage |
|---|
| Children (ages 1 to 18) | Up to 213% FPL | approximately $5,450/month for a family of 4 |
| Infants (under age 1) | Up to 213% FPL | same as children |
| Pregnant Women | Up to 199% FPL | approximately $2,580/month individual |
| Parents and Caretaker Relatives | Up to 100% FPL | approximately $1,325/month for a family of 3 |
| Aged, Blind, or Disabled (ABD) | $1,330/month individual | approximately 100% FPL |
| Breast and Cervical Cancer Program | Up to 200% FPL | $2,660/month individual |
| Family Planning Services | Up to 194% FPL | $2,580/month individual |
| Nursing Home / Long-Term Care | $2,982/month | approximately 300% of SSI |
| Working Disabled (Ticket to Work) | Up to 250% FPL | contact SCDHHS for dollar figure |
| Former Foster Care Youth | No income limit | up to age 26 |
Children
Children under 19 can qualify for Healthy Connections with household income up to 213% FPL. Infants under age one whose mothers were covered during pregnancy are automatically enrolled and remain eligible through the child's first birthday. There is no asset test for children.
Pregnant Women
Pregnant women qualify with household income up to 199% FPL. Coverage extends 12 months after delivery (the postpartum extension applies regardless of income changes during that period). There is no asset test for pregnant women.
Parents and Caretaker Relatives
Adults who live with and care for a dependent child qualify as parents or caretaker relatives. The income limit is 100% FPL, which works out to roughly $1,255 per month for a single parent or $2,120 per month for a family of three in 2026. This is the most restrictive category for working-age adults with children.
Aged, Blind, or Disabled (ABD)
Adults who are 65 or older, certified blind, or determined disabled under Social Security rules may qualify under the ABD category. The income limit is $1,330 per month for a single person and $1,804 per month for a couple. The asset limit is $9,950 for individuals and $14,950 for couples.
Breast and Cervical Cancer Program
Women who have been diagnosed with breast or cervical cancer, or a related pre-cancerous condition, may qualify for full Medicaid coverage through this category regardless of disability status. The income limit is 200% FPL, or $2,660 per month for a single person.
Family Planning Only
Low-income individuals who need contraceptive and family planning services only can receive limited Medicaid coverage at up to 194% FPL. This category does not provide full Medicaid benefits.
Long-Term Care and Nursing Home Limits
South Carolina has a separate income and asset threshold for Medicaid covering nursing home stays and Home and Community Based Services (HCBS) waivers.
| Criteria | Single Applicant | Married (Institutionalized Spouse) |
|---|
| Monthly Income Limit | $2,982 | $2,982 (applicant only) |
| Asset Limit | $2,000 | $2,000 (applicant) / up to $66,480 (community spouse) |
| Home Equity Cap | $752,000 | $752,000 |
| Spouse Monthly Needs Allowance | N/A | up to $4,066.50/month |
Applicants whose income exceeds $2,982 per month may still qualify by using a Qualified Income Trust, sometimes called a Miller Trust. The trust deposits excess income each month, bringing the countable amount below the limit. Working with a Medicaid planning professional or legal aid organization is advisable before pursuing this option.
The community spouse resource allowance protects the spouse who stays home from losing all household assets. The at-home spouse can retain up to $66,480 in countable assets in 2026, plus the primary residence (if they are living in it), a vehicle, and personal belongings.
The Coverage Gap in South Carolina
Because South Carolina has not expanded Medicaid, adults between 19 and 64 without dependent children and without a disability face a gap. If your income is above the parent category limit (100% FPL) but below the ACA marketplace subsidy threshold (100% FPL), you may not qualify for either Medicaid or subsidized marketplace coverage.
South Carolina legislators introduced a Medicaid expansion bill in the 2025 to 2026 legislative session (Bill 3109), but as of mid-2026, the state has not expanded coverage. If you fall in the coverage gap, check whether you qualify for any of the limited-scope programs (family planning, breast and cervical cancer) or for a marketplace plan with cost-sharing reductions. The Benefits Navigator screener can help you identify what is available in your situation.
Asset Limits Summary
| Program | Individual Asset Limit | Couple Asset Limit |
|---|
| ABD (Regular Medicaid) | $9,950 | $14,950 |
| Nursing Home / HCBS Waiver | $2,000 | $2,000 (applicant) |
| Children | None | None |
| Pregnant Women | None | None |
| Family Planning | None | None |
Certain assets are not counted. These include your primary home (as long as you or a spouse lives in it), one vehicle, household furnishings, personal property, and burial funds up to $10,000.
How to Apply for Healthy Connections
South Carolina offers four ways to apply. Pick the method that works best for your situation.
Step 1: Gather your documents. Before applying, collect proof of identity (driver's license or state ID), proof of South Carolina residency (utility bill, lease, or similar), Social Security numbers for all household members, proof of income (pay stubs, tax returns, award letters), and proof of citizenship or immigration status.
Step 2: Choose your application method.
- Online: Apply at benefitsportal.sc.gov. This is the fastest method and lets you upload documents directly.
- By phone: Call 1-888-549-0820 (Healthy Connections Help Center). Hours are Monday through Friday, 8 a.m. to 6 p.m. ET.
- By fax: Complete a paper application and fax it to 888-820-1204 (toll-free fax).
- By mail: Send your completed application and documents to SCDHHS Central Mail, P.O. Box 100101, Columbia, SC 29202-3101.
- In person: Visit your local county Department of Social Services office. Find your county office at scdhhs.gov.
Step 3: Submit your application. SCDHHS has up to 45 days to process standard Medicaid applications. Pregnant women and children may receive a faster decision, typically within 7 days.
Step 4: Respond to any requests. If SCDHHS needs additional documentation, you will receive a notice by mail. Respond promptly, as missing the deadline can result in your application being denied.
Step 5: Receive your determination letter. If approved, you will receive a Healthy Connections card and an explanation of your covered services. If denied, the letter will explain the reason and your right to appeal.
Step 6: Report changes. Once enrolled, report income changes, household changes (new family member, someone moving out), or address changes within 10 days. You must complete an annual renewal to stay enrolled.
What Healthy Connections Covers
Approved Healthy Connections members receive coverage for doctor visits, hospital stays, emergency care, prescription drugs, mental health and substance use treatment, preventive care, dental services (adults have limited coverage), vision, lab work, and transportation to medical appointments for those who qualify. Long-term care benefits vary by waiver program.
Additional Programs to Consider
If you do not qualify for full Medicaid, you may qualify for one of these related programs:
- CHIP (Children's Health Insurance Program): Covers children in families that earn too much for Medicaid but cannot afford private insurance. South Carolina's CHIP covers children up to 208% FPL under the Healthy Connections Kids program.
- SNAP: Food assistance for low-income households. Income limits are generally 130% FPL, though categorical eligibility may apply.
- LIHEAP: Home energy assistance for families struggling with utility bills.
- Marketplace Plans: ACA subsidies start at 100% FPL for South Carolina residents not eligible for Medicaid.
Run a free check across all programs you might qualify for at benefitsusa.org/screener or visit the South Carolina benefits page for a full breakdown of available programs.
Frequently Asked Questions
Does South Carolina have Medicaid expansion?
No. South Carolina has not expanded Medicaid under the Affordable Care Act. Adults aged 19 to 64 without dependent children and without a qualifying disability generally cannot get Medicaid in South Carolina, even with very low income.
What is the income limit for a family of 4 in South Carolina Medicaid?
For children, a family of four can earn up to approximately 213% FPL, which is roughly $5,450 per month in 2026. For parents or caretaker relatives, the limit drops to 100% FPL, which is approximately $2,560 per month for a family of four.
How do I apply for Medicaid in South Carolina?
Apply online at benefitsportal.sc.gov, call 1-888-549-0820, fax a paper application to 888-820-1204, or mail it to SCDHHS Central Mail, P.O. Box 100101, Columbia, SC 29202-3101. Processing takes up to 45 days for standard applications.
What is the asset limit for Medicaid in South Carolina?
For the ABD (Aged, Blind, or Disabled) program, the asset limit is $9,950 for individuals and $14,950 for couples. For nursing home Medicaid, the limit is $2,000 for the applicant. Children and pregnant women have no asset limit.
Can I get Medicaid if my income is slightly above the limit?
It depends on the program. For nursing home care, a Qualified Income Trust (Miller Trust) can bring your countable income below the $2,982 threshold. For other categories, there is generally no spend-down option in South Carolina, but you may qualify for a marketplace plan with subsidies.
How long does it take to get approved for Medicaid in South Carolina?
Standard applications take up to 45 days. Applications for children and pregnant women are often processed faster, sometimes within 7 days. If SCDHHS requests additional documents, the clock may pause until you respond.
What does Healthy Connections cover?
Healthy Connections covers doctor visits, hospital stays, emergency room care, prescription drugs, mental health services, preventive care, lab and X-ray services, and transportation assistance. Adult dental coverage is limited. Long-term care benefits are available through separate waiver programs.
Does South Carolina check immigration status for Medicaid?
Yes. To qualify for full Medicaid, applicants must be U.S. citizens or qualified immigrants with satisfactory immigration status. Undocumented immigrants generally do not qualify for full Medicaid, though emergency services and pregnancy-related care may be available under certain circumstances.
What happens if my Medicaid application is denied?
You have the right to appeal. The denial letter will include instructions for requesting a fair hearing. You must file your appeal within 30 days of the denial date. You can also contact a legal aid organization or benefits counselor for help with your appeal.
Is there a phone number for South Carolina Medicaid questions?
Yes. Call the Healthy Connections Help Center at 1-888-549-0820, Monday through Friday, 8 a.m. to 6 p.m. ET. You can also visit scdhhs.gov for information and online services.
