South Carolina Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in South Carolina.
7.6 million Medicaid long-term care recipients nationwide
South Carolina Department of Health and Human Services (SCDHHS)
Processing Time
30-45 days for standard Medicaid; Community Choices Waiver can take 60-90 days. Waiting lists may exist depending on capacity and funding.
South Carolina Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in South Carolina, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). South Carolina follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$3,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
South Carolina Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $7,511/month average (semi-private), $8,244/month (private) (the average monthly nursing home cost in South Carolina).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in South Carolina
Nursing Home Care
Medicaid pays 100% of nursing home costs in South Carolina once eligibility is established. The average monthly cost is $7,511/month average (semi-private), $8,244/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Community Choices Waiver - Community Residential Care Facility (CRCF) Services: South Carolina's Community Choices Waiver includes coverage for individuals residing in Community Residential Care Facilities (South Carolina's term for assisted living). Medicaid covers personal care services, medication administration, and care coordination. Room and board costs are not covered—residents must pay housing costs from their monthly Medicaid income or private resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
South Carolina offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Community Choices Waiver
Serves individuals age 65+ or adults age 18-64 with disabilities who meet nursing facility level of care. Provides adult day care, case management, home modifications, personal emergency response systems, personal care, respite care, and other support services. South Carolina's primary HCBS waiver with approximately 6,500 participants statewide.
Program Details →HIV/AIDS Waiver
Serves individuals diagnosed with HIV/AIDS who meet nursing facility level of care. Some elderly individuals with HIV/AIDS qualify.
Program Details →How to Apply for Medicaid in South Carolina
South Carolina Medicaid applications typically take 30-45 days for standard Medicaid; Community Choices Waiver can take 60-90 days. Waiting lists may exist depending on capacity and funding.. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in South Carolina through:
- Online at scdhhs.gov/apply or MyBenefits.sc.gov
- Phone: 1-888-549-0820 (SCDHHS) or 1-800-768-5700 (SC Healthy Connections)
- Download application and mail to: SCDHHS, P.O. Box 8206, Columbia, SC 29202-8206
- In-person at local Department of Social Services office (46 county offices)
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in South Carolina from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
South Carolina-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Part B premiums. QI pays Part B premiums (limited funding).
Learn MoreHealthy Connections (SC Medicaid)
South Carolina's Medicaid program name. Most beneficiaries enrolled in one of four managed care organizations (MCOs) for medical services.
Learn MoreSC Access (Adult Companion Care)
State-funded program providing in-home companion services for low-income seniors not eligible for Medicaid waivers.
Learn MoreNeed Help with South Carolina Medicaid?
Contact South Carolina Department of Health and Human Services (SCDHHS) for specific questions about eligibility, application status, or covered services.