South Carolina Medicaid

Last verified: June 2026

What is Healthy Connections, South Carolina's Medicaid program?

Healthy Connections is South Carolina's Medicaid program. The South Carolina Department of Health and Human Services (SCDHHS) administers the program from its Columbia headquarters, with county offices across the state. As of 2025, approximately 1.1 million South Carolinians are enrolled — around 21% of the state's population.

Because South Carolina has not expanded Medicaid, eligibility is limited to specific categories: children, pregnant women, parents and caretaker relatives with dependent children, people who are aged or disabled, and some other narrow groups. Adults without children, regardless of income, do not qualify unless they are aged, blind, or have a qualifying disability.

Most Healthy Connections members receive care through a managed care organization (MCO). MCOs under contract with SCDHHS include Absolute Total Care (Centene), Molina Healthcare of South Carolina, Select Health of South Carolina, and Carolina Complete Health. Members choose an MCO at enrollment; the MCO then coordinates all covered services.

Who is generally eligible for Healthy Connections?

Eligibility categories and income limits effective March 1, 2026, per SCDHHS:

• Children under 19 (Partners for Healthy Children) — up to 208% FPL
• Pregnant women — up to 194% FPL
• Parents and caretaker relatives with a dependent child at home — at or below 62% FPL
• People age 65 or older (Aged, Blind, or Disabled category) — at or below 100% FPL
• People who are blind or have a qualifying disability — at or below 100% FPL
• Former foster care youth up to age 26 (no income limit applies)
• Individuals with breast or cervical cancer needing treatment — up to 200% FPL
• Working disabled individuals — up to 250% FPL with earned income

Source: SCDHHS Program Eligibility and Income Limits page, effective March 1, 2026. Verify current income thresholds at scdhhs.gov or by calling the Member Help Center at 1-888-549-0820.

The coverage gap in South Carolina

South Carolina's decision not to expand Medicaid creates a coverage gap. A single adult without children who earns less than 100% FPL earns too little for marketplace premium tax credits (which start at 100% FPL) but earns too much — or simply doesn't qualify — for Healthy Connections. Per KFF research, South Carolina has one of the larger uninsured populations in the Southeast as a result.

Adults in the coverage gap may be able to access care through Federally Qualified Health Centers (FQHCs), which provide sliding-scale services regardless of insurance. Use the HRSA Health Center Finder at findahealthcenter.hrsa.gov to locate an FQHC in South Carolina.

Healthy Connections Prime: coverage for dual eligibles

South Carolinians who qualify for both Medicare and Medicaid — called dual eligibles — may be enrolled in Healthy Connections Prime, a separate managed care program specifically for people with dual eligibility. Healthy Connections Prime coordinates Medicare and Medicaid benefits through a single plan to reduce gaps and administrative complexity for members who need both.

South Carolina Medicaid topics

What does South Carolina Medicaid (Healthy Connections) cover?

Medicaid covers a broad range of health services. Federal law mandates certain benefits — inpatient and outpatient hospital care, physician services, lab work, X-rays, and nursing facility services, among others. States add optional services on top of those. Dental, vision, and long-term home care coverage vary by state.

The national benefits overview lists required and commonly optional services. Check the South Carolina Medicaid (Healthy Connections) website for the current state-specific benefit package.

How to apply

Most people can apply online through South Carolina's Medicaid portal, by phone, or in person at a local eligibility office. The how to apply page walks through each method, what documents you'll need, and what to expect during the review period.

Under 42 CFR 435.912, states must process most standard Medicaid applications within 45 days (90 days for disability-based applications). South Carolina must follow that federal timeline.