What Home Care Plus Offers and How It Works in South Carolina

Home Care Plus is a Medicaid program that pays for in-home care when you need help with daily tasks

Home Care Plus is South Carolina's Medicaid waiver program for people who need personal care assistance at home instead of moving to a nursing facility. The program covers services like bathing, dressing, meal preparation, and light housekeeping. A nurse or social worker visits your home to assess what you need, then arranges for a home health aide to come on a schedule that fits your life.

The program is run through South Carolina's Department of Health and Human Services (DHHS), and it operates differently from traditional home health care. Instead of short-term recovery care after a hospital stay, Home Care Plus is designed for people with ongoing needs who want to stay in their own homes. Medicaid pays the provider directly, so there is no bill sent to you if you meet the program's requirements.

South Carolina has a waiting list for Home Care Plus because demand exceeds available funding. The state prioritizes people based on urgency and how long they have been waiting. Getting on the list does not mean you will receive services immediately, but it does mean your name is in the system and you will be contacted when a slot opens.

Key Takeaways

• Home Care Plus covers personal care tasks like bathing, dressing, and meal prep for people who need daily help but want to stay at home.
• You must be Medicaid-may be able to access and have a medical need documented by a doctor or nurse assessment to be considered.
• South Carolina maintains a waiting list, and services begin once funding becomes available and your name reaches the top.
• A nurse or social worker will visit your home to determine what services you need and how often the aide should visit.
• The program pays home health aides directly, so you do not receive a bill if you are enrolled and meet ongoing requirements.

Who can receive Home Care Plus services

To receive Home Care Plus, you must be a South Carolina resident and meet Medicaid income and asset limits. These limits change each year, so the exact dollar amounts depend on your household size and the current year. You can contact your local DHHS office or call the Medicaid hotline to learn the current thresholds for your situation.

You also need a medical reason for the services. A doctor, nurse practitioner, or physician assistant must document that you need help with activities of daily living—bathing, dressing, toileting, eating, or moving around your home. The assessment happens at your home, and the evaluator will ask about your current abilities and what tasks you struggle with most.

Age is not a barrier. Home Care Plus serves working-age adults with disabilities, older adults, and people recovering from serious illness. What matters is that you need regular help and that staying at home is medically appropriate for you.

How to get on the waiting list

Contact your local DHHS office or call the South Carolina Medicaid hotline to ask about Home Care Plus. You will need to provide basic information about your household income, assets, and current living situation. The office will tell you whether you likely meet Medicaid requirements and explain the next steps.

If you appear to meet the income and asset limits, DHHS will schedule a home visit with a nurse or social worker. This person will assess your medical needs and your home environment. They will ask detailed questions about what you can and cannot do on your own, and they will note any safety concerns in your home.

After the assessment, your name goes on the waiting list in the order it was received, unless you have been flagged as urgent. Urgent cases—such as someone about to be discharged from a hospital with no one to care for them—may move higher on the list. You will be notified by mail or phone when a slot opens and services can begin.

What services Home Care Plus covers

Home Care Plus pays for a home health aide to help with personal care tasks. This includes bathing and showering, dressing, grooming, toileting, and transferring (moving from bed to chair, for example). The aide can also help with meal preparation, light housekeeping, laundry, and shopping for groceries or medications.

The program does not cover skilled nursing care, physical therapy, or medical equipment. If you need those services, they may be covered under a different Medicaid program or through Medicare if you are may be able to access. Your nurse or social worker can explain what other programs might help with those needs.

The number of hours per week that Home Care Plus covers depends on your assessed needs and the program's available funding. Some people receive a few hours per week, while others receive more. The care plan is reviewed regularly, and hours can be adjusted if your needs change.

How the program works once you are enrolled

Once you are approved and a slot opens, DHHS will work with a home care agency to assign an aide to you. The agency handles hiring, training, and scheduling. You will meet with the aide and the agency supervisor to set up a routine that works for your household. Most people have the same aide visit on the same days and times each week, which helps build trust and consistency.

Your care plan is reviewed at least once a year by a nurse or social worker. If your needs change—if you need more help or less help—you can request a reassessment. If you move, change your Medicaid status, or no longer need the services, you must notify DHHS so they can update your case.

If you have a problem with your aide or the agency, contact your DHHS caseworker or the home care agency directly. Most issues can be resolved quickly. If an aide is not showing up, is not performing tasks correctly, or is not respectful, you have the right to request a different aide or a different agency.

Waiting list status and what to do while you wait

While you are on the waiting list, you may be able to receive other forms of support. Some people are covered under South Carolina's Community Choices Waiver or other Medicaid programs that offer in-home services. Your DHHS caseworker can explain what other programs you might be on or what you might be able to access while waiting for Home Care Plus.

You can also explore other resources in your community. Area agencies on aging, local nonprofits, and senior centers sometimes offer low-cost or free assistance with household tasks, transportation, or meal delivery. These do not replace Home Care Plus, but they can help bridge the gap while you wait.

Check in with your DHHS office periodically to confirm your name is still on the list and to update any changes in your situation. If you move, change your phone number, or your income changes, let them know. Staying in touch helps ensure you are contacted when a slot opens.

Costs and what Medicaid covers

If you are enrolled in Home Care Plus and meet all program requirements, Medicaid pays the home care agency directly. You should not receive a bill for the aide's services. However, you are still responsible for any Medicaid premiums or cost-sharing that applies to your specific Medicaid plan.

Some Medicaid plans charge a small copay for certain services, though many do not charge for in-home personal care. Your DHHS caseworker or your Medicaid plan can tell you whether any copays apply to your coverage. If you cannot afford a copay, you can ask DHHS about hardship exemptions.

If you have Medicare in addition to Medicaid, Medicare does not cover the type of personal care that Home Care Plus provides. Medicaid is the primary payer for Home Care Plus services, and Medicare does not interfere with that coverage.

Frequently Asked Questions

How long does it usually take to get off the waiting list?

Wait times vary depending on how many people are ahead of you and how quickly funding becomes available. Some people wait a few months, while others wait a year or longer. You can ask your DHHS caseworker for an estimate based on your position on the list, though they cannot may provide a specific date.

Can I choose which home care agency provides my aide?

DHHS contracts with multiple agencies in most areas of South Carolina. You can request a specific agency if you have a preference, and DHHS will try to honor that request if the agency has availability. If you are unhappy with your assigned agency, you can ask to switch to a different one.

What happens if my income increases while I am on Home Care Plus?

If your income rises above the Medicaid limit, you may lose coverage. However, Medicaid has rules that allow some income to be set aside for work or other purposes. Contact your DHHS caseworker immediately if your income changes so they can recalculate your may be able to access and explain your options.

Can Home Care Plus pay for a family member to be my aide?

In most cases, no. Home Care Plus requires that aides be employed by a licensed home care agency, not by you or your family. This protects both you and your family member by ensuring proper training, background checks, and oversight. Your caseworker can explain the specific rules that apply in your situation.

What if I need care at night or on weekends?

Home Care Plus can cover evening and weekend visits if your assessed needs include those times. The care plan is based on what you actually need, not on standard business hours. Talk with your nurse assessor about your schedule and what times work best for you.