Who Qualifies for Healthy Connections Medicaid in South Carolina right now

If you’re trying to figure out whether you qualify, you’re in the same spot as a lot of folks who call or walk into a county eligibility office. The rules are precise but not mysterious. South Carolina calls its program Healthy Connections Medicaid, and eligibility depends on which category you fit into, your household income, and in a few cases your resources. I’ll walk you through the same checkpoints we use at the counter so you can size up your chances before you set aside a morning to apply.

Do I qualify under South Carolina’s current rules?

Start with your category. South Carolina hasn’t adopted the ACA’s expansion to cover all low-income adults. To qualify today, you must fit one of the state’s existing groups and meet the related income and residency rules.

Here are the main groups and their 2026 limits and signals we check first:

• Children under 19 (Partners for Healthy Children). Covered at incomes up to 208% FPL. For a family of three, that’s $4,735.46 per month as of March 1, 2026. Benefits are full-scope Medicaid or CHIP, including dental and vision for kids.
• Pregnant people. Covered at incomes up to 194% FPL. For a family of two, that’s $3,498.46 per month effective March 1, 2026. Coverage continues for 12 months after the baby’s birth.
• Parent or caretaker relative living with a dependent child. This group is limited to very low income, at or below 62% FPL. For a family of three, that monthly limit is $1,411.53, effective March 1, 2026.
• Aged, Blind, or Disabled (ABD). Full Medicaid for people 65+, or who meet disability or blindness criteria. Income is generally limited to 100% FPL (for an individual, $1,330 per month as of March 1, 2026) with a resource limit of $9,950 for one person or $14,910 for a couple effective January 1, 2026.
• Former foster youth up to age 26. No income test, as long as you were on Medicaid when you aged out and you live in South Carolina.

If you don’t fall into one of those, the limited-benefit Healthy Connections Checkup (family planning) may still be available up to 194% FPL, and there’s a hospital-only program, MIAP, for some inpatient stays at or below 200% FPL with strict resource caps including no more than $500 in liquid assets and a $35,000 equity cap on a primary residence.

Local help is available statewide. Healthy Connections county eligibility offices are open Monday–Friday, 8:30 a.m.–5 p.m. If you prefer to go in person, examples include the Charleston County office at 3685 Rivers Ave., Suite 102, North Charleston, SC 29405, the Greenville County office at 352 Halton Rd., Suite 200, Greenville, SC 29607, and the Richland County office at 7499 Parklane Rd., Suite 124, Columbia, SC 29223. You can also call the Healthy Connections Member Contact Center at 888-549-0820 to ask questions before you head over.

Which South Carolina Medicaid category fits my situation?

Children: “Partners for Healthy Children”

For most families, children qualify even when the adults don’t. If your family’s income is at or below 208% FPL, the kids will likely qualify for full-scope coverage through Medicaid or CHIP. As of March 1, 2026, a family of four can earn up to $5,720.00 per month and still have eligible children. We often see parents turned away for being over the parent/caretaker limit, but their kids still get approved under this higher threshold.

There’s no separate premium to enroll a child. If your child is approved, you’ll get a notice explaining whether they’re in Medicaid or CHIP and whether you need to select a managed care plan. If you do, South Carolina Healthy Connections Choices can walk you through picking a plan by phone at 877-552-4642, Monday–Friday, 8 a.m.–6 p.m.

Pregnancy and the first year after delivery

Pregnant South Carolinians can qualify up to 194% FPL with full benefits, and the mother’s coverage lasts 12 months postpartum. For a family of three, that limit is $4,416.73 per month as of March 1, 2026. Newborns are covered up to age one. If you deliver at a hospital and haven’t applied, the hospital’s social services staff can help you start the application before you’re discharged.

Parents and caretaker relatives

This category is for an adult who lives with and takes daily care of a minor child. Income must be at or below 62% FPL based on household size. For a two-person household, the limit is $1,118.06 per month; for three people, $1,411.53, both effective March 1, 2026. If your income is above this, check whether the children still qualify under the children’s 208% FPL limit described above. It’s common here for the child to be approved even when the parent isn’t.

Aged, Blind, or Disabled

For full-scope ABD Medicaid, countable income is limited to 100% FPL ($1,330 per month for an individual as of March 1, 2026) and countable resources are capped at $9,950 for one person and $14,910 for a couple as of January 1, 2026. If Social Security hasn’t already established disability, the state will review disability using the same SSI rules.

There are also Medicare Savings Programs for people who have Medicare but need help with costs. QMB can pay Medicare premiums and cost sharing at 100% FPL, while SLMB and QI help with Part B premiums at 120% FPL and 135% FPL respectively. For one person, those monthly limits are $1,596 (SLMB) and $1,796 (QI) as of March 1, 2026. These programs keep the same resource cap as ABD ($9,950 individual; $14,910 couple, effective January 1, 2026).

Long-term care and home- and community-based services

For nursing home Medicaid or a home- and community-based waiver, income can go up to 300% of the SSI Federal Benefit Rate. That’s $2,982 per month as of January 1, 2026, with a listed spousal allocation of $4,066.50. You must need a nursing facility level of care and receive institutional or waiver services for a period of 30 consecutive days. If you’re trying to keep a spouse at home, talk with the eligibility worker about how spousal income and resources are handled before you move assets; the spousal allocation is a key detail in that review.

Two limited options if you don’t meet full-benefit criteria

Healthy Connections Checkup is a limited-benefit family planning program for individuals up to 194% FPL. It covers preventive and family planning services, not full medical care. If you’re approved for a full-benefit category later, your coverage shifts accordingly.

MIAP (Medically Indigent Assistance Program) sponsors inpatient hospital care for some residents at or below 200% FPL. Resources are highly restricted, including no more than $500 in liquid assets and a $6,000 combined cap on certain personal property. MIAP isn’t full Medicaid, but it can protect you from hospital charges in a qualifying admission.

How do I apply and where do I take paperwork?

You have three practical routes, and the state accepts applications year-round. Pick the one that fits your schedule and whether you need face-to-face help.

• Online. Use the state’s Healthy Connections application portal. If you get stuck choosing a plan after approval, the enrollment broker South Carolina Healthy Connections Choices answers at 877-552-4642, Monday–Friday, 8 a.m.–6 p.m.
• By mail. Send a signed application to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101. Keep copies of anything you mail. If you want delivery confirmation, send it with tracking.
• In person. County eligibility offices are open Monday–Friday, 8:30 a.m.–5 p.m. Examples: 3685 Rivers Ave., Suite 102, North Charleston; 352 Halton Rd., Suite 200, Greenville; 7499 Parklane Rd., Suite 124, Columbia. Bring identification, proof of South Carolina residency, Social Security numbers (or proof of application), and proof of income for everyone in the household who has it.

Need help getting the paperwork right? The Healthy Connections Member Contact Center at 888-549-0820 can answer program questions. SC Thrive runs a free helpline at 800-726-8774 and can assist with the application if you want a neutral set of eyes before you submit.

Why many low-income adults still don’t qualify in South Carolina

South Carolina has not adopted the ACA’s adult expansion. That means an adult without a dependent child at home won’t qualify for full-benefit Medicaid based on income alone, even at very low income. Adults in that situation often land in one of two places: the Healthy Connections Checkup limited-benefit category (family planning only) if they meet the 194% FPL income test, or no Medicaid at all unless they’re pregnant, age 65 or older, or meet disability rules. The upshot is simple but easy to miss: the state covers children generously at 208% FPL, but it covers parents only at 62% FPL, and most childless adults are not eligible for full Medicaid.

If you’re a parent with income above the parent/caretaker limit, apply for the kids anyway. A common real-world outcome at the counter is a denial letter for the parent paired with an approval for the children. That result is normal here and not an error.

What if I have Medicare or need long-term care?

If you have Medicare and limited income, check the Medicare Savings Programs. QMB (at 100% FPL) pays Medicare premiums, deductibles, and coinsurance. SLMB and QI pay the Part B premium at 120% FPL and 135% FPL respectively. For a single person, that’s $1,596 per month for SLMB and $1,796 for QI as of March 1, 2026, with resource limits of $9,950 individual and $14,910 couple effective January 1, 2026.

For long-term care Medicaid or a home- and community-based waiver, income up to $2,982 per month (that’s 300% of the SSI Federal Benefit Rate as of January 1, 2026) can qualify if you meet the nursing facility level of care. There’s also a listed $4,066.50 spousal allocation. Don’t assume you’re over-income before talking to someone who works these cases every day; spousal budgeting rules matter, and a simple check with the county office during their 8:30 a.m.–5 p.m. window can clarify things before bills stack up.

Key things to know before you apply

• Paper applications go to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101. That’s the statewide intake box the back office works from every day.
• County eligibility offices are open Monday–Friday, 8:30 a.m.–5 p.m.. If you want in-person help, Charleston County’s office is at 3685 Rivers Ave., Suite 102, North Charleston; Greenville County’s is at 352 Halton Rd., Suite 200, Greenville; and Richland County’s is at 7499 Parklane Rd., Suite 124, Columbia.
• For plan selection help, South Carolina Healthy Connections Choices answers at 877-552-4642, Monday–Friday, 8 a.m.–6 p.m.. That’s the number we hand out when members need to pick or change a managed care plan.
• Children and pregnancy categories use higher income thresholds than the parent/caretaker group. It’s common for kids to qualify at 208% FPL while the parent does not at 62% FPL. File for everyone in the household so each person can be evaluated correctly.
• Long-term care Medicaid uses a different ceiling: up to $2,982/mo in income and a listed spousal allocation of $4,066.50 as of January 1, 2026, plus a nursing facility level of care and a 30-day service period. Bring any nursing home or home-care documentation with you.
• If you have Medicare and low income, ask about QMB, SLMB, or QI. For one person, $1,596 monthly gets you into SLMB and $1,796 into QI as of March 1, 2026; both have resource caps tied to the ABD limits.
• If you need a hand organizing documents or estimating household income, SC Thrive can help at 800-726-8774. They’re used to fielding calls right before renewal deadlines and right after hospital stays.

Reader Q&A

Can a single adult with no children qualify for full Medicaid here?

Not based on income alone. South Carolina has not adopted the ACA adult expansion, so adults without a dependent child at home generally do not qualify unless they are pregnant, 65 or older, or meet disability rules. Some adults may be eligible for the limited-benefit Healthy Connections Checkup (family planning) up to 194% FPL, but that is not full-scope coverage.

My kids might qualify but I’m over the parent/caretaker limit. Should I still apply?

Yes. Children are evaluated under the Partners for Healthy Children standards up to 208% FPL, which is much higher than the 62% FPL limit for parents and caretaker relatives. It’s normal here for kids to be approved while the parent is denied, and the state will issue separate decisions for each person on the application.

How long does pregnancy coverage last after delivery?

Once you’re approved during pregnancy, Medicaid continues for 12 months postpartum. Your newborn is also covered up to age one. If you deliver without having applied, ask the hospital social services staff to help you start the application before discharge.

I have Medicare but can’t afford my premiums. Can Medicaid help without putting me in a managed care plan?

Yes. The QMB, SLMB, and QI programs help people with Medicare pay premiums and, for QMB, cost sharing too. For 2026, SLMB’s monthly income limit for one person is $1,596 and QI is $1,796, with the same resource caps as ABD coverage. These programs don’t enroll you in a Medicaid managed care plan; they just help with Medicare costs.

Here’s how to narrow your next step. If you have kids or are pregnant, check your household against the 208% FPL and 194% FPL figures and file right away. If you’re 65+, on Medicare, or think you meet disability rules, call 888-549-0820 or visit a county office during the 8:30 a.m.–5 p.m. window and ask specifically about ABD or the Medicare Savings Programs.

Published: September 10, 2026 · Reviewed by the South Carolina editorial team