Explains important basics about South Carolina Medicaid. Topics include protections for the community spouse, transfers, income, and estate recovery.."
" In order to receive benefits under the South Carolina Medicaid program, one must meet certain financial and non-financial requirements and fit into one of the categorical groups listed below..."
" At least one child in the home is under age 18 (age 19 if in a secondary school) and lives in a family with low income. Countable resources must be at or below $30,000 per Budget Group... "
Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.
"...The poverty thresholds are the original version of the federal poverty measure... The poverty guidelines are the other version of the federal poverty measure.
Due to changes under the Federal Deficit Reduction Act, individuals who claim to be a U.S citizen are required to provide proof of citizenship, nationality and identity when they apply or complete an annual review form for Medicaid benefits on or after July 1, 2006. The SC Department of Health and Human Services is advising individuals who currently receive or may need to apply for Medicaid to begin collecting the appropriate documents now...."
" You must Complete an Application and provide the proper required documentation in order to receive benefits under the appropriate Medicaid program or other programs managed by the South Carolina Department of Health and Human Services..."
"To apply for Medicaid or another coverage program the Department of Health and Human Services manages, you must fill out an application and send it to us..."
" These forms are easy to complete on-line and can save you time. You are able to save your application and go back to it at a later time to complete it or to make changes to your information. We will continue to add new forms in the future..."
" Anyone can apply for CLTC services; referrals may be made by anyone with knowledge of the individual’s needs and the permission of the person being referred. Many referrals come from family members, friends, clergy, home health nurses..."
" The Breast and Cervical Cancer Prevention and Treatment Act of 2000 allows states to provide full Medicaid benefits to uninsured women who are found to be in need of treatment for breast or cervical cancer or pre-cancerous lesions (CIN 2/3 or atypical breast hyperplasia). This coverage group is known as the Breast and Cervical Cancer Program (BCCP)...."
Have questions? Contact the Medicaid office in your county..."
"...To Apply for Medicaid Toll Free (888) 549-0820"
" Healthy Connections Choices is a program that helps Medicaid members enroll in health plans. When members enroll, they choose a health plan and a doctor (or clinic). Healthy Connections Choices helps members choose the health plan that is best for them...."
"Company Name... Name in SC... Operational in SC... Contact Phone Number..."
This is a Medicaid Managed Care program. An HMO is a company that contracts with clinics, doctors, hospitals, pharmacies and other providers. You choose a primary care doctor who is a member of the HMO. Your primary care doctor must provide or arrange the health care that you need..."
"A health plan is a way for you to get Medicaid services. When you are in a health plan, you will have your own doctor (or clinic).
Your health plan will make sure you can see the right doctor when you need to. All plans provide the same medical services as Medicaid..."
"Find a doctor, clinic or hospital near where you live. You can search for doctors (or clinics) by what their specialty is and by which health plans they work with. You can also search for doctors, clinics or hospitals by county, Zip code, or name..."
"All plans offer basic Medicaid benefits. They also offer extra benefits such as disease management and some extra dental and vision benefits. Find the health plans and benefits offered in your county ..."
"Disclaimers: Call the Provider first to see if they are accepting new patients.
" Health Connections Kids is a health insurance program for uninsured children... Children in Healthy Connections Kids have these benefits..."
Thirty-two percent of South Carolina’s children are enrolled in Medicaid..."
...The two major federal funding sources for low-income children’s public health insurance are Medicaid and the State Children’s Health Insurance Program (SCHIP). States enjoy some flexibility in their Medicaid programs for children,..."
Most family plans are funded through Medicaid, but a handful of states have waivers to use State Children’s Health Insurance Program (SCHIP) funds to cover parents. ..."
Research suggests that, on average, families need an income of about twice the federal poverty level to meet their most basic needs. Children living in families with incomes below this level—$40,000 for a family of four in 2006—are referred to as low income..."
Partners for Healthy Children is a health insurance program for children who live in South Carolina. It provides free health care to children in families with low income. The program does not provide any coverage for the adults in the household but the income of the entire family is considered in the deciding if the children are eligible for services. The income of the household must be less than or equal to 150% of the Federal Poverty Level as published annually in the Federal Register. Covered Medical Services include doctor's visits, dental services, vision care, prescription drugs and hospital inpatient, outpatient and emergency care. ..."
Individual state profiles..."
"Do children in South Carolina’s CHIP program receive the same comprehensive benefits as children in Medicaid?..."
South Carolina’s Healthy Connection Kids provides free and low-cost health care for children. If you are a family of four with income of $44,100 or less, your child may be eligible....."
Individual state profiles..."
One in ten women in South Carolina receives health care coverage through Medicaid.... Medicaid is the most important source of coverage for low-income women. In 2006-07, 26 percent of all low-income women in South Carolina were..."
Medicaid benefits: Online database"
Within certain limits, Medicaid will pay for services that are medically necessary. In addition, some services are limited to a certain number during the state fiscal year. (The state fiscal year runs from July 1 through June 30 of the following year.) Medicaid can pay for the following medical services..."
Women under age 65 diagnosed, and in need of treatment for either and Coverage for women diagnosed by BCN is limited to women age 47-64: Breast Cancer Cervical Cancer Pre-Cancerous Lesions (CIN 2/3 or atypical hyperplasia) can be eligible for Medicaid coverage ..."
" Women who apply and are determined eligible are eligible for 12 months. Pregnant women, after delivery and moving to the Family Planning waiver program, are eligible for 10 months of family planning services. Benefits received by both groups include the full range of family planning services covered by the South Carolina Medicaid program..."
As of June 30, 2003, 1,515,712 people were covered under the South Carolina’s Medicaid/SCHIP programs. There were 1,395,812 enrolled in the Medicaid program and 119,900 enrolled in the Medicaid SCHIP expansion program (South Carolina does not have a separate SCHIP program). In state fiscal year 2003, South Carolina spent almost $9 billion to provide Medicaid services...."
PARTICIPATING PHARMACIES - Most pharmacies located in South Carolina participate in the SC Medicaid Pharmacy Services program. Also, many pharmacies in Georgia and North Carolina located near the SC state line are enrolled to provide service to You. Click on the link below to locate..."
Dental services are defined as any covered diagnostic, preventive, therapeutic, rehabilitative or corrective procedure. For a comprehensive listing of covered procedures and specific guidelines, go to Chapter 400 of the provider manual. ..."
...Dental Services - For people under the age 21, Medicaid can pay for dental check-ups and other dental services through the EPSDT program. For people age 21 and over, Medicaid will pay for emergency dental services only..."
Community Long Term Care (CLTC) offers programs to help individuals who want to live at home, need assistance with their care, and are financially eligible for Medicaid..."
The SC Medicaid Program sponsors the payment of long-term care for those individuals who reside in licensed and certified nursing facilities. The Medicaid program also pays for special services for those individuals who participate in the home and community-based waiver..."
Medicaid will cover the cost of some types of long-term care, but to qualify one must meet Medicaid's strict income and asset eligibility requirements. Medicaid was designed as a resource for individuals who could not otherwise pay for their own medical needs. It was not designed to act as a national long-term care financing tool."
These are South Carolina Nursing Homes in cities A - Z." In addition to the state directory described above, there are nursing home directories for principal South Carolina cities. An example:
A consumer's guide to information and help about assisted living in South Carolina, with a directory of assisted living facilities..."
" For a SLMB, the Medicaid Program is required to pay the Medicare Part B premium only. These individuals are NOT entitled to any other Medicaid benefits; therefore, they do not receive a Medicaid card..."
"The following is a list of all South Carolina 1915(c) Waivers by name - complete with a description, contact information and web link..."
...This list contains information about state-specific Medicaid waiver and demonstration programs. Users can access fact sheets, copies of proposals, approval letters, and other documents related to specific programs..."
" Report Fraud. Click to Report Fraud or Call the Hotline Phone Number (1-888-364-3224)..."
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