South Carolina Medicaid: The Medicaid Project: South Carolina Medicaid Eligibility, Programs, Requirements

Topics on this page:

South Carolina Medicaid definition, About Medicaid
Medicaid Insurance in South Carolina: How It Works
South Carolina Medicaid Eligibility, Requirements
South Carolina Medicaid Citizenship Requirements
Applying for South Carolina Medicaid
South Carolina Medicaid Offices, Medicaid Hotline
South Carolina Medicaid Health Plans, Managed Care, HMO
Find South Carolina Medicaid Physicians, Healthy Connections Doctors
Health Programs for Children: CHIP: South Carolina

South Carolina Health Insurance: Affordable Health Insurance, Health Care Options (on a separate page)
South Carolina Medicaid Benefits and Coverage: Medicaid Services
Medicaid Prescription Drugs; Preferred Drug List
Medicaid Dental Services
South Carolina Medicaid and Nursing Homes, Assisted Living, Home Health Care
South Carolina Medicare / Medicaid Dual Eligibles - Medicaid for people who are on Medicare
South Carolina Medicaid Waiver Programs
Report Medicaid Fraud in South Carolina

Medicaid in South Carolina*: "Healthy Connections (Medicaid) is South Carolina's grant-in-aid program by which the federal and state governments share the cost of providing medical care for needy persons who have low income. Title XIX of the Social Security Act that was signed into law by the president on July 30, 1965 authorized the program. Congress has continually changed the Medicaid program since it was created and enacted by legislation. South Carolina began participation in the Medicaid program in July 1968."
*source: South Carolina Department of Health and Human Services, Columbia, SC 29202-8206

South Carolina Children’s Medicaid and Children's Health Insurance Program:: "The Partners for Healthy Children program was authorized under Title XXI of the Social Security Act. This program provides Medicaid coverage for children who live in families with income at or below 150% of the Federal Poverty Level. "
*source: South Carolina Department of Health and Human Services, Columbia, SC 29202-8206

South Carolina Medicaid / Medicare: What's the difference?: ARE (HEALTHY CONNECTIONS) MEDICAID AND MEDICARE THE SAME?
No, Healthy Connections (Medicaid) is a program that pays for health care for needy people of the state. To receive Medicaid benefits, an individual must meet certain non-financial and financial guidelines and categorical requirements...

Medicare is a health insurance program for people age 65 and over or people who have received Social Security disability benefits for 24 months. There is no financial eligibility test for Medicare...

A person can have both Medicaid and Medicare. For a person who has both, Healthy Connections (Medicaid) will pay the monthly Medicare premium and certain services not covered by Medicare. Cost sharing will be paid only for Qualified Medicare Beneficiaries (QMB)...."
*source: South Carolina Department of Health and Human Services, Columbia, SC 29202-8206

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Medicaid in South Carolina: How It Works; An Introduction to South Carolina Medicaid

web page:
WHAT IS HEALTHY CONNECTIONS (MEDICAID)?

source:South Carolina Department of Health and Human Services
languages: English, Spanish
from the web page:
"...Because state and federal governments share the cost of the Medicaid program, states are given some flexibility in providing coverage to its needy citizens. For this reason, the rules for Medicaid coverage vary from state to state. An individual who is eligible in South Carolina is not necessarily eligible if he or she moves to North Carolina, Georgia, etc..."
- also from South Carolina Department of Health and Human Services:
  brochure or publication:
  Your Guide to Medicaid
  27 pages; languages: English
  from the publication:
  "This book will tell you about the South Carolina Healthy Connections Medicaid Program. It also tells you how to use your Healthy Connections Medicaid Card. The program should cover most of your health care needs..."
web page:
A Consumer's Guide to Getting and Keeping Health Insurance in South Carolina: MEDICAID

source:healthinsuranceinfo.net - Georgetown University's Health Policy Institute
languages: English
from the web page:
"...In South Carolina, you may be eligible for Medicaid if you are an infant, a child, pregnant, the parent of a dependent child, elderly, or disabled and your family income meets the Medicaid income standards...."

web page:
Key Medicaid Information for South Carolina

source:Elder Law Answers
"Explains important basics about South Carolina Medicaid. Topics include protections for the community spouse, transfers, income, and estate recovery.."
web page:
South Carolina & United States State Medicaid Fact Sheets

source:Kaiser Family Foundation
file size: languages: English

South Carolina Medicaid Eligibility, How to get Medicaid in South Carolina, Requirements

web page:
Who Is Eligible? (for Medicaid)

source:South Carolina Department of Health and Human Services
languages: English
from the web page: " 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..."
- also from South Carolina Department of Health and Human Services:
  web page:
  MEDICAID COVERAGE GROUPS - Low Income Families (LIF)
  languages: English
  from the web page:
  " 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... "
web page:
Medicaid Eligibility

source: Centers for Medicare & Medicaid Services
languages: English
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.
web page:
2011 HHS Poverty Guidelines

source: Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services
languages: English
from the web page:
"...The poverty thresholds are the original version of the federal poverty measure... The poverty guidelines are the other version of the federal poverty measure.

South Carolina Medicaid Citizenship Requirements

brochure:
Updated Rules Regarding Citizenship

source:South Carolina Bureau of Health Services and Delivery Systems
languages: English
from the brochure:
"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...."

Applying for South Carolina Medicaid

web page:
Select the Application that best fits your need

source:South Carolina Department of Health and Human Services
languages: English
from the web page: " 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..."
- also from South Carolina Department of Health and Human Services:
  web page:
  How And Where To Apply
  languages: English
  from the web page: "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..."
web page:
E-Forms for Medicaid (Long Term Care in the community or Nursing Home Care)

source:South Carolina Access
languages: English
from the web page: " 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..."
web page:
How Do I Apply For Community Long Term Care (CLTC)

source:South Carolina Bureau of Long Term Care and Behavioral Health Services
languages: English
from the web page: " 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..."
publication:
APPLICATION FOR SOUTH CAROLINA MEDICAID Breast and Cervical Cancer Program

source:Foundation for Health Coverage Education
4 pages; languages: English
from the publication: " 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)...."

South Carolina Medicaid Area Offices, Medicaid Hotline

web page:
DHHS County Offices

source:South Carolina Department of Health and Human Services
languages: English
from the web page:
"Have questions? Contact the Medicaid office in your county..."
hotline:
South Carolina Medicaid HELPLINE
According to The South Carolina Department of Health and Human Services: "...To Apply for Medicaid Toll Free (888) 549-0820"

South Carolina Medicaid Health Plans, HMO

brochure:
Fact Sheet: What is South Carolina Healthy Connections Choices?

source:South Carolina Bureau of Health Services and Delivery Systems
2 pages; languages: English
from the brochure: " 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...."
- also from South Carolina Bureau of Health Services and Delivery Systems:
  web page:
  South Carolina Medicaid Managed Care Health Plans
  languages: English
  from the web page: "Company Name... Name in SC... Operational in SC... Contact Phone Number..."
web page:
Medicaid Options

source:South Carolina Bureau of Eligibility Processing
languages: English
from the web page:
"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..."
web page:
Choosing a health plan

source:South Carolina Healthy Connections Choices
languages: English
from the web page:
"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..."
- also from South Carolina Healthy Connections Choices:
  web page:
  Find a doctor, clinic or hospital
  languages: English
  from the web page: "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..."
- web page:
  Health plans
  languages: English
  from the web page: "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 ..."

Find South Carolina Medicaid Physicians, Healthy Connections Doctors

web page:
Try the New Provider Search Engine - Search for Providers

source:South Carolina Department of Health and Human Services
languages: English, Spanish
from the web page: "Disclaimers: Call the Provider first to see if they are accepting new patients.

Children's Medicaid: Health Programs for Children: South Carolina CHIP:

web page:
SC Healthy Connections Kids (SCHIP)

source:South Carolina Bureau of Health Services and Delivery Systems
languages: English
from the web page: " Health Connections Kids is a health insurance program for uninsured children... Children in Healthy Connections Kids have these benefits..."
- also from South Carolina Bureau of Health Services and Delivery Systems:
  web page:
  SC Healthy Connections Kids (SCHIP) FAQs
  languages: English
brochure or publication:
South Carolina MEDICAID FACTS

source:AMERICAN ACADEMY OF PEDIATRICS
languages: English
from the brochure:
"Thirty-two percent of South Carolina’s children are enrolled in Medicaid..."
Medicaid brochure:
South Carolina Public Health Insurance for Children

source:National Center for Children in Poverty (NCCP)
languages: English, Spanish
from the brochure:
"...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,..."
- also from National Center for Children in Poverty (NCCP):
  web page:
  South Carolina Public Health Insurance for Parents
  languages: English
  from the web page:
  "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. ..."
- web page:
  South Carolina Demographics of Low-Income Children
  languages: English
  from the web page:
  "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..."
web page:
South Carolina Partners for Healthy Children

source:Benefits.gov
languages: English, Spanish
from the web page:
"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. ..."
web page:
South Carolina: CHIP Program Name and Type

source:Kaiser Family Foundation statehealthfacts.org
languages: English, Spanish
from the web page:
"Individual state profiles..."
bublication / brochure:
Health Coverage for All Children: South Carolina

source:Children's Defense Fund
languages: English
from the web page:
"Do children in South Carolina’s CHIP program receive the same comprehensive benefits as children in Medicaid?..."
- also from Children's Defense Fund:
  brochure:
  Children’s Health Coverage South Carolina
  2 pages; languages: English
  from the brochure:
  "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....."
web page:
South Carolina: CHIP Program Name and Type

source:Kaiser Family Foundation statehealthfacts.org
languages: English, Spanish
from the web page:
"Individual state profiles..."
web page:
South Carolina Medicaid, SCHIP, & Federal Authority

source:State Coverage Initiatives
languages: English

South Carolina Medicaid Benefits and Coverage: Medicaid Services

brochure or publication:
Women and Medicaid in South Carolina

source:National Women's Law Center
3 pages; languages: English, Spanish
from the brochure or publication:
"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..."
web page:
(South Carolina Medicaid) Benefits by State: (October 2008)

source:Kaiser Family Foundation
languages: English, Spanish
from the web page:
"Medicaid benefits: Online database"
web page:
What Services Are Covered

source:South Carolina Department of Health and Human Services
languages: English
from the web page:
"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..."
- also from South Carolina Department of Health and Human Services):
  web page:
  Breast & Cervical Cancer Program
  languages: English
  from the web page:
  "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 ..."
- web page:
  Family Planning (FP) Waiver Services
  languages: English
  from the web page:
  " 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..."
brochure or publication:
Mental Health and Substance Abuse Services in Medicaid and SCHIP in South Carolina

source: US Dep't of Health and Human Services, Substance Abuse and Mental Health Services Administration
file size: 7 pg.; languages: English
from the brochure:
"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...."

Medicaid Prescription Drugs; Preferred Drug List

brochure or publication:
South Carolina Medicaid Pharmacy Services Program

source:Magellan Medicaid Administration, Inc
3 pages; languages: English
from the brochure:
"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..."

South Carolina Medicaid Dental Services; Dentist

web page:
Find an Oral Health Provider: South Carolina Dental Providers

source:InsureKidsNow.gov
languages: English
web page:
Dental Program Information (South Carolina Medicaid)

source: South Carolina Department of Health and Human Services
languages: English
from the web page:
"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. ..."
- also from South Carolina Department of Health and Human Services:
  web page:
  What Services Are Covered?
  languages: English
  from the web page:
  "...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..."

South Carolina Medicaid and Nursing Homes, Assisted Living, Home Health Care

web page:
Community Long Term Care

source:South Carolina Bureau of Long Term Care and Behavioral Health Services
languages: English
from the web page:
"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..."
web page:
Individuals In Nursing Facilities And/Or Receiving Home And Community-Based (Waiver) Services - An Overview

source:South Carolina Bureau of Eligibility Processing
languages: English
from the web page:
"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..."
web page:
Medicaid and Long-Term Care - South Carolina

source:New York Life Insurance Company
languages: English, Spanish
from the web page:
"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."
web site:The South Carolina Long Term Care Care Project
South Carolina Medicare Medicaid Nursing Homes Directory
languages: English
from the web page:
"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:
- Columbia South Carolina Nursing Homes
South Carolina Assisted Living
languages: English
from the web page:
"A consumer's guide to information and help about assisted living in South Carolina, with a directory of assisted living facilities..."
South Carolina Home Health Care

South Carolina Medicare / Medicaid Dual Eligibles - Medicaid for people who are on Medicare

web page:
SLMB/QMB/QI Programs (Specified Low Income Medicare Beneficiaries (SLMB) )

source:South Carolina Department of Health and Human Services
languages: English
from the web page: " 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..."

South Carolina Medicaid Waiver Programs

web page:
Contact Info and Descriptions for all South Carolina Medicaid 1915(c) HCBS Waivers, 2006

source:Center for Personal Assistance Services
languages: English
from the web page: "The following is a list of all South Carolina 1915(c) Waivers by name - complete with a description, contact information and web link..."
web page:
Medicaid Waivers and Demonstrations List

source:Centers for Medicare & Medicaid Services
languages: English
from the web page:
"...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 Medicaid Fraud in South Carolina

web page:
Medicaid Fraud Costs Taxpayers Millions!

source:South Carolina Department of Health and Human Services
languages: English
from the web page: " Report Fraud. Click to Report Fraud or Call the Hotline Phone Number (1-888-364-3224)..."

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South Carolina Medicaid &
Healthy Connections

Definitions of Medicaid in South Carolina

Medicaid in South Carolina*

South Carolina Children’s Medicaid and Children's Health Insurance Program:

South Carolina Medicaid / Medicare: What's the difference?

Medicaid in South Carolina: How It Works; An Introduction to South Carolina Medicaid

South Carolina Medicaid Eligibility, How to get Medicaid in South Carolina, Requirements

South Carolina Medicaid Citizenship Requirements

Applying for South Carolina Medicaid

South Carolina Medicaid Area Offices, Medicaid Hotline

South Carolina Medicaid Health Plans, HMO

Find South Carolina Medicaid Physicians, Healthy Connections Doctors

Children's Medicaid: Health Programs for Children: South Carolina CHIP:

South Carolina Medicaid Benefits and Coverage: Medicaid Services

Medicaid Prescription Drugs; Preferred Drug List

South Carolina Medicaid Dental Services; Dentist

South Carolina Medicaid and Nursing Homes, Assisted Living, Home Health Care

South Carolina Medicare / Medicaid Dual Eligibles - Medicaid for people who are on Medicare

South Carolina Medicaid Waiver Programs

Report Medicaid Fraud in South Carolina

SC: South Carolina Medicaid: The Medicaid Project, Eligibility, South Carolina Medicaid Rules, Application

Other Medicaid topics:

South Carolina Medicaid & Healthy Connections

Definitions of Medicaid in South Carolina

Medicaid in South Carolina*

South Carolina Children’s Medicaid and Children's Health Insurance Program:

South Carolina Medicaid / Medicare: What's the difference?

Medicaid in South Carolina: How It Works; An Introduction to South Carolina Medicaid

South Carolina Medicaid Eligibility, How to get Medicaid in South Carolina, Requirements

South Carolina Medicaid Citizenship Requirements

Applying for South Carolina Medicaid

South Carolina Medicaid Area Offices, Medicaid Hotline

South Carolina Medicaid Health Plans, HMO

Find South Carolina Medicaid Physicians, Healthy Connections Doctors

Children's Medicaid: Health Programs for Children: South Carolina CHIP:

South Carolina Medicaid Benefits and Coverage: Medicaid Services

Medicaid Prescription Drugs; Preferred Drug List

South Carolina Medicaid Dental Services; Dentist

South Carolina Medicaid and Nursing Homes, Assisted Living, Home Health Care

South Carolina Medicare / Medicaid Dual Eligibles - Medicaid for people who are on Medicare

South Carolina Medicaid Waiver Programs

Report Medicaid Fraud in South Carolina

SC: South Carolina Medicaid: The Medicaid Project, Eligibility, South Carolina Medicaid Rules, Application

Other Medicaid topics:

South Carolina Medicaid &
Healthy Connections