TL;DR
- This guide covers South Carolina Medicaid eligibility, income limits, covered services, and how to apply.
- South Carolina has not expanded Medicaid, so adult coverage is more limited.
- Take the free screening to see exactly which South Carolina programs you qualify for.
South Carolina Medicaid Overview
Medicaid in South Carolina has more limited coverage for adults because the state has not expanded Medicaid under the ACA. However, children, pregnant women, and people with disabilities have broader eligibility..
South Carolina Medicaid Income Limits 2026
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|---|---|
| 1 | $21,597/year | $1,799/month |
| 2 | $29,186/year | $2,432/month |
| 3 | $36,777/year | $3,064/month |
| 4 | $44,367/year | $3,697/month |
| 5 | $51,956/year | $4,329/month |
These limits apply to the standard Medicaid population. Children, pregnant women, and people with disabilities often qualify at higher income levels.
Children's Medicaid in South Carolina
Children in South Carolina can qualify for Medicaid at higher income levels than adults, often up to 200% FPL or more. Children under 6 typically have the highest income limits.
Pregnant Women
Pregnant women in South Carolina can qualify for Medicaid with incomes up to 185-200% FPL in most cases. Coverage includes prenatal care, delivery, and postpartum care for 12 months after delivery.
What South Carolina Medicaid Covers
Federal law requires all state Medicaid programs to cover:
- Inpatient and outpatient hospital services
- Physician services
- Laboratory and X-ray services
- Nursing facility services
- Home health services
- Early and periodic screening for children (EPSDT)
- Family planning services
- Federally qualified health center services
South Carolina also covers optional services including dental care, vision care, prescription drugs, and physical therapy.
How to Apply for Medicaid in South Carolina
- Visit South Carolina's Medicaid website or benefits portal
- Complete the application online, by phone, in person, or by mail
- Provide proof of identity, income, residency, and citizenship or immigration status
- Wait for a determination (many states process within 45 days, some faster)
- If approved, select a managed care plan if required in your area
You can also apply through Healthcare.gov. If your income qualifies for Medicaid, the marketplace will transfer your application to South Carolina's Medicaid agency.
Presumptive Eligibility
South Carolina offers presumptive eligibility, which means you can get temporary Medicaid coverage while your full application is being processed. This is especially helpful for pregnant women and people who need immediate medical care.
Medicaid Managed Care in South Carolina
Most South Carolina Medicaid beneficiaries are enrolled in managed care plans (HMOs). You will choose a plan and a primary care provider.
Renewing Your South Carolina Medicaid
Medicaid coverage must be renewed annually. South Carolina will send you a renewal form before your coverage period ends. Complete and return it promptly to avoid gaps in coverage. If you miss the deadline, you may be able to reinstate coverage by contacting your Medicaid office quickly.
Related Resources
- Texas Benefits Guide 2026: Every Program Available to Residents
- Connecticut Medicaid Eligibility 2026: Income Limits and How to Apply
- Kentucky SNAP Benefits Guide 2026: Amounts, Eligibility, and How to Apply
- Benefits During a Strike: What Workers Can Get
- Elder Justice Programs: Protection Against Elder Abuse
Find Out What Benefits You Qualify For
Most people qualify for more benefits than they think. In fact, over $30 billion in government benefits goes unclaimed every year simply because people do not know they are eligible.
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Frequently Asked Questions
What should I know about south carolina medicaid overview?
Medicaid in South Carolina has more limited coverage for adults because the state has not expanded Medicaid under the ACA. However, children, pregnant women, and people with disabilities have broader eligibility..
What should I know about south carolina medicaid income limits 2026?
These limits apply to the standard Medicaid population. Children, pregnant women, and people with disabilities often qualify at higher income levels.
What South Carolina Medicaid Covers?
Federal law requires all state Medicaid programs to cover:
How to Apply for Medicaid in South Carolina?
You can also apply through Healthcare.gov. If your income qualifies for Medicaid, the marketplace will transfer your application to South Carolina's Medicaid agency.
What should I know about medicaid managed care in south carolina?
Most South Carolina Medicaid beneficiaries are enrolled in managed care plans (HMOs). You will choose a plan and a primary care provider.
What should I know about renewing your south carolina medicaid?
Medicaid coverage must be renewed annually. South Carolina will send you a renewal form before your coverage period ends. Complete and return it promptly to avoid gaps in coverage.
What are the benefits of find out what benefits you qualify for?
Most people qualify for more benefits than they think. In fact, over $30 billion in government benefits goes unclaimed every year simply because people do not know they are eligible.