South Carolina Medicaid

 

Medicaid in South Carolina is called Healthy Connections, and is a great health insurance program for low-income residents of the state who qualify. SC Healthy Connections offers health insurance to individuals and families living in South Carolina who are legal U.S. citizens or permitted residents. Medicaid is available for a variety of groups and offers specialized programs pertaining to each one who is eligible.

Coverage offered by Healthy Connections is paid for in full by the state and federal government, and is applied to services deemed medically necessary by the state. Depending on the type of plan, this can include but is not limited to doctor’s office visits, hospital stays, dental and vision care, disease management, medical equipment, care coordination, and prescription medications.

 

Eligibility for SC Healthy Connections

Though the first set of criteria is to be a resident or the United States with a Social Security Number, there are emergency and maternity services available for those who are non-citizens living in South Carolina. Income criteria ranges based on the group to which you belong, and is based on a percentage of Federal Poverty Level (FPL). Anyone who is over the age of 65, blind, or disabled receiving Social Security Income (SSI) is also instantly eligible. The following is an outline of most qualifying groups for Healthy Connections.

  • Pregnant women and infants under age 1 with a household income less than or equal to 185% of FPL.
  • Parents and relative caretakers living with children up to age 18 with an income at or below 93% of FPL, with no more than $30,000 in assets.
  • Children ages 1 – 18 with a family income at or below 150% of FPL.
  • Aged, blind or disabled persons with a total income of up to 100% of FPL, and resources of no more than $4000 for individuals and $6000 for couples.
  • Families and children in a cash assistance program such as TANF, Aid to Families with Dependent Children, or Family Independence.
  • Qualified Medicare Beneficiaries (QMB) – individuals over age 65 on Medicare with income at or below 120% of FPL.
  • Persons who want to use family planning services with a household income at or below 185% of FPL.
  • Employed disabled individuals whose income does not exceed 250% of FPL.
  • Elderly, blind or disabled persons living in a long-term care facility that participates in the Optional State Supplementation Program with no more than $1157/month income and under $2000 in assets.
  • Individuals with high medical bills and income over the allowed Medicaid limit (Medically Needy).
  • Children with special mental or physical health needs or a chronic medical condition.
  • Women in need of cervical or breast cancer treatment.

 

Healthy Connections Medicaid Card

When you apply for the South Carolina Healthy Connections program and have been approved, you will receive a Medicaid identification card. In addition to that card, the health plan you choose may come with its own separate card. Plans that issue their own cards include Absolute Total Care, HealthPlan Medicaid, UnitedHealthcare Community Plan, and First Choice by Select Health of South Carolina.

Other plans operate through the ID card provided by South Carolina Healthy Connections, such as Carolina Medical Homes, South Carolina Solutions, and Palmetto Physician Connections. It is necessary to keep this card on you at all times in case you need medical care or have any questions regarding your plan.

This card gives you access to the providers designated by your plan, and most of the time is it completely free of charge. There can be a copayment involved with certain services for some individuals, but they will let you know up front and the cost is not unmanageable. Every individual who uses Medicaid, even under the same roof, will be issued their own ID card with a number specific to them.

To avoid fraud, keep track of your card and make sure not to lose it, as it could easily be misused by the wrong hands. Also, even if you lose your eligibility it is important to hold on to your card in the event that you qualify again in the future. If it does get lost, contact the South Carolina Healthy Connections office at 888 549 0820.

You can also receive care out of the state if you leave South Carolina, as long as you show your card to the provider you are seeing. Your card should contain directions on how to get medical attention out-of-state on the back.

 

Resources

South Carolina Healthy Connections Choices

South Carolina Department of Health & Human Services

Apply for Benefits

Contact South Carolina Healthy Connections

888 549 0820