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Learn About Requirements for Medicaid in South Carolina

Medicaid eligibility requirements in South Carolina provide a path for low-income families and other needy individuals to get assistance in the form of health care coverage. Understanding how to qualify for Medicaid makes it possible for applicants to take advantage of the program, which is known as Healthy Connections in South Carolina. The process to qualify for Medicaid is established in part by the federal government, which works in tandem with the state to fund and operate Medicaid for the population. The benefits of Medicaid are numerous, but for individuals or families to take advantage of the system, they must meet several provisions that include legal status in the country, income levels and more. Learn more about SC Medicaid benefits eligibility guidelines by reading through the information provided on this web page.


Who qualifies for Medicaid in South Carolina?

Determining who is eligible for Healthy Connections Medicaid assistance begins with understanding the categories of individuals who may apply. The Healthy Connections program quickly identifies eligibility for Medicaid benefits by separating applicants into different groups. For example, low-income pregnant women and infants who cannot afford health insurance are eligible to apply for Medicaid. Additional groups of eligible applicants include low-income families, children younger than 19 years of age and adults 65 years of age or older. Eligibility for Medicaid in South Carolina extends to former foster children between 18 and 26 years of age, regardless of their income.

The Medicaid eligible groups listed above are just some examples of those who may qualify for Medicaid benefits. Medicaid eligibility requirements were expanded under the Affordable Care Act (ACA) Medicaid expansion. However, South Carolina has yet to accept the Medicaid expansion guidelines outlined in the ACA.

What are the requirements for Medicaid in South Carolina?

Medicaid eligibility rules in South Carolina include a broad range of provisions outlined by the program. Understanding the procedures to qualify for SC Medicaid makes it more likely that eligible candidates will receive aid. Additionally, failing to satisfy any one of the Medicaid benefits eligibility guidelines means applicants will be disqualified for assistance. Medicaid eligibility requirements include the following:

  • Candidates must fall within any established income thresholds.
  • Candidates must provide proof of permanent residency in South Carolina.
  • Candidates must provide proof of citizenship or legal immigration status.

Eligibility for Medicaid is only possible for U.S. citizens or non-citizens who are in the U.S. with proper legal status. For citizens, providing a Social Security Number is required to prove status. Non-citizens will have to provide documentation demonstrating their legal status. To qualify for Medicaid benefits in South Carolina, both groups must also demonstrate their residence in South Carolina through acceptable forms of documentation.

What are the income requirements for Medicaid in South Carolina?

South Carolina Medicaid requirements will typically call for applicants to fall under a maximum income level. However, these income requirements for SC Medicaid will depend on the type of Medicaid program to which the petitioner is applying. For example, the Medicaid eligibility guidelines for the Medically Indigent Assistance Program (MIAP) and the Breast & Cervical Cancer Program both require the candidate’s household income to not exceed 200 percent of the Federal Poverty Level (FPL), which currently translates to $4,050 in monthly income for a family of four. However, to be eligible for Medicaid benefits through the Parent/Caretaker Relatives program, a family of four cannot exceed $1,255.50 in monthly income. To learn more about specific income requirements for Medicaid, download our free guide today.

What are the Medicaid application guidelines in South Carolina?

Qualifying for South Carolina Medicaid is vital for low-income families who are seeking much-needed health care coverage. However, meeting Medicaid eligibility requirements is a process that includes substantial information and documentation. Ultimately, to determine Medicaid benefits eligibility, government officials will need to have this information provided by an application form. The process to qualify for Medicaid benefits gets underway when a petitioner begins applying for Medicaid benefits. The SC Medicaid application guidelines require beneficiaries to provide accurate data. Agents reviewing a Medicaid application will verify all details provided by applicants, and info that cannot be verified may be grounds for disqualification.

What are common Medicaid disqualification in South Carolina?

Understanding Medicaid eligibility requirements makes it more likely for applicants to receive assistance or learn if they are ineligible. One common cause for applicants to not qualify for Medicaid in South Carolina includes failing to provide proof of legal residency in the state. Potential beneficiaries cannot get assistance from a state unless they live in the state on a long-term basis. Failing to meet income requirements for Medicaid is also grounds for disqualification. In some cases, failing to provide proof of medical need may make eligibility for Medicaid impossible.