Medicaid for Senior Care in South Carolina
What Medicaid Actually Covers for Senior Care
In South Carolina, Medicaid is known as Healthy Connections, and it's a lifeline for many families navigating senior care. If your parent needs the intensive support of a nursing home, Healthy Connections Nursing Home Medicaid can cover comprehensive services like room and board, personal care, skilled nursing, doctor visits, prescription medications, and even mental health counseling. However, it won't pay for private rooms or non-medically necessary items. Your parent would keep a small personal needs allowance of just $60 per month, with most other income going towards their care.
For those who need a nursing home level of care but wish to stay at home or in a community setting like assisted living, the South Carolina Community Choices Waiver is the primary program. This waiver acts like a voucher, offering crucial support such as in-home personal care, modifications to make their home safer, personal emergency response systems, adult day health care, specialized medical equipment, and home-delivered meals. It helps with daily activities like bathing, dressing, and eating, allowing your parent to remain independent for longer. What's important to know is that while this waiver covers many services, it generally does not cover the cost of room and board in assisted living facilities.
Do You Qualify?
Determining eligibility for Medicaid in South Carolina involves both medical and financial criteria. Your parent must be 65 or older (or have a qualifying disability) and be a South Carolina resident. For Nursing Home Medicaid and the Community Choices Waiver, they must also require a nursing facility level of care.
For 2026, a single applicant for Nursing Home Medicaid or the Community Choices Waiver must have a monthly income no higher than $2,982 and countable assets of no more than $2,000. If both parents are applying, their combined asset limit is $4,000. If only one parent is applying, the applicant's asset limit remains $2,000, but the non-applicant spouse can keep up to $66,480 in assets.
Many families ask about the home. Your parent’s primary residence is generally exempt from asset limits if they intend to return home, or if a spouse or dependent relative lives there. There's a home equity limit of $752,000 for Nursing Home Medicaid and waivers, but this limit doesn't apply if a spouse or dependent lives in the home. Be aware, though, that the home is not protected from Medicaid's Estate Recovery Program after your parent passes away. If your parent has a pension or other income that pushes them over the limit, a Qualified Income Trust (QIT), sometimes called a "Miller Trust," can help them become income-eligible. If assets exceed the limit, they may need to be "spent down" on approved items, but remember the strict 60-month (five-year) look-back period on asset transfers, which can cause penalties if rules are broken.
Waitlists & How to Apply
Navigating the application process and understanding waitlists is crucial. Nursing Home Medicaid is an entitlement program, meaning if your parent qualifies, they are guaranteed benefits. However, finding an available bed in a Medicaid-accepting facility can still be a challenge. The situation is different for the Community Choices Waiver; it is not an entitlement, and there are limited spots available. As of January 2025, the Community Choices Waiver had a waitlist of 23,140 individuals, with wait times potentially lasting months to years.
To apply, you can visit the South Carolina Department of Health and Human Services (SCDHHS), also known as Healthy Connections. Applications can be submitted online through apply.scdhhs.gov, faxed to 888-820-1204, mailed to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or delivered in person to a local Healthy Connections county office. For specific Community Choices Waiver inquiries, you can contact your local Community Long Term Care (CLTC) office or call their Centralized Intake at (888) 971-1637. You'll need documents like proof of identity, Social Security number, residency, income, and asset information. A decision on eligibility is typically made within 45 days, though disability determinations can extend this to 90 days.
Last updated: March 2026. Sources: CMS, state Medicaid agency, Genworth 2024.