South Carolina Medicaid & Elder Care
South Carolina's Healthy Connections Medicaid offers vital long-term care support for seniors through its Community Choices Waiver, requiring a Nursing Facility Level of Care and utilizing Miller Trusts for income over the cap.
Medicaid Report Card
Overall State Performance Index
Based on CMS Nursing Home Compare + state Medicaid agency data
View Methodology arrow_forwardSouth Carolina Monthly Costs
South Carolina's average nursing home costs are approximately 13% lower than the 2026 national average, and assisted living costs are about 21% lower than the national median.
Waiver Programs
Community Choices (CC) Waiver
Also called: Community Choices
The Community Choices Waiver provides home and community-based services for frail elderly individuals (age 65 and older) and persons with physical disabilities (ages 18-64) who meet nursing facility level of care criteria. This waiver offers an alternative to institutional care, allowing eligible participants to receive support in their homes or community residential care facilities.
- check_circle Case Management
- check_circle Personal Care Assistance
- check_circle Adult Day Health Care
- check_circle Home Modifications
- check_circle Specialized Medical Equipment
- check_circle Personal Emergency Response System
- check_circle Companion Care
insights Program Snapshot
- Functional criterion
- Nursing Facility Level of Care
- Administered by
- South Carolina Department of Health and Human Services (SCDHHS) Community Long Term Care (CLTC) division
- Recertification
- Annual
- Self-direction
- Available for Attendant Care and Companion Care
2026 Eligibility Requirements
| Criteria | Individual Limit | Married (Both Applying) |
|---|---|---|
| Monthly Income | $2,982 | $5,964 |
| Asset Limit | $2,000 | $4,000 |
| Home Equity Limit | $752,000 | |
| Level of Care | Nursing Facility Level of Care (NFLOC) | |
Estate Recovery Warning
South Carolina's Estate Recovery Program is federally mandated to recoup Medicaid long-term care costs from deceased beneficiaries' estates. Recovery is deferred for surviving spouses or minor/disabled children, and undue hardship waivers can be requested.
Spend-Down & Asset Protection
PROTECTED ASSETS
COMMON PITFALLS
- warning Look-back Period: Gifts or asset transfers made within 60 months of application trigger heavy penalties.
- warning Excess Income: Failing to establish a Miller Trust if monthly income exceeds the state's income cap.
- warning Joint Accounts: The full balance of joint bank accounts is often counted as the applicant's asset.
First Steps for Families
Locate your ADRC
Contact your local South Carolina Aging and Disability Resource Center.
Gather 5 years of records
Bank statements, deeds, asset transfers for the Medicaid look-back period.
Financial assessment
Consult a Medicaid planner if assets exceed $2,000.
Resource Contact
South Carolina Department of Health and Human Services
How to Apply for South Carolina Long-Term Care Medicaid
Assess Level of Care
Obtain medical certification confirming the need for a Nursing Facility Level of Care.
Gather Records
Collect 60 months of financial statements, income verification, medical, identity, and property documents.
Setup Miller Trust
Establish a Qualified Income Trust if monthly income exceeds South Carolina's Medicaid income cap.
Submit Application
Apply online via Healthy Connections, or submit forms by mail, fax, or in person to a local SCDHHS county office.
Interviews
Attend required interviews and evaluations with a Medicaid caseworker.
Approval & Care
Receive a final eligibility determination and activate Medicaid benefits for long-term care services.
Documents You'll Need
Financial Verification
- 5 years of bank statements
- Stock/bond certificates
- Retirement account information
- Proof of all assets
Income Verification
- Social Security award letters
- Pension statements
- VA benefit statements
- Other income sources
Medical/Identity
- Social Security card
- Medicare card
- Driver's license or state ID
- Doctor's clinical assessments of functional need
Property/Residency
- Home deed
- Vehicle registration
- Proof of South Carolina residency
- Utility bills
Frequently Asked Questions About South Carolina Medicaid
Does South Carolina Medicaid pay for assisted living?
Yes, South Carolina Medicaid, through programs like the Community Choices Waiver, can cover services in community residential care facilities (assisted living facilities) for eligible seniors who meet a Nursing Facility Level of Care. However, it typically does not cover the room and board costs of assisted living.
What is the South Carolina Medicaid income limit for seniors in 2026?
For Nursing Home Medicaid and Home and Community Based Services (HCBS) Waivers, the individual income limit for seniors in South Carolina in 2026 is $2,982 per month. For married couples where both are applying, the combined income limit is $5,964 per month. If income exceeds this cap, a Qualified Income Trust (Miller Trust) may be required.
How long is the HCBS waiver waitlist in South Carolina?
South Carolina's Home and Community Based Services (HCBS) waivers, such as the Community Choices Waiver, are not entitlements and may have waitlists. While specific waitlist counts or average wait times for the Community Choices Waiver are not publicly published, it is acknowledged that eligible seniors may experience wait times to receive services.
Will Medicaid take my parent's house in South Carolina?
South Carolina Medicaid's Estate Recovery Program may place a claim against a deceased beneficiary's estate, including their home, to recover costs of long-term care services received after age 55. However, recovery is deferred if a surviving spouse or a child under 21, or who is blind or permanently disabled, resides in the home. Undue hardship waivers are also available.
Can I be paid to care for my parent through South Carolina Medicaid?
South Carolina's Community Choices Waiver, which provides home and community-based services, may offer self-direction options for certain services like attendant care and companion care. This can potentially allow family members, excluding spouses or legal guardians of adults, to be paid as caregivers for their parents.
Medicaid vs Medicare for long-term care in South Carolina?
Medicare primarily covers short-term, skilled nursing care and rehabilitation, not ongoing long-term custodial care in South Carolina. Medicaid (Healthy Connections) is the primary payer for long-term care services, including nursing home care and home and community-based services through waivers like the Community Choices Waiver, for eligible low-income seniors.
TOPICAL GUIDES — HOW MEDICAID WORKS
EXPLORE SOUTH CAROLINA
Last updated: April 24, 2026. Sources: South Carolina Department of Health and Human Services, CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.