South Carolina
What Is South Carolina’s Medicaid Program for Long-Term Care?
South Carolina’s Medicaid program, known as Healthy Connections, offers healthcare coverage to low-income individuals. For seniors aged 65 and older, Medicaid can help cover long-term care services in nursing homes, assisted living, or at home.
What Types of Medicaid Long-Term Care Programs Are Available in South Carolina?
What Is Institutional or Nursing Home Medicaid?
This program is an entitlement, meaning anyone who qualifies will receive services. Care is provided only in nursing homes.
What Are Medicaid Waivers or Home and Community Based Services (HCBS)?
These waivers are not entitlements—there may be waiting lists due to limited availability. Services are designed to delay or prevent nursing home placement and can be provided at home, in adult day care, foster care, or assisted living.
What Is Regular Medicaid for the Aged, Blind, or Disabled (ABD)?
Also an entitlement, this program provides various long-term care supports, such as personal care or adult day services, to eligible individuals.
What Are the Financial Eligibility Rules for Long-Term Care Medicaid in South Carolina?
What Are the 2025 Income and Asset Limits?
Here are the basic criteria for eligibility in 2025:
- Income: Under $2,901/month
- Assets: Under $2,000
- Level of care: Nursing Home Level of Care
Note: Not meeting all requirements does not automatically mean you are ineligible.
What Are the Eligibility Limits by Marital Status?
| Type of Medicaid | Income Limit | Asset Limit | Level of Care |
|---|---|---|---|
| Single | $2,901/month* | $2,000 | Nursing Home |
| ABD | $1,305/month‡ | $9,660 | Assistance with ADLs |
| Married (both applying) | $5,802/month* | $4,000 | Nursing Home |
| ABD | $1,763/month‡ | $14,470 | Assistance with ADLs |
| Married (one applying) | $2,901/month* (applicant) | $2,000 (applicant) & $66,480 (spouse) | Nursing Home |
| ABD | $1,763/month‡ | $14,470 | Assistance with ADLs |
* Income exceeding these limits must be paid toward care, with limited allowances.
† Some HCBS beneficiaries may not keep income up to this level.
‡ SSI recipients in SC automatically qualify for ABD Medicaid.
How Does Medicaid Define and Count Income?
What Income Is Considered Countable?
Income from most sources is counted, including employment wages, Social Security, pensions, IRA withdrawals, and dividends. Exceptions include Holocaust restitution and VA Aid & Attendance in SC.
How Is Income Treated for Married Couples?
For Nursing Home or HCBS:
- Only the applicant’s income is counted.
- The non-applicant spouse may receive up to $3,948/month (MMNA) in income transfers.
For ABD:
- Both spouses’ incomes are counted.
- No spousal income allowance is given.
What Assets Are Countable vs. Exempt?
What Assets Count Toward the Medicaid Limit?
Countable assets include bank accounts, stocks, bonds, and property not used as a primary residence.
What Assets Are Exempt?
Examples include:
- Personal belongings and household goods
- One vehicle
- Burial funds up to $1,500 per spouse
- One home (if conditions are met)
- IRAs/401Ks in payout status (for applicants); always exempt for spouses
How Are Assets Treated for Married Couples?
Assets are considered jointly owned. The non-applicant spouse may retain up to $66,480 (2025) through the Community Spouse Resource Allowance.
What Is Medicaid’s Look-Back Rule?
Transfers of assets within 60 months before applying are reviewed. Giving away or undervaluing assets during this time results in a penalty period.
When Is a Home Exempt from Medicaid Asset Limits?
The home is exempt if the applicant or their spouse lives there. If neither does, the applicant must show Intent to Return. The equity interest must be below $730,000 (2025). The home is not exempt from Medicaid Estate Recovery.
What Are the Medical Requirements for Long-Term Care Medicaid?
Applicants must meet specific care needs:
- Nursing Home/HCBS: Must meet Nursing Facility Level of Care (NFLOC).
- ABD: Must require assistance with Activities of Daily Living (ADLs).
What If a Senior Is Over the Income or Asset Limits?
What Is a Qualified Income Trust (QIT)?
A QIT allows income above the Medicaid limit to be deposited into an irrevocable trust. These funds can only be used for approved purposes like medical care. SC Medicaid must be the remainder beneficiary.
What Is a Medicaid Asset Spend Down?
Applicants can reduce countable assets by spending on home modifications, debt payments, burial arrangements, etc. Documentation is essential to comply with the Look-Back Rule.
What Is Medicaid Planning?
Medicaid planners assist over-income or over-asset individuals with legal strategies to become eligible and protect their assets, such as the family home.
What Medicaid Programs Are Available for South Carolina Seniors?
Community Choices Waiver
Provides in-home and community-based services like adult day care, home modifications, and help with ADLs for seniors who qualify for nursing home care.
Healthy Connections Prime
A managed care program for individuals eligible for both Medicaid and Medicare, providing long-term care services at home or in the community.
PACE
The Program of All-Inclusive Care for the Elderly offers combined Medicare and Medicaid benefits, often with extras like dental and vision care.
Money Follows the Person
Also called Home Again in SC, this federal program helps Medicaid beneficiaries return to home or community settings after living in a facility.
How Do Seniors Apply for Medicaid in South Carolina?
Applications can be submitted online via Healthy Connections, or through local county offices. Program-specific forms are required. For help, contact the Members Help Center at 888-549-0820.
