To apply for Medicaid in South Carolina, submit an application to the state’s Healthy Connections program through the Department of Health and Human Services (SCDHHS). You have four options: online at apply.scdhhs.gov, by phone at (888) 549-0820, by mail using Form 3400, or in person at a county SCDHHS office.1SCDHHS. Getting Started The online application takes about 15 minutes if your documents are ready. The bigger question for most people isn’t how to apply but whether they’ll qualify, because South Carolina has not expanded Medicaid and limits coverage to specific groups.
Who Qualifies for South Carolina Medicaid
South Carolina restricts Medicaid to categorical eligibility groups: children, pregnant women, parents and caretaker relatives with dependent children, and people who are aged, blind, or disabled (ABD).2South Carolina Legislature. 2025-2026 Bill 3109 – Medicaid Expansion Being low-income alone does not qualify you. A single adult with no children and no disability will not be approved regardless of how little they earn.
Within each covered group, income is measured against the Federal Poverty Level (FPL). For 2026, the FPL is $15,960 per year for one person and $33,000 for a family of four.3HHS ASPE. 2026 Poverty Guidelines – 48 Contiguous States The thresholds SCDHHS applies vary by group:4Medicaid. Medicaid, Children’s Health Insurance Program, and Basic Health Program Eligibility Levels
- Parents and caretaker relatives: up to 62 percent of the FPL. For a family of three, that’s roughly $1,412 per month.
- Pregnant women: up to 194 percent of the FPL, a much more generous ceiling.
- Children from birth through age 18: up to 208 percent of the FPL, which reaches about $68,640 for a family of four. South Carolina runs children’s coverage through Medicaid directly rather than a separate CHIP program.
- Aged, blind, or disabled adults: at or below 100 percent of the FPL, or $15,960 per year for one person in 2026.
If you’re a non-disabled adult without dependent children, you fall into what analysts call the coverage gap. You earn too little for subsidized marketplace insurance (which begins at 100 percent of the FPL) and don’t fit any Medicaid category. Community health centers with sliding-scale fees are often the only remaining option, and it’s worth checking whether a disability-based pathway might apply.
Resource Limits for ABD Applicants
ABD applicants face an additional test that other groups don’t. As of January 2026, countable resources cannot exceed $9,950 for an individual or $14,910 for a couple.5SCDHHS. Program Eligibility and Income Limits Bank accounts, stocks, bonds, and secondary properties count. Your primary home and one vehicle generally do not. These limits were raised substantially in recent years, so a past denial for excess assets may no longer reflect the current rules.
Documents to Gather Before You Start
The single most common cause of a stalled application is missing paperwork. Have these ready before you begin:
- Social Security numbers for everyone in the household seeking coverage.
- Proof of South Carolina residency, such as a utility bill, lease, or piece of mail with your current address.
- Proof of citizenship or immigration status: a birth certificate, U.S. passport, or permanent resident card.
- Income verification: recent pay stubs, your most recent federal tax return, or an employer letter. If self-employed, bring profit-and-loss documentation.
- For ABD applicants only, asset documentation: bank statements, property records, and investment account statements.
The paper form is SCDHHS Form 3400, “Application for Medicaid and Affordable Health Coverage,” available on the SCDHHS website or at any county office.6SCDHHS. Forms Report gross monthly household income before taxes and deductions. Household size follows tax filing rules, so count everyone you’d claim on a return. Miscounting the household is one of the most frequent errors, and it changes which FPL percentage the state applies to your case.
Submitting the Application
SCDHHS accepts applications four ways:
- Online at apply.scdhhs.gov. This is the fastest route.
- By phone at (888) 549-0820, Monday through Friday, 8 a.m. to 6 p.m., with help from a representative.7SCDHHS. Where to Go For Help
- By mail, using a completed Form 3400 sent to the central processing address printed on the form.
- In person at your county SCDHHS office during business hours.
Free application help is available through SC Thrive, a nonprofit that partners with SCDHHS.1SCDHHS. Getting Started Whichever channel you choose, keep copies of everything you send. If SCDHHS later disputes what you reported, those copies are your evidence.
How Long Approval Takes
Federal rules give SCDHHS 45 days from the date it receives your completed application to issue a decision.8SCDHHS. FAQs Applications that involve a disability determination get 90 days because a medical review is required.9eCFR. 42 CFR 435.912 – Timely Determination of Eligibility During that window, caseworkers verify your income and cross-check your information with state and federal databases. The decision arrives by mail.
The clock only runs while your application is complete. Blank fields or missing income documents trigger a request for more information, and the processing period effectively restarts. Submitting a thorough application the first time is the biggest factor in how quickly you’re approved.
Retroactive Coverage for Bills Before You Applied
Medicaid can pay for medical care you received up to three months before the month you applied, provided you would have qualified during those earlier months. If a health crisis delayed your application, that lookback can wipe out bills you’re already carrying. Coverage runs from when you became eligible, not from when SCDHHS finishes processing your case, so a slow approval doesn’t shrink the retroactive window. Beginning in January 2027, federal legislation reduces this lookback to two months for most applicants; the three-month rule holds through the end of 2026.
Keeping Coverage: Annual Renewals
Every 12 months, SCDHHS reviews whether you still qualify. The agency first tries to renew you automatically using wage databases and other benefit records. If it can confirm your eligibility that way, you’ll get a Continuation of Benefits notice and don’t need to act.
If automatic renewal fails, SCDHHS mails a review form to your address on file. You have 60 days from the date on the notice to complete and return it. Miss that deadline and you can lose coverage even if you still qualify. Outdated contact information is where most renewal problems start. If you’ve moved, update your address through tools.apply.scdhhs.gov or by calling (888) 549-0820.
If Your Application Is Denied
A denial can be appealed. SCDHHS must send you written notice of any adverse action, and federal law gives you the right to a fair hearing before a hearing officer.10SCDHHS. Appeals11Legal Information Institute (LII). 42 CFR Part 431 Subpart E – Fair Hearings for Applicants and Beneficiaries You have up to 90 days from the date of the notice to request a hearing. File online through the SCDHHS website or by calling the Member Contact Center at (888) 549-0820.
If you’re an existing beneficiary whose coverage is being reduced or terminated and you request a hearing before the effective date of the change, your benefits generally continue until the hearing officer decides. Before appealing, read the denial letter closely. The most common reasons are income slightly above the limit, missing documentation, or not fitting an eligible category. If the issue is missing paperwork, resubmitting a complete application is often faster than pursuing a hearing.
Estate Recovery for Long-Term Care
ABD applicants and their families should know about estate recovery. South Carolina law requires SCDHHS to seek repayment from the estates of certain deceased Medicaid recipients for the cost of long-term care the state covered.12South Carolina Legislature. South Carolina Code Title 43 Chapter 7 Section 43-7-460 – Recovery of Medical Assistance From Estates Recovery applies when someone dies in a nursing facility or similar institution, or when someone age 55 or older received nursing facility care, home and community-based services, or related hospital and prescription drug coverage.
The state cannot pursue recovery while a surviving spouse is alive, and recovery is barred when there’s a surviving child under 21 or a surviving child who is blind or permanently disabled. Heirs can also request a hardship waiver. Estate recovery does not affect benefits during your lifetime, but families holding significant property should plan for it, and an elder law attorney is the right person to consult before transferring assets.