South Carolina Medicaid

Updated August 2026

Healthy Connections is South Carolina's Medicaid program. The South Carolina Department of Health and Human Services (SCDHHS) administers the program from its Columbia headquarters, with county offices across the state. As of 2025, approximately 1.1 million South Carolinians are enrolled — around 21% of the state's population.

South Carolina has not expanded Medicaid — adults without children typically do not qualify

South Carolina is one of the remaining states that has not adopted the ACA Medicaid expansion. Working-age adults without dependent children generally do not qualify for Healthy Connections Medicaid regardless of income. If you are in this situation and need health coverage, visit healthcare.gov to explore marketplace options.

What is Healthy Connections, South Carolina's Medicaid program?

Because South Carolina has not expanded Medicaid, eligibility is limited to specific categories: children, pregnant women, parents and caretaker relatives with dependent children, people who are aged or disabled, and some other narrow groups. Adults without children, regardless of income, do not qualify unless they are aged, blind, or have a qualifying disability.

Most Healthy Connections members receive care through a managed care organization (MCO). MCOs under contract with SCDHHS include Absolute Total Care (Centene), Molina Healthcare of South Carolina, Select Health of South Carolina, and Carolina Complete Health. Members choose an MCO at enrollment; the MCO then coordinates all covered services.

Who is generally eligible for Healthy Connections?

Eligibility categories and income limits effective March 1, 2026, per SCDHHS:

Children under 19 (Partners for Healthy Children) — up to 208% FPL
Pregnant women — up to 194% FPL
Parents and caretaker relatives with a dependent child at home — at or below 62% FPL
People age 65 or older (Aged, Blind, or Disabled category) — at or below 100% FPL
People who are blind or have a qualifying disability — at or below 100% FPL
Former foster care youth up to age 26 (no income limit applies)
Individuals with breast or cervical cancer needing treatment — up to 200% FPL
Working disabled individuals — up to 250% FPL with earned income

Source: SCDHHS Program Eligibility and Income Limits page, effective March 1, 2026. Verify current income thresholds at scdhhs.gov or by calling the Member Help Center at 1-888-549-0820.

The coverage gap in South Carolina

South Carolina's decision not to expand Medicaid creates a coverage gap. A single adult without children who earns less than 100% FPL earns too little for marketplace premium tax credits (which start at 100% FPL) but earns too much — or simply doesn't qualify — for Healthy Connections. Per KFF research, South Carolina has one of the larger uninsured populations in the Southeast as a result.

Adults in the coverage gap may be able to access care through Federally Qualified Health Centers (FQHCs), which provide sliding-scale services regardless of insurance. Use the HRSA Health Center Finder at findahealthcenter.hrsa.gov to locate an FQHC in South Carolina.

Healthy Connections Prime: coverage for dual eligibles

South Carolinians who qualify for both Medicare and Medicaid — called dual eligibles — may be enrolled in Healthy Connections Prime, a separate managed care program specifically for people with dual eligibility. Healthy Connections Prime coordinates Medicare and Medicaid benefits through a single plan to reduce gaps and administrative complexity for members who need both.