South Carolina Medicaid for Seniors & Long-Term Care
Updated August 2026
Seniors age 65 and older who require nursing facility-level care may qualify for Healthy Connections long-term care Medicaid. Eligibility requires meeting both a medical standard (needing nursing facility level of care) and a financial standard (income and assets below the limits).
$2,982/mo
Individual income limit (300% of SSI FBR, effective Jan. 2026)
$2,000
Individual resource (asset) limit
CLTC
Community Long Term Care — SC's primary HCBS waiver
South Carolina's long-term care Medicaid income limit is 300% of the SSI Federal Benefit Rate — $2,982/month as of January 2026
Per SCDHHS Program Eligibility and Income Limits (effective January 1, 2026), the income limit for Healthy Connections nursing facility and HCBS waiver coverage is $2,982 per month for an individual. A married couple may also apply a spousal allocation of $4,066.50 per month to protect the community spouse's income.
Long-term care eligibility for seniors in South Carolina
The income limit for long-term care Healthy Connections is 300% of the Social Security Federal Benefit Rate — $2,982 per month for an individual as of January 1, 2026, per SCDHHS. There is a separate resource (asset) limit, generally $2,000 for a single individual. A community spouse — the husband or wife who remains at home — may retain a protected resource amount under federal spousal impoverishment rules.
- Must be a South Carolina resident
- Must be a U.S. citizen or qualified noncitizen
- Must require nursing facility level of care (determined by SCDHHS clinical assessment)
- Income at or below $2,982/month (individual, effective January 2026)
- Countable resources generally at or below $2,000 for a single individual
- Community spouse may retain protected resources under federal spousal impoverishment rules
Community Long Term Care (CLTC): staying home instead of a nursing facility
South Carolina's Community Long Term Care (CLTC) division administers home and community-based waiver services for people who need nursing facility-level care but choose to remain at home or in community settings. The specific 1915(c) waiver CLTC operates for seniors and adults with physical disabilities is the Community Choices (CC) Waiver, SCDHHS's primary HCBS waiver program for this population.
- Personal care assistance and attendant care
- Home health aide and skilled nursing visits
- Adult day care
- Respite care for family caregivers
- Medical supplies and equipment
- Home modifications (wheelchair ramps, grab bars)
- Homemaker services
- Care coordination and case management
Before you can apply for HCBS waiver services, SCDHHS requires a CLTC determination — a clinical assessment confirming that you meet the nursing facility level of care standard. This must be done before completing the financial application. Contact your local SCDHHS office or call CLTC at 1-888-549-0820 to request the assessment.
Coverage for dual eligibles: Healthy Connections Prime has ended
South Carolina previously offered Healthy Connections Prime, a Medicare-Medicaid managed care plan for "dual eligibles" — people who qualify for both Medicare and Healthy Connections Medicaid. Per SCDHHS, Healthy Connections Prime ended as of January 1, 2026, in response to new federal requirements for health plans serving dual eligibles.
Members who were enrolled in Prime were transitioned to a Dual Special Needs Plan (D-SNP), which now serves the same coordinating role — combining Medicare and Medicaid benefits, including long-term services and supports, under a single plan. Contact SCDHHS at 1-888-549-0820 for help choosing or confirming enrollment in a D-SNP.
Nursing facility coverage
South Carolina Medicaid (Healthy Connections) covers skilled nursing facility care for seniors who meet clinical and financial criteria. Once approved, Medicaid pays the nursing home directly — the resident contributes most of their monthly income toward the cost of care, typically all income minus a personal needs allowance, and Medicaid covers the gap. If income exceeds the institutional Medicaid limit, South Carolina may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible.
Spousal protections and estate recovery
When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse is entitled to keep a minimum amount of assets — the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income, called the minimum monthly maintenance needs allowance (MMMNA), if their own income is insufficient. South Carolina's current CSRA is set by SCDHHS and published on their website.
SCDHHS operates an estate recovery program. The state may seek reimbursement from the estate of a Healthy Connections member who received long-term care services — nursing facility or HCBS waiver — after age 55. Recovery applies to the cost of those services paid by Medicaid, not to other Medicaid-covered health care. South Carolina enforces the federal 60-month (5-year) lookback period for asset transfers. Consult an elder law attorney before transferring assets if a family member may need long-term care Medicaid in the near future.
South Carolina Medicaid (Healthy Connections)
- SCDHHS (Healthy Connections): scdhhs.gov
- CLTC assessment line: 1-888-549-0820
Related guides
Medicaid for Seniors
How Medicaid pays for nursing home and long-term care for older adults.
Read more →Estate Recovery
When states can seek reimbursement from an enrollee's estate after death.
Read more →Medicaid & Social Security
How Social Security benefits and Medicaid eligibility interact.
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