As of , South Carolina Medicaid — administered by the S.C. Department of Health and Human Services (SCDHHS) — has updated its income thresholds, resource limits, and enrollment pathways. South Carolina has not expanded Medicaid under the ACA, which means adults without dependent children face a coverage gap that affects hundreds of thousands of residents. I’ve tracked every threshold change since 2023, and the adjustments matter: the Section 1619(b) continued Medicaid threshold for disabled workers in South Carolina just rose to $44,963 annually. If you receive SSI, are pregnant, disabled, elderly, or a parent with low income, this guide tells you exactly where you stand today.
- South Carolina’s Section 1619(b) Medicaid threshold: $44,963/year for disabled workers in 2026.
- SSI recipients in SC receive automatic Medicaid enrollment upon award — no separate application required.
- SC has not expanded Medicaid. Most adults without children earning over ~$$10,490/year fall into the coverage gap.
- SC is piloting a new Medicare-Medicaid coordination model with CMS for dual-eligible residents.
- Applications processed within 45 days (90 days for disability-based cases).
South Carolina Medicaid Income Limits by Eligibility Group — 2026
Read more: Medicaid Eligibility by State
The table below reflects federal poverty level calculations. South Carolina uses both MAGI-based (Modified Adjusted Gross Income) and non-MAGI rules depending on the category. Federal law defines Medicaid income and resource standards, but states can raise those limits above the federal floor using disregards — except for QDWIs.
| Eligibility Group | Income Limit (% FPL) | Monthly Income Limit (Est. 2026) | Resource Limit |
|---|---|---|---|
| Pregnant Women | 194% FPL | ~$2,531/mo | No limit |
| Children (Ages 1–18) | 208% FPL | ~$2,714/mo | No limit |
| Infants (Age 0–1) | 208% FPL | ~$2,714/mo | No limit |
| Parents / Caretaker Relatives | 67% FPL | ~$874/mo (family of 3) | $3,000 |
| Elderly (Age 65+) / Blind / Disabled | 100% FPL | ~$1,255/mo (individual) | $2,000 |
| Nursing Home / Long-Term Care | 300% SSI | ~$2,829/mo (2026) | $2,000 |
| Medically Needy (Spend-Down) | Varies | Excess spent on medical bills | $4,000 (couple) |
| Healthy Connections Kids (CHIP) | 208% FPL | ~$6,388/mo (family of 4) | No limit |
Source: SC DHHS Eligibility Guidelines. FPL figures based on federal poverty level. All amounts rounded to nearest dollar.
⚠️ South Carolina Has NOT Expanded Medicaid
As of , South Carolina remains one of the few states that has not adopted ACA Medicaid expansion. Childless adults ages 19–64 generally do not qualify for SC Medicaid unless they are elderly, blind, or disabled. A coverage gap exists for adults earning too much for Medicaid but too little for Marketplace subsidies.
Asset & Resource Limits in Detail
Read more: Alaska Medicaid 2026: Income Limits & How to Apply
SC Medicaid separates applicants into MAGI households and non-MAGI households. This distinction determines whether assets are counted at all.
MAGI Groups (No Asset Test)
- Children under age 19
- Pregnant women
- Parents and caretaker relatives
- Former foster youth (up to age 26)
No resource test applies to these groups.
Non-MAGI Groups (Asset Test Applies)
- Elderly (age 65+): $2,000 individual
- Blind / Disabled: $2,000 individual
- Couples: $3,000 combined
- Long-term care: $2,000 (applicant only)
Exempt Assets (Not Counted)
One vehicle (any value)
Personal belongings & household goods
Burial plots
Prepaid funeral (up to $10,000)
Life insurance (face value ≤$1,500)
What Does South Carolina Medicaid Cover?
Read more: SSI Payment Dates May 2026: 1 Deposit on May 1
SC Medicaid is branded Healthy Connections. Most members enroll in a managed care plan. Coverage includes the following services as of :
🏥 Medical
- Doctor visits
- Hospital stays (inpatient & outpatient)
- Emergency room care
- Lab & X-ray
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