SC Healthy Connections Medicaid Income Limits 2026

For how South Carolina compares with other states, see our national Medicaid income limits guide.

South Carolina Medicaid Income Limits by Household Size (Effective March 1, 2026)

SCDHHS publishes 3 family-based monthly limits on its income chart, and all three took effect March 1, 2026. These are the percentages South Carolina prints on its own chart; they don't include the federal 5% income disregard, which the next section explains.

Source: SCDHHS, Program Eligibility and Income Limits (opens in a new tab), monthly income effective March 1, 2026. The pregnancy row's yearly figure for three is $53,000.80 on the same page.

Babies under 1 are covered two ways: through the Pregnant Women and Infants group and through Partners for Healthy Children, which runs to 208% for every child under 19. A baby born to a mother on Healthy Connections stays covered to age 1.

Who's missing from the table: adults 19 to 64 who aren't pregnant, don't have a dependent child at home and don't have a disability. South Carolina has no full-Medicaid group for them. That's the coverage gap, covered further down.

Yearly equivalents and the 5% disregard

Here are the same limits as yearly income, plus the higher line that applies when the federal 5% disregard is needed to pass:

The yearly column is the SCDHHS monthly figure times 12. The disregard columns are a Grantsights calculation from the 2026 HHS poverty guidelines ($15,960 for one, $27,320 for three, plus $5,680 per person). The SCDHHS manual itself describes the children's line as "208% (213% with 5% disregard)," and the Palmetto Pathways waiver page describes the parent line as 62% plus 5%, or 67%.

South Carolina's federal listing tells the same story. Per the Medicaid.gov eligibility levels table (opens in a new tab), which reflects state decisions as of December 1, 2023, the state sits at 208% for children of all ages, 194% for pregnancy, 62% for parents and "No" for adult expansion. Those match the 2026 SCDHHS chart, so the percentages haven't moved since 2023; only the dollar amounts rose with the poverty guidelines.

How Healthy Connections Counts Your Income

South Carolina uses MAGI rules (Modified Adjusted Gross Income) for 5 groups on its chart: children, pregnant women, parents and caretakers, foster care and Family Planning. Section 200 of the SCDHHS manual says MAGI "eliminates existing income disregards and replaces them with a general 5% Federal Poverty Level (FPL) disregard when needed." In 2014, South Carolina folded its old average disregards into the limits themselves, which is why the parent line went from 50% to 62% and children's coverage from 200% to 208%.

What that means when you fill out the application:

• Start with gross pay. Healthy Connections counts income before taxes, though pre-tax retirement and health insurance deductions come off under tax rules.
• Taxable income counts. Wages, self-employment profit, unemployment and Social Security benefits of people in the tax household count. SSI and child support you receive don't.
• Household size follows your taxes. SCDHHS builds a separate household for each person based on who files and who's claimed as a dependent. Two people in the same home can end up with different household sizes.
• Pregnancy adds the baby. Under the federal MAGI household rule at 42 CFR 435.603 (opens in a new tab), a pregnant woman counts herself plus each baby she's expecting.
• No asset test for families. The SCDHHS manual says there's no resource limit for MAGI groups, so savings, a car or a house don't count for children, parents or pregnancy.
• Short absences don't change the household. A child in the hospital or away for less than 30 days still counts at home, according to manual section 202.

Medicaid for people who are 65 or older, blind or disabled uses SSI-based income rules and does count resources. Those limits are next.

Healthy Connections for Seniors, Blind and Disabled People: Income and Asset Limits

South Carolina's main community group for older and disabled adults, Aged, Blind or Disabled (ABD), reaches 100% of poverty ($1,330 a month for one person), well above the $994 SSI rate. Per the SCDHHS income limits page, the 2026 standards are:

Sources: SCDHHS Program Eligibility and Income Limits (opens in a new tab) (FPL-based income effective March 1, 2026; SSI-based limits and resources effective January 1, 2026) and the SCDHHS Medicaid Policy and Procedures Manual, Section 300, chapters 302 and 304. The SSI row's resource limit is from manual chapter 404.

Long-term care numbers SCDHHS uses in 2026:

• Personal needs allowance: a nursing home resident keeps $60 a month for cost of care from October 1, 2025 on, up from $30, per manual section 304. Waiver participants keep up to $2,982.
• Spouse at home: the couple subtracts a spousal share of $66,480 (effective January 1, 2026), and the rest must fall under the individual limit. South Carolina uses that single figure instead of a range.
• Spousal income allocation: up to $4,066.50 a month, as listed on the SCDHHS income limits page.
• Look-back: SCDHHS reviews transfers within 60 months before a nursing home or waiver application.
• Excess resources: applicants for nursing home or waiver care generally get 30 days to spend down excess resources, with at least 15 days' notice, under manual section 304.05.02A.

For more on SSI itself, see our SSI income limits guide and SSI benefits guide.

South Carolina and Medicaid Expansion: The Adult Coverage Gap

South Carolina is one of 10 states that haven't expanded Medicaid, according to KFF's expansion tracker dated October 16, 2026 (a non-government compilation), which counts 41 states including DC as having adopted it. In a state that expanded, an adult 19 to 64 qualifies up to 138% of poverty, about $1,835 a month for one person. In South Carolina, that same adult usually gets nothing unless a child, pregnancy, age or disability opens another door.

The gap exists because Marketplace premium tax credits only begin at 100% of poverty, as HealthCare.gov's Medicaid expansion page (opens in a new tab) explains; below that line, a South Carolina adult with no qualifying group gets neither Medicaid nor a subsidy. For one person in 2026, 100% of poverty is $1,330 a month.

Grantsights calculation from the SCDHHS March 2026 chart and the 2026 HHS poverty guidelines ($15,960 for one, $27,320 for three). The children in these households qualify for Partners for Healthy Children at every income shown.

Palmetto Pathways to Independence: proposed, not running

SCDHHS submitted the Palmetto Pathways to Independence waiver to federal regulators on June 23, 2025. According to the SCDHHS waiver page, it would add a group for parents and caretakers aged 19 to 64 with income above 67% and up to 100% of poverty, who'd have to complete 80 hours a month of work or other community engagement. When Grantsights checked the waiver page on November 3, 2026, the latest step listed was still the June 2025 submission, with no approval or start date posted. Until SCDHHS announces one, parents above $1,411.53 a month in a family of three have no Healthy Connections group.

What the 2025 federal law changes in South Carolina

• Work requirements and six-month renewals: the federal community engagement rule published in the Federal Register on June 3, 2026 (opens in a new tab) requires states to start by January 1, 2027, but it applies to the ACA expansion group. South Carolina has no expansion group, so current Healthy Connections members aren't in it, and renewals stay annual.
• Noncitizen eligibility from October 1, 2026: SCDHHS's public notice dated August 31, 2026 says lawful permanent residents who meet the waiting rules, Cuban/Haitian entrants, COFA citizens, and lawfully present pregnant women and children keep eligibility. Others whose status no longer qualifies may still get Emergency Services coverage. CMS letter SHO #26-001 (opens in a new tab), dated April 8, 2026, sets the federal rule.

Options for adults in the gap

• Family Planning: limited coverage for preventive and family planning care for men and women up to 194% of poverty ($2,580.20 a month for one), who aren't eligible for full Medicaid. SCDHHS notes it doesn't count as minimum essential coverage.
• Medically Indigent Assistance Program: hospital inpatient care for residents up to 200% of poverty, with a $500 cash limit and a $35,000 home equity cap. Ask the hospital's social services office.
• Breast and Cervical Cancer Program: full Medicaid for uninsured people under 65 screened through the Best Chance Network, up to 200% of poverty ($2,660 a month for one).
• Community health centers: South Carolina's federally funded clinics set fees by income, whatever your insurance. Search HRSA's health center finder (opens in a new tab).

Worked Examples: South Carolina Households in 2026

For example, a family of three in Greenville earning $2,000 a month (a single dad with children aged 3 and 10) gets this result on the March 2026 chart:

1. Both children: the Partners for Healthy Children limit for three is $4,735.46, so both kids qualify with $2,735 to spare.
2. Dad: the parent limit for three is $1,411.53, and even with the 5% disregard it's about $1,525. At $2,000 he's over, and he's also under $2,277, the 100% poverty line for three. Specifically, he's about $475 over the parent line with the disregard and $277 under the Marketplace floor, so he's in the coverage gap: no Healthy Connections and no Marketplace tax credit. If Palmetto Pathways were running, he'd fall inside its proposed 67% to 100% band.

A couple in Columbia expecting their first child counts as a household of three. On $4,300 a month together, she's $116.73 under the $4,416.73 pregnancy line. Her coverage runs through the pregnancy and 12 months after the birth, and the baby is covered to age 1. Her husband isn't covered: at $4,300 he's far over the $1,411.53 parent limit, but he's above 100% of poverty, so he can buy a subsidized Marketplace plan.

One retiree in Charleston, a widowed 74-year-old, has $1,280 a month in Social Security and $6,500 in the bank. She's under the $1,330 ABD income limit and the $9,950 resource limit, so she gets full Healthy Connections. Because she's also under 100% of poverty with Medicare Part A, QMB pays her Medicare premiums, deductibles and copays. If her Social Security were $1,500, she'd lose full Medicaid but still qualify for SLMB, which pays her Part B premium.

What SCDHHS Doesn't Tell You About These Limits

Grantsights analysis of the SCDHHS March 2026 chart and manual found 5 things the income page doesn't say plainly:

1. A child's limit is more than 3 times a parent's. For a family of three, Partners for Healthy Children stops at $4,735.46 and the parent line stops at $1,411.53. That's a ratio of 3.35 to 1. A parent working full time at $9 an hour (about $1,560 a month) is already over the parent limit, while the kids stay covered until the household earns three times that.
2. The chart shows the lower number. The 5% disregard lifts children to 213%, pregnancy to 199% and parents to 67% when it's needed to pass. For a family of three, that's an extra $113.84 a month of room for kids and $113.84 for parents. If you're a little over the chart, apply anyway.
3. The ABD limit beats the SSI rate. Many sites quote $994 as the ceiling for older adults. South Carolina's ABD group goes to $1,330 for one person, and its $9,950 resource limit is almost 5 times SSI's $2,000. An older adult over the SSI line can still get full Healthy Connections.
4. Nursing home resources have two limits. The default is $2,000, but manual section 304.14 lets someone whose income is under the ABD limit keep up to $9,950. Families often spend down more than they need to.
5. The parent line has barely moved in a decade. The 62% standard dates to the 2014 MAGI conversion, per the SCDHHS manual's own table. To be honest about what that means: a parent's coverage tracks inflation in the poverty guidelines and nothing more. Only the dollar amounts rise each year with the poverty guidelines.

Common Mistakes and Red Flags

A common mistake is measuring the whole family against the parent limit. In South Carolina, a parent's income can be 3 times the parent line and the children still qualify, so your best bet is to apply for the kids even when you know you won't qualify yourself. It's worth it: the application is free and covers everyone in one go.

Other errors South Carolina applicants make:

• Using take-home pay. Healthy Connections looks at gross income, so read the top line of your pay stub.
• Forgetting the unborn baby. A pregnant woman living alone is a household of two, with a limit of $3,498.46, not $2,580.20.
• Applying the senior asset test to families. Children, parents and pregnant women have no resource limit.
• Underestimating what seniors can get. An older adult over $994 may still qualify for ABD up to $1,330, QI up to $1,796, or nursing home Medicaid up to $2,982.
• Ignoring the annual review. Healthy Connections has to be renewed every year. If SCDHHS can't renew you from data it already has, it mails a review form, and coverage ends if you don't send it back by the due date.
• Missing mail after a move. Notices go to the address on file, so update it at apply.scdhhs.gov or by phone before your review month.

Red flags for scams: applying for Healthy Connections is free. SCDHHS posts its own scam warning, and anyone who charges a fee to apply, promises guaranteed approval, or asks for your account password or Medicaid number by text isn't SCDHHS. Real help comes from SCDHHS at (888) 549-0820, your county eligibility office, or SC Thrive, the free application partner SCDHHS links from its site.

How to Apply for Healthy Connections Medicaid and How Long It Takes

Up to 45 days is how long SCDHHS says a decision generally takes, according to its member FAQ, though some categories, such as disability-based applications, can take longer.

1. Apply online at apply.scdhhs.gov, which asks you to set up a free identity-verified login for most account features. You can also apply at HealthCare.gov (opens in a new tab), which forwards Medicaid-eligible applications to SCDHHS.
2. Other ways in: call (888) 549-0820 (TTY 888-842-3620), Monday through Friday from 8 a.m. to 6 p.m.; visit your county eligibility office; or apply at most hospitals and federally qualified health centers. Paper applications go to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101, or fax (888) 820-1204.
3. Have ready: dates of birth and Social Security numbers, proof of income, any SSI or veterans' benefits, bank balances (for seniors and disability applications), and rent and utility amounts.
4. Pregnant? SCDHHS says you may be able to get care while the application is processed; call (888) 549-0820 and ask.
5. Watch for a category notice. SCDHHS mails a notice saying which group you qualified for and whether you need to pick a managed care plan. Your card should arrive within about a week of approval.

What to Do If You're Denied

You have 30 days from the date on your denial or closure notice to ask for an appeal, according to SCDHHS's member pages. Send your contact information, a copy of the notice, and what you're appealing and why, through the SCDHHS File an Appeal page (opens in a new tab) or the Office of Appeals and Hearings.

• Keep your coverage during the appeal. SCDHHS's appeals FAQ says you can request continued benefits if you ask within 10 days of the date on the notice.
• Hearings are in person. Most are held at 1801 Main Street in Columbia, and SCDHHS says hearings aren't held by phone. You can ask for a different location.
• Check the math first. Ask which household size, income figure and group SCDHHS used. A tax-filer mix-up or a missed disregard is fixable.
• Reapply if things change. A pregnancy, a new baby, a job loss or a disability finding can change the answer.

If You're Over the South Carolina Medicaid Limit

$15,960 to $63,840 a year is the 2026 income range where a single adult can get a Marketplace premium tax credit, and that's one of several routes once you're over Healthy Connections limits:

• Marketplace coverage: South Carolina uses HealthCare.gov, where tax credits run from 100% to 400% of poverty. Parents over the $1,411.53 parent limit but above 100% of poverty usually land here.
• Medicare: at 65, or after 24 months on Social Security disability. QMB, SLMB and QI can then pay premiums for people up to $1,796 a month.
• WIC: South Carolina WIC food benefits reach pregnant women, new mothers and children under 5 at up to 185% of poverty; details are in our WIC income limits guide.
• Food help: see our South Carolina food stamps guide and SNAP income limits guide.
• Seniors and people with disabilities: our help for seniors programs guide and disability grants for individuals guide cover help beyond Medicaid.
• Where the percentages come from: the federal poverty guidelines guide explains each 2026 figure.
• Neighboring states: North Carolina expanded Medicaid and Florida didn't; compare our North Carolina Medicaid income limits guide and Florida Medicaid income limits guide.

Looking for help with food, rent or utilities too? Grantsights' free eligibility checker points you to official programs to look at. It doesn't decide Healthy Connections eligibility or file an application; only SCDHHS can do that.

When These Limits Change Next

South Carolina's poverty-based limits changed on March 1, 2026, about six weeks after HHS published the new guidelines. According to HHS ASPE's 2026 poverty guidelines (opens in a new tab), published in January 2026, 100% of poverty is $15,960 for one person and $27,320 for three; every percentage in this guide rests on those figures. Expect the next chart after HHS releases its 2027 guidelines in early 2027. SCDHHS hasn't posted a 2027 date.

SSI-based limits change each January 1. According to SSA's 2027 COLA fact sheet (opens in a new tab), the SSI rate rises from $994 to $1,029 for one person and from $1,491 to $1,544 for a couple in January 2027. Three times $1,029 would put the nursing home and Katie Beckett income limit at $3,087, a Grantsights calculation; SCDHHS hadn't posted its January 2027 figures when Grantsights checked.

FAQ: South Carolina Medicaid Income Limits

What is the income limit for Healthy Connections Medicaid in 2026?

For a family of three: $4,735.46 a month for children, $4,416.73 for pregnancy and $1,411.53 for a parent, effective March 1, 2026.

Did South Carolina expand Medicaid?

No. Adults 19 to 64 without children, a pregnancy or a disability generally can't get full Healthy Connections at any income.

What is the Partners for Healthy Children income limit?

208% of poverty: $4,735.46 a month for three and $5,720 for four, with no premium.

What is the Healthy Connections limit for pregnant women?

194% of poverty: $3,498.46 a month for two and $4,416.73 for three, counting the unborn baby.

Can a single adult get Medicaid in South Carolina?

Usually only if pregnant, 65 or older, blind or disabled; Family Planning offers limited coverage up to $2,580.20 a month.

What is the nursing home income limit?

$2,982 a month in 2026, with a $2,000 resource limit (or $9,950 for someone under the ABD income limit).

What are the limits for seniors and people with disabilities?

$1,330 a month for one person and $1,804 for a couple, with $9,950 and $14,910 resource limits.

When do the limits change?

Poverty-based limits changed March 1, 2026; SSI-based limits change each January 1.

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Sources

1. SCDHHS: Program Eligibility and Income Limits (opens in a new tab), income effective March 1, 2026; resources and SSI-based limits effective January 1, 2026
2. SCDHHS Medicaid Policy and Procedures Manual, Section 200: MAGI Related Programs (opens in a new tab) (chapters 201 to 204)
3. SCDHHS Medicaid Policy and Procedures Manual, Section 300: Non-MAGI Related Programs (opens in a new tab) (chapters 302 and 304, including sections 304.05 and 304.14)
4. SCDHHS: Palmetto Pathways to Independence Waiver (opens in a new tab), submitted June 23, 2025
5. SCDHHS Public Notice: Alien Medicaid Eligibility, effective October 1, 2026 (opens in a new tab), August 31, 2026
6. SCDHHS: Member FAQs (opens in a new tab), Annual Reviews (opens in a new tab) and Getting Started (opens in a new tab)
7. SCDHHS: File an Appeal and Appeals and Hearings FAQs (opens in a new tab)
8. Medicaid.gov eligibility levels table (December 2023 data), used here for South Carolina (opens in a new tab), state decisions as of December 1, 2023
9. CMS: SHO #26-001, Implementation of Section 71109 "Alien Medicaid Eligibility" (opens in a new tab), April 8, 2026
10. eCFR: 42 CFR 435.603, Application of modified adjusted gross income (opens in a new tab)
11. HHS ASPE: 2026 Poverty Guidelines (opens in a new tab)
12. SSA: 2027 Cost-of-Living Adjustment Fact Sheet (opens in a new tab)
13. Federal Register: Medicaid Program; Community Engagement Requirement for Certain Individuals (opens in a new tab), June 3, 2026
14. HealthCare.gov: Medicaid expansion and what it means for you (opens in a new tab)
15. HRSA: Find a Health Center (opens in a new tab)
16. KFF (non-government compilation): Status of state Medicaid expansion decisions (opens in a new tab), October 16, 2026