MEDICAID

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 Medicaid is a program that provides health coverage to some low-income South Carolina residents. Medicaid covers families with children and pregnant women, the elderly, and people with disabilities, if state and federal guidelines are met. Legal residents who are not U.S. citizens may be eligible for Medicaid however, questions concerning immigration status and eligibility should be directed to the South Carolina Department of Health and Human Services. 

  • For certain categories of people, eligibility for Medicaid is based on the amount of the household income.

In South Carolina, you may be eligible for Medicaid if you are an infant, a child, pregnant, the parent of a dependent child, elderly, or disabled and your family income meets the Medicaid income standards.

Income eligibility levels for these categories are described below.  Your assets and some expenses also may be taken into account, so you should contact the South Carolina Department of Health and Human Services for more information. 

Low income persons eligible for Medicaid in South Carolina*

Category                  Income eligibility (as percent of federal poverty level)
Infant                          185% (monthly income of about $2,647 for family of 3)
Child 1-19                   150% (monthly income of about $2,146 for family of 3)
Parents
   Non-Working             48%
   Working Parents       97%
Pregnant woman       185%

* Eligibility information was compiled from State Health Facts Online, the Henry J. Kaiser Family Foundation, and may have changed since this guide was published.  Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.
To get an idea of how your income compares to the federal poverty level (FPL), use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2007:

Size of Family Unit              Poverty Guideline (annual income)
              1                                       $10,210
              2                                       $13,690
              3                                       $17,170

For larger families add $3,480 for each additional person

So, for example, using this guideline, 185% of the federal poverty level for a family of 3 would be an annual income of $31,765 or a monthly income of about $2,647.

  • Parents who receive benefits under Temporary Assistance for Needy Families (TANF) (also called Family Independence) should also know that when you get a job and your TANF benefits end, you generally can stay on Medicaid for a 24-month transitional period.

In addition, your children may qualify for Medicaid if your family’s income meets certain income standards. (See above)

  • Poor elderly or disabled people who get Supplemental Security Income (SSI) benefits are automatically eligible for Medicaid.

Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your Medicaid coverage at least for a limited time.

  • Retired or disabled people who have low incomes and are enrolled in Medicare may also qualify for help from Medicaid. Even though your income may be too high to qualify for Medicaid insurance coverage, there may be other ways Medicaid can help you.

If your household income is below the poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance.  This is called the Qualified Medicare Beneficiary (QMB) program. 

If your household income is above 100% but below 120% of the poverty level, Medicaid will pay for your monthly Medicare premiums only.  This is called the Specified Low-Income Medicare Beneficiary (SLMB) program.

  • If you are uninsured and screened and diagnosed with breast or cervical cancer by the Best Chance Network, you may be eligible for full Medicaid benefits. In addition, you may also be eligible for Medicaid benefits if you have been diagnosed with breast of cervical cancer outside of the Best Change Network (see below).
  • There may be other ways that Medicaid can help. To find out if you or other members of your family qualify for Medicaid, contact the South Carolina Department of Health and Human Services.

To obtain the locations and telephone numbers of South Carolina Department of Health and Human Services eligibility staff located at a branch office near you, call (888)-549-0820.


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