Where to start your Medicaid application in South Carolina

In South Carolina, you apply for Medicaid through the Department of Health and Human Services (DHHS). You can start your application online through the South Carolina DHHS website, by mail, by phone, or in person at your local DHHS office. The online portal is the fastest route — you can submit everything without waiting for an appointment, and you'll get a confirmation number immediately.

If you don't have internet access or prefer to speak with someone, call the DHHS Customer Service line at 1-888-549-0820. They can answer questions about what you'll need and help you decide whether to apply online or by mail. Local DHHS offices are also listed on the state website if you want to apply in person.

Before you start, gather your documents. You'll need proof of income (pay stubs, tax returns, or a letter from your employer), proof of citizenship or legal residency, proof of your Social Security number, and proof of your address. If you're applying for a child, you'll also need their birth certificate.

Key Takeaways

  • Apply online through the South Carolina DHHS website, by phone at 1-888-549-0820, by mail, or in person at your local DHHS office.
  • You will need proof of income, citizenship or legal residency, Social Security number, and address before you start.
  • The state processes applications within 30 days, though some cases take longer if DHHS needs more information from you.
  • South Carolina has different Medicaid programs for adults, children, pregnant women, and seniors — the one you're in depends on your age and income.
  • If you're denied, you have the right to request a hearing to challenge the decision.

What documents you need to have ready

DHHS will ask for specific proof of each thing they need to verify. For income, bring recent pay stubs (usually the last 30 days), your most recent tax return, or a letter from your employer on company letterhead stating your job title and pay. If you're self-employed, bring your tax return and a profit-and-loss statement. If you receive unemployment, Social Security, or child support, bring the award letter or bank statement showing the deposits.

For citizenship or legal residency, a U.S. birth certificate, passport, or naturalization papers work. If you're a legal permanent resident, bring your green card or I-797 approval notice. For your Social Security number, bring your Social Security card, a tax return, or a W-2. Your address can be proven with a utility bill, lease, mortgage statement, or government mail dated within the last 60 days.

If any of these documents are in another language, bring the original and an English translation. If you don't have a document, ask DHHS what alternative proof they will accept — they often have options.

How the online application works

The South Carolina DHHS online portal walks you through a series of questions about your household, income, and assets. You'll enter your name, date of birth, Social Security number, and address. Then you'll list everyone in your household and their relationship to you, because Medicaid counts household income together.

The system will ask about your income sources and amounts. Be as accurate as you can — if your income varies, use an average of the last three months. You'll also answer questions about your assets (savings, vehicles, property) and whether you're pregnant, disabled, or caring for a child. At the end, you'll upload or attach your documents directly through the portal.

Once you submit, you'll receive a confirmation number and a message telling you what happens next. DHHS will send you a letter within 30 days with a decision, though they may ask for more information before then. Check your mail and any email address you provided.

Income limits and which program you might be in

South Carolina Medicaid has different income limits depending on which program covers you. For adults aged 19 to 64 without children, the limit is roughly 138% of the federal poverty level, which is about $1,900 per month for a single person (this amount changes yearly). For children under 19, the limit is higher — around 211% of poverty level. Pregnant women and new mothers have their own limits.

Your household size matters too. If you have dependents, DHHS counts their income along with yours. The state website has a current income chart you can check before you apply. If your income is slightly over the limit, you may still be in a different program — ask DHHS whether you might be in a spend-down program or a medically needy category.

South Carolina also runs a program called SC CARES for adults who don't have dependent children and don't meet the standard Medicaid income limit. The rules are different, and you apply the same way.

What happens after you submit your application

DHHS has 30 days to process your application and send you a decision letter. If they need more information, they'll contact you by mail or phone and give you a deadline to respond — usually 10 days. If you miss the deadline, they may deny your application, but you can reapply.

If you're approved, your Medicaid coverage starts on the first day of the month you applied, or sometimes the first day of the following month depending on when in the month you applied. DHHS will send you a Medicaid card in the mail. If you're denied, the letter will explain why and tell you how to request a hearing to challenge the decision.

While you're waiting, if you have an urgent medical need, you can still go to the emergency room. Medicaid will cover it retroactively if you're approved, going back to the date you applied.

Requesting a hearing if you're denied

If DHHS denies your application, you have the right to request a fair hearing. The denial letter will explain how to request one — you usually have 30 days from the date of the letter. You can request a hearing by mail, phone, or online through the DHHS website.

At the hearing, you can present documents and explain why you believe the decision was wrong. You can bring someone with you to help — a family member, friend, or advocate. You don't need a lawyer, though you can bring one if you want. The hearing officer will listen to both sides and make a new decision.

Requesting a hearing doesn't cost anything, and it doesn't affect any other benefits you receive. If you win, your Medicaid coverage will start from the date you originally applied.

Keeping your Medicaid active after approval

Once you're approved, DHHS will send you a renewal notice before your coverage ends. In South Carolina, most people renew their Medicaid every 12 months. The renewal notice will tell you what information to update and how to submit it — usually online, by mail, or by phone.

Report any major changes right away: if you get a new job, if your income changes, if someone moves into or out of your household, or if you move to a new address. You can report changes through the DHHS website or by calling customer service. If you don't report changes and your income goes over the limit, DHHS may end your coverage and ask you to repay benefits.

Keep your Medicaid card with you when you go to the doctor or pharmacy. If your card is lost or damaged, call DHHS and they'll send you a replacement.

Frequently Asked Questions

How long does it take to hear back after I apply?

DHHS has 30 days to make a decision from the date you submit your application. If they need more information from you, they'll contact you and give you time to respond. Some applications are approved faster — sometimes within a week or two if everything is clear.

Can I apply if I'm not a U.S. citizen?

You must be a U.S. citizen or a may have access to legal permanent resident to get Medicaid in South Carolina. Bring proof of your status when you apply. Some immigrants who don't meet this requirement may be able to get emergency Medicaid for urgent medical care only.

What if my income is too high for regular Medicaid?

If your income is slightly over the limit, ask DHHS about SC CARES or medically needy programs — these have different rules. You can also check whether any dependents in your household might be in a separate program with a higher income limit.

Do I have to reapply every year?

Yes, most people renew their Medicaid once a year. DHHS will send you a renewal notice before your coverage ends. You can renew online, by mail, or by phone using the same process as your original application.

What if I need Medicaid right away for an emergency?

Apply as soon as possible. While your application is being processed, you can still go to the emergency room and receive care. If you're approved, Medicaid will cover the emergency visit retroactively, going back to the date you applied.