Where to start your Medicaid application in South Carolina

In South Carolina, you submit your Medicaid application through the Department of Health and Human Services (DHHS), which runs the state's Medicaid program called Healthy Connections. You can apply online through the DHHS website, by mail, in person at a local DHHS office, or by phone. The online portal is the fastest route — you can start an application any time and return to finish it later without losing your work.

Before you start, gather documents that show your income, household size, and citizenship or immigration status. These might include recent pay stubs, tax returns, a lease or mortgage statement, and a birth certificate or passport. You do not need all of these to begin — DHHS will tell you what you are missing and give you time to send it in.

The application itself asks about your household income, assets, age, disability status, and whether you are pregnant or caring for children. Answer honestly and completely. If your situation changes after you submit — your income drops, someone moves out, you lose a job — report it within 30 days, because your coverage depends on the information being current.

Key Takeaways

  • Apply through the DHHS website at scdhhs.gov, by phone at 1-888-549-0820, by mail to your local DHHS office, or in person at any DHHS county office.
  • You will need proof of income, household size, citizenship or immigration status, and Social Security numbers for everyone in your household.
  • DHHS will contact you within 30 days to ask for missing documents or to tell you whether you are covered.
  • If you are denied, you can request a hearing to challenge the decision, and you have the right to bring someone to speak for you.
  • Your coverage can start the month you submit your application if you meet the income and other rules, even if DHHS is still reviewing your documents.

What documents you need to have ready

DHHS requires proof of several things, and what counts as proof depends on your situation. For income, a recent pay stub works if you are employed; if you are self-employed, you will need tax returns or profit-and-loss statements. If you receive unemployment, Social Security, child support, or other income, bring statements from those sources dated within the last 30 days.

For household size and relationships, bring birth certificates for children and a marriage certificate if you are married. For citizenship, a birth certificate, passport, or naturalization papers work. If you are not a U.S. citizen, you will need immigration documents showing your status — some immigration categories make you ineligible for Medicaid, while others do not, so bring whatever you have.

For housing costs, bring a lease, mortgage statement, or property tax bill to show where you live. If you receive benefits from other programs — SNAP, TANF, SSI — bring those award letters, because they can speed up the process. You do not have to submit everything at once; DHHS will ask for what is missing after you apply.

How long approval takes and when coverage starts

DHHS has 30 days from the date you submit your application to make a decision. In practice, this means 30 days from when they receive a complete application — if you are missing documents, the clock does not start until you send them in. If DHHS needs more information, they will contact you by mail or phone and give you at least 10 days to respond.

Your coverage can start as early as the first day of the month in which you submit your application, even if DHHS has not finished reviewing everything. This is called presumptive may be able to access, and it means you are covered while they verify your information. If you are later found ineligible, you will be notified and coverage will end, but you will not be billed for services you received while presumptively covered.

Once you are approved, your coverage lasts 12 months unless your circumstances change. DHHS will send you a renewal notice before your 12 months are up, and you will need to report any changes in income, household, or address during that year.

Income limits and who can get Medicaid in South Carolina

South Carolina's Medicaid income limits depend on your household size and whether you are in a category that qualifies. The state covers children under 19 whose household income is below 211% of the federal poverty line, pregnant women and new mothers up to 211%, and adults over 65 or blind or disabled people whose income is below 75% of the poverty line. The income limits change each year, so check the DHHS website for the current numbers.

South Carolina has not expanded Medicaid to cover all adults under 65 with low income, so if you are a working-age adult without children and your income is above the disability threshold, you will not be covered. This is a significant gap — many people in this situation have no path to Medicaid in South Carolina, though they may be able to get coverage through the federal marketplace at healthcare.gov.

Asset limits also apply. You can own a home and a car without it affecting your coverage, but if you have more than $2,000 in cash, bank accounts, or other liquid assets (or $3,000 if you are over 65), you may be ineligible. Some assets do not count — your primary home, one vehicle, and certain retirement accounts are excluded.

What to do if DHHS denies your application

If DHHS sends you a notice of denial, read it carefully — it will explain why you were denied and what you can do next. You have the right to request a fair hearing to challenge the decision. You must request the hearing within 30 days of the denial notice, and you can do this by phone, mail, or in person at your local DHHS office.

At a fair hearing, you can present documents, call witnesses, and explain why you believe the decision was wrong. You can bring someone to speak for you — a family member, friend, lawyer, or advocate. DHHS will also present their case. A hearing officer who is not part of the original decision will listen to both sides and make a new decision. This process usually takes 30 to 60 days.

While you wait for a hearing, your coverage does not continue — you will need to find other ways to pay for medical care. However, if the hearing officer rules in your favor, your coverage can be restored retroactively to the date you were denied, and you will not owe for services received during that gap.

Reporting changes and keeping your coverage active

After you are approved, you must report changes to DHHS within 30 days. Changes that matter include a new job or job loss, a raise or pay cut, someone moving into or out of your household, a change in your address, or a change in your citizenship status. You can report changes online, by phone, by mail, or in person.

If you do not report a change and DHHS finds out later, your coverage can be terminated and you may be asked to repay benefits you received while ineligible. This is called overpayment recovery, and it can take years to resolve. It is much easier to report changes as they happen.

When your 12-month coverage period is ending, DHHS will send you a renewal notice. You will need to submit updated income and household information to stay covered. If you do not respond to the renewal notice, your coverage will end automatically, even if you still meet the income requirements.

Other ways to apply if you cannot reach DHHS by phone

If the main DHHS phone line is busy or you prefer not to call, you can apply online at scdhhs.gov by creating an account and filling out the application form. The online system is available 24 hours a day and you can save your progress and come back to it. You can also visit any DHHS county office in person — there is one in each county, and staff can help you fill out the application on the spot.

If you are homeless or do not have a mailing address, tell DHHS when you apply. They can arrange for notices to be sent to a shelter, a trusted friend's address, or a local agency that serves you. You can also ask to receive notices by email or phone instead of mail.

Community action agencies and legal aid organizations in South Carolina also help people apply for Medicaid for free. If you are struggling to navigate the process, calling 211 will connect you to local resources that can walk you through it.

Frequently Asked Questions

Can I apply for Medicaid if I am not a U.S. citizen?

It depends on your immigration status. Lawful permanent residents (green card holders) and refugees can get Medicaid. Some other statuses, like temporary protected status or asylum seekers, may also may have access to. Undocumented immigrants are not covered by regular Medicaid, though South Carolina does cover emergency medical services for anyone regardless of status. Bring your immigration documents when you apply so DHHS can determine what you are covered for.

What happens if my income goes up after I am approved?

Report the income change to DHHS within 30 days. If your new income is above the limit for your category, your coverage will end on the last day of the month you report the change. You may be able to get coverage through your employer's health plan or through the federal marketplace at healthcare.gov, which has open enrollment in the fall and special enrollment periods if you lose Medicaid.

Can I get Medicaid while I am waiting for a disability decision from Social Security?

Yes. If you have applied for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you can apply for Medicaid at the same time. Tell DHHS that you have a pending disability case and bring the letter from Social Security showing your application date. Some people are approved for Medicaid before their disability decision comes through.

What if I move to another state after I am approved?

Your South Carolina Medicaid coverage ends when you move. You will need to apply for Medicaid in your new state. Each state has different income limits and categories, so you may be covered in one state but not another. Contact the Medicaid office in your new state as soon as you move to find out what you need to do.

Can I use my Medicaid card right away or do I have to wait for it to arrive in the mail?

You can use your coverage as soon as it starts, even before your card arrives. When you go to a doctor or hospital, tell them you have Medicaid and give them your Social Security number or case number — they can verify your coverage in their system. Your physical card usually arrives within two weeks, but you do not need it to receive care.