South Carolina Medicaid income limits depend on your household size and which program you're trying to enter

South Carolina sets different income thresholds for different Medicaid programs. For most adults without children, the limit is around 48% of the federal poverty level — roughly $700 per month for a single person as of 2024, though this figure changes yearly. Parents and children have higher limits. Pregnant women and newborns have their own thresholds. Seniors and people with disabilities may may have access to under different rules entirely. The exact number that matters to you depends on which category you fall into and your household composition.

Income limits are not the only factor. South Carolina also looks at your resources (savings, property), citizenship status, and whether you're a resident of the state. Even if your income is below the limit, you may not may have access to if you have too much in the bank or don't meet other requirements. The reverse is also true: some people slightly above the income limit may still may have access to under special programs.

Key Takeaways

  • South Carolina's income limits vary by program: parents and children have higher thresholds than childless adults, and pregnant women have their own category.
  • For most working-age adults without dependents, the income limit is approximately 48% of federal poverty level, which translates to roughly $700 monthly for a single person in 2024.
  • Your income limit may be higher if you are pregnant, a parent, a senior, or a person with a disability, as these groups have separate program rules.
  • Income limits change every year on January 1st, so the exact dollar amount you need to stay under shifts annually based on federal poverty guidelines.
  • Exceeding the income limit does not automatically disqualify you; some programs have special pathways or your household size calculation may differ from what you expect.

Income limits for parents and children in South Carolina

Parents caring for children in South Carolina can have higher income and still may have access to for Medicaid than childless adults. The income limit for a parent with one child is roughly double the limit for a single adult with no dependents. A parent with two children has an even higher threshold. These limits exist because the state recognizes that a household with children has more expenses.

Children themselves have a separate income limit that is typically higher than the adult limit. A child in a household can may have access to even if a parent's income is too high, as long as the child's own income (if any) falls below the child threshold. This matters in households where a teenager works or receives Social Security.

To find the exact current limits for your household size, contact the South Carolina Department of Health and Human Services (DHHS) directly or visit their website. Income limits shift on January 1st each year, so a number that was correct in December may no longer apply in January.

Income limits for pregnant women and newborns

Pregnant women in South Carolina can may have access to for Medicaid at a higher income level than most other adults. This program covers prenatal care, delivery, and postpartum services. The income threshold for pregnant women is set at a percentage of federal poverty level that is higher than the limit for childless adults, though lower than the limit for parents with multiple children.

Newborns born to a mother on Medicaid are automatically covered for their first year of life, regardless of the household's income. This means a newborn may remain on Medicaid even if the mother's income later rises above the limit. After that first year, the child's coverage depends on whether the child's own income and the household's income meet the regular child Medicaid limits.

Income limits for seniors and people with disabilities

South Carolina has separate Medicaid programs for seniors (age 65 and older) and for working-age people with disabilities. These programs often have higher income limits than the standard adult program. Some seniors and disabled individuals may may have access to for Medicaid even with income that would disqualify a younger, non-disabled adult.

Additionally, people receiving Supplemental Security Income (SSI) from Social Security may may have access to for Medicaid automatically or through a streamlined process, depending on their state of residence and the specific program. If you receive SSI, contact DHHS to learn whether you are already covered or need to take additional steps.

How South Carolina counts your household income

South Carolina counts income in a specific way for Medicaid purposes, and the way they count may differ from how you think of your household. Generally, they include wages, self-employment income, Social Security, unemployment benefits, child support, and some other sources. They do not count certain income, such as Supplemental Security Income (SSI) in some cases, or income from certain assistance programs.

Your household size for Medicaid purposes is not always the same as the number of people living in your home. Medicaid has specific rules about who counts as part of your household for income calculation. For example, a live-in partner may or may not count depending on your state of residence and marital status. A grown child living with you may not count. These rules are complex, and getting the household size wrong can lead to an incorrect income information.

Before you assume you are over the limit, ask DHHS how they would count your specific household. You may be surprised to learn that your household size for Medicaid is smaller than you expected, which could put you under the income limit.

What to do if your income is above the limit

If your income exceeds the standard Medicaid limit for your category, you have a few options. First, check whether you might may have access to under a different program category — for example, as a parent rather than a childless adult, or as a pregnant woman. Second, ask DHHS whether your household size calculation might be different from what you assumed, since a smaller household size means a higher income limit.

Some people slightly above the income limit may still may have access to through special programs or pathways. South Carolina also has other health coverage options, such as the state's marketplace insurance (through Healthcare.gov) or employer-sponsored coverage. If you do not may have access to for Medicaid, you may be able to find affordable coverage elsewhere, and you may be may have access to to tax credits or subsidies to help pay the premium.

Income limits change every January

South Carolina's Medicaid income limits are tied to the federal poverty level, which the federal government updates every January 1st. This means the exact dollar amount of the income limit you need to stay under changes every year. A person who may have access to in December may no longer may have access to in January if their income stayed the same but the limit went down, or they may newly may have access to if the limit went up.

If you were denied Medicaid in the past because your income was too high, it is worth checking again the following January. The limit may have risen enough to include you. Conversely, if you are currently on Medicaid, your coverage may be reviewed annually to confirm you still meet the income limit.

Frequently Asked Questions

What is the exact income limit for a single adult in South Carolina right now?

The limit for a single childless adult is approximately 48% of the federal poverty level. In 2024, this is roughly $700 per month, but this figure changes every January 1st. For the exact current amount, contact the South Carolina Department of Health and Human Services or visit their website, as the number shifts with federal poverty guidelines.

Does my spouse's income count toward the Medicaid income limit?

Yes, in most cases a spouse's income is counted as part of your household income for Medicaid purposes. However, the rules can be complex depending on whether you are legally married, whether you live together, and which Medicaid program you are applying for. Ask DHHS how your specific household would be counted before you assume you are over the limit.

If I work part-time and my income goes up and down, which number do I report?

Medicaid typically looks at your income over the past month or the past three months, depending on the program. If your income varies, you may be asked to provide recent pay stubs or tax documents so DHHS can calculate an average. Tell them about seasonal work or irregular hours upfront so they understand your situation.

Can I get Medicaid if I am slightly over the income limit?

Possibly. First, confirm that your household size and income calculation are correct, since many people discover they were counted differently than expected. Second, ask whether you might may have access to under a different program category. Third, some special programs or pathways may allow people slightly above the standard limit to may have access to. Contact DHHS to discuss your specific situation.

What happens to my Medicaid if my income goes above the limit after I am approved?

You are typically required to report income changes to DHHS. If your income rises above the limit, your Medicaid coverage may end. However, you may have a grace period or a transition period before coverage stops. Report changes promptly so you understand when your coverage ends and can explore other options, such as marketplace insurance.