Healthy Connections Income Limits (South Carolina Medicaid, 2026)

Healthy Connections is the official brand name for South Carolina's Medicaid program, run by the South Carolina Department of Health and Human Services (SCDHHS). South Carolina is one of ten states that chose not to expand Medicaid under the Affordable Care Act, meaning the Healthy Connections income thresholds for working-age adults without disabilities remain among the lowest in the nation. The 2026 Federal Poverty Level, anchored at $15,960 for a single person and $33,000 for a family of four in the 48 contiguous states per HHS ASPE poverty guidelines, sets every threshold on this page. Parents and caretaker relatives face a hard cap of 62% FPL ($9,895 per year for one person, $20,460 for a family of four). Adults without dependent children who are not elderly or disabled fall into a coverage gap: they earn too little for Affordable Care Act marketplace subsidies, which begin at 100% FPL, but they do not qualify for Healthy Connections under current South Carolina law.

South Carolina Healthy Connections covers six main population groups with different income thresholds. Parents and caretaker relatives with a dependent child in the home qualify at 62% FPL. Pregnant women qualify at a much more generous 194% FPL, and South Carolina extended postpartum coverage to 12 months effective April 2022, matching the federal option under the American Rescue Plan Act. Children qualify through a combined Medicaid and CHIP pathway called Partners for Healthy Children (PHC), which extends coverage up to 208% FPL with no premium or cost-sharing for families. Aged, blind, and disabled (ABD) adults qualify at 100% FPL with an asset test ($9,950 individual / $14,910 couple as of 2026). Working disabled adults qualify at 250% FPL for earned income, with an unearned income cap of 100% FPL. Former foster care youth qualify with no income limit up to age 26. Healthy Connections uses Modified Adjusted Gross Income (MAGI) rules for most of these groups, meaning most non-cash income and certain deductions matter more than simple gross wages.

South Carolina Healthy Connections serves roughly 1.3 million residents and is administered primarily through managed care organizations (MCOs) under the Healthy Connections Prime program for most Medicaid members. SCDHHS contracts with managed care plans that coordinate physical health, behavioral health, and pharmacy benefits in most counties. Applications go through the Healthy Connections Citizen Portal at apply.scdhhs.gov. SNAP, TANF, and child care subsidies in South Carolina use a separate portal run by the Department of Social Services (benefitsportal.dss.sc.gov), so Medicaid applicants should use the SCDHHS portal specifically. The KFF Medicaid state data tracker confirms South Carolina remains a non-expansion state as of 2026, and approximately 105,000 South Carolinians fall into the ACA coverage gap created by the state's non-expansion decision.

Healthy Connections (South Carolina Medicaid) income limits by household size (2026)

Healthy Connections (South Carolina Medicaid) income limits by household size, 2026. Adult column = parents and caretaker relatives (62% FPL, the non-expansion state limit). Children column = Partners for Healthy Children Medicaid/CHIP combined (208% FPL). Pregnancy column = 194% FPL with 12 months postpartum. Add $3,522 per year for each additional person in the adult column.

Healthy Connections (South Carolina Medicaid) eligibility requirements (non-income)

Healthy Connections eligibility in 2026 depends on both income and non-income criteria. South Carolina's non-expansion status means income alone does not determine eligibility for most working-age adults. The following requirements apply across most Healthy Connections coverage groups, with category-specific variations noted below.

• South Carolina residency: Applicants must live in South Carolina with the intent to remain. This does not require a minimum duration of residency, but SCDHHS will ask for a utility bill, lease, mortgage statement, or other address documentation. Homeless individuals may use a shelter address or a letter from a social worker.
• U.S. citizenship or qualifying immigration status: Most Healthy Connections coverage requires citizenship or a qualifying immigration status (lawful permanent resident, refugee, asylee, or certain other humanitarian categories). Newly arrived lawful permanent residents face a federal five-year bar before qualifying for most Medicaid coverage. Pregnant women and children may qualify for emergency Medicaid regardless of immigration status. South Carolina does not cover undocumented adults with state-only funds.
• Social Security Number: All applicants applying for themselves must provide a Social Security Number or proof of application for one. Household members not applying for coverage (such as an undocumented parent applying only for a citizen child) do not need to provide their own SSN.
• Household composition and dependent child requirement for adults: Parents and caretaker relatives must have a dependent child under age 19 living in the home to qualify through the adult MAGI category. Adults without dependent children who are not pregnant, 65 or older, or certified as disabled are generally excluded from Healthy Connections under South Carolina's non-expansion rules. This is the structural cause of South Carolina's ACA coverage gap.
• Asset test for aged, blind, and disabled categories: MAGI-based groups (parents, pregnant women, children, former foster care youth) have no asset test. Aged, blind, and disabled (ABD) Healthy Connections uses a resource limit of $9,950 for an individual and $14,910 for a couple as of 2026. Countable resources include bank accounts, stocks, bonds, and second vehicles, but exclude one primary home, one vehicle, household goods, and burial funds up to $10,000.
• No other disqualifying coverage: Applicants cannot have access to cost-effective employer-sponsored insurance that covers the same services Healthy Connections would cover. SCDHHS conducts a cost-effectiveness test. If employer coverage is available and deemed cost-effective, the applicant may be enrolled in Medicaid as secondary coverage but not primary. Medicare beneficiaries with low income may qualify for Medicare Savings Programs rather than full Healthy Connections.

What income counts for Healthy Connections (South Carolina Medicaid)

Healthy Connections uses Modified Adjusted Gross Income (MAGI) rules for most eligibility categories, following federal Medicaid guidelines. MAGI aligns with the tax definition of income, which means some income that feels significant (like child support received) does not count, while some income that may seem distant (like taxable Social Security) does count. South Carolina does not apply an additional state-level 5% income disregard for most categories. The income limits published by SCDHHS are the actual cutoffs, not a pre-disregard figure.

Income sources included

• Wages, salaries, and tips: All W-2 earnings before deductions count as MAGI income for Healthy Connections. This includes overtime pay, bonuses, and commissions.
• Self-employment net earnings: Net profit from self-employment (gross receipts minus ordinary and necessary business expenses) counts. SCDHHS typically requires a 12-month profit and loss statement or prior-year Schedule C for self-employed applicants.
• Social Security Disability Insurance (SSDI) benefits: The taxable portion of SSDI counts as MAGI income. SSDI is different from SSI (Supplemental Security Income), which is excluded. Many disabled South Carolinians receive SSDI, which can affect Healthy Connections eligibility for the adult MAGI category.
• Unemployment compensation: All unemployment insurance benefits count as MAGI income in the month received. This includes regular state unemployment and federal pandemic-era benefits when those were active.
• Pension, retirement, and 401(k) distributions: Taxable pension and retirement distributions, including 401(k) and IRA withdrawals, count as MAGI income. Roth IRA qualified distributions that are excluded from taxable income do not count.
• Interest, dividends, and capital gains: Investment income (bank interest, stock dividends, capital gains from asset sales) counts as MAGI income in the year received. Capital losses can offset capital gains but cannot offset other income types for Medicaid MAGI purposes.
• Alimony under pre-2019 divorce decrees: Alimony received under divorce agreements finalized before January 1, 2019 counts as MAGI income under the pre-TCJA rules still in effect for Medicaid. Alimony from agreements finalized after December 31, 2018 does not count.
• Rental and royalty income: Net rental income (after deducting mortgage interest, depreciation, property taxes, and maintenance on rental properties) counts as MAGI income. Royalty income from patents, copyrights, or mineral rights also counts.

Income sources excluded

• Supplemental Security Income (SSI): SSI payments from the federal government are excluded from MAGI income for Healthy Connections. SSI recipients typically qualify for Medicaid automatically through a separate non-MAGI track rather than through the income-limit calculation.
• Child support received: Child support payments received from a non-custodial parent are excluded from MAGI income under federal Medicaid rules. This is one of the most commonly misunderstood exclusions.
• Veterans' benefits: VA disability compensation, VA pension, GI Bill education benefits, and other veterans' benefits are excluded from MAGI income. This exclusion is particularly relevant for South Carolina, which has one of the larger veteran populations in the Southeast.
• Workers' compensation: Payments from workers' compensation for workplace injuries or illness are excluded from MAGI income.
• TANF and most cash assistance: Temporary Assistance for Needy Families (TANF) cash payments and most other means-tested cash assistance programs are excluded from MAGI income calculations.
• Gifts, inheritances, and loan proceeds: One-time receipt of a gift, inheritance, or loan is excluded from MAGI income in the year received. However, if received funds generate investment income in subsequent years (interest on an inherited savings account, for example), that subsequent income does count.

How to apply for Healthy Connections (South Carolina Medicaid) in South Carolina

Healthy Connections applications go through the SCDHHS Citizen Portal at apply.scdhhs.gov, South Carolina's dedicated Medicaid online intake system. Applications can also be submitted by phone at 1-888-549-0820, by mail to SCDHHS, or in person at any county SCDHHS office. South Carolina splits benefits applications across two portals: Medicaid uses the SCDHHS portal, while SNAP, TANF, and child care subsidies use the DSS Benefits Portal at benefitsportal.dss.sc.gov. Medicaid applicants should use apply.scdhhs.gov specifically. Healthy Connections has no application fees and no enrollment windows; applications are accepted year-round.

1. 1. Gather your documents before starting: photo ID, Social Security Numbers for all household members applying, proof of South Carolina residency, proof of citizenship or immigration status, and one month of recent pay stubs (or 12 months of self-employment records).
2. 2. Create an account at apply.scdhhs.gov or call 1-888-549-0820 to start an application by phone. The online portal allows you to save progress and upload supporting documents. You can also apply in person at any SCDHHS county office.
3. 3. Complete the application: list every household member, report all income sources for all members, indicate whether anyone in the household is pregnant, disabled, or a foster care youth, and attach supporting documents. SCDHHS uses household income for MAGI categories.
4. 4. Sign and submit the application electronically. SCDHHS will send a confirmation with a case number. Save this number for follow-up inquiries.
5. 5. Respond promptly to any SCDHHS requests for additional verification. SCDHHS sends a 10-day notice if it needs more information. Failing to respond within that window is one of the most common reasons applications are denied.
6. 6. Wait for the eligibility notice. MAGI-based applications (parents, pregnant women, children) are decided within 45 days. Disability-based applications requiring a medical determination take up to 90 days. Pregnancy applications that meet urgent-care criteria may be expedited.

Official portal: apply.scdhhs.gov

Documents needed

• Photo ID for the head of household (South Carolina driver's license, state ID card, or passport)
• Social Security Numbers (or proof of SSN application) for every household member applying for Healthy Connections coverage
• Proof of South Carolina residency: a utility bill, bank statement, lease or mortgage statement, or official mail addressed to your current address
• Proof of U.S. citizenship or qualifying immigration status: birth certificate, U.S. passport, Certificate of Naturalization, permanent resident card, Employment Authorization Document, or refugee or asylum documents
• Last 30 days of pay stubs for all employed household members (or a 12-month profit and loss statement for self-employed applicants, plus a prior-year federal tax return)
• Documentation of any other income: Social Security or SSDI award letter, pension statements, unemployment benefit notice, VA award letter
• For pregnant women: a statement from a physician or midwife confirming pregnancy and estimated due date

Processing timeline: MAGI-based Healthy Connections applications (parents, pregnant women, children) are typically decided within 45 days of the date SCDHHS receives the application. Applications requiring a disability determination (for ABD Medicaid) can take up to 90 days because a medical review is required. Pregnant women with urgent healthcare needs may receive an expedited eligibility decision. South Carolina provides 12 months of continuous eligibility for children once enrolled, per the federal mandate effective January 2024.

Common reasons applications get denied

• Income above the category-specific threshold: the most common single reason for Healthy Connections denials. Parents at 62% FPL face one of the lowest adult income caps in the nation; any income above this threshold disqualifies the adult applicant even if children in the household still qualify.
• Adult applicant without a dependent child, not pregnant, not disabled, not elderly: South Carolina's non-expansion rules exclude most working-age adults without dependents entirely from Healthy Connections, regardless of income level.
• Failure to respond to a 10-day SCDHHS information request: SCDHHS sends a notice if it needs additional verification. Applications are denied if the applicant does not respond within 10 days. This is the most avoidable denial reason.
• Federal five-year bar for recent lawful permanent residents: lawful permanent residents (green card holders) who arrived in the U.S. within the past five years are barred from most federal Medicaid coverage by the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). South Carolina does not use state funds to cover this group during the bar period.
• Assets above the resource limit for ABD categories: aged, blind, and disabled applicants who hold countable assets exceeding $9,950 (individual) or $14,910 (couple) will be denied unless they can reduce assets to below the limit through exempt purchases or proper spend-down planning.

If your child's household income is above the Healthy Connections Medicaid limit

South Carolina's Partners for Healthy Children (PHC) program combines Medicaid and CHIP coverage in a single enrollment pathway for children under age 19. Children from birth through age 18 qualify up to 208% of the Federal Poverty Level, which is $68,640 per year for a family of four in 2026. Medicaid covers children in families below the lower thresholds within that range; CHIP covers the higher-income band. There are no premiums and no cost-sharing for children enrolled in Partners for Healthy Children. Applications go through the same SCDHHS portal at apply.scdhhs.gov. Children who lose Medicaid eligibility because family income rises are automatically evaluated for CHIP within the same system.

Compare Medicaid and CHIP income limits across all 50 states

If you are 65 or older or have Medicare with limited income: Medicare Savings Programs

South Carolina Healthy Connections administers three Medicare Savings Programs (MSPs) for low-income South Carolinians who have Medicare. These programs help pay Medicare premiums, deductibles, and copays. The Qualified Medicare Beneficiary (QMB) program covers Medicare Parts A and B premiums plus cost-sharing for individuals earning up to 100% FPL ($1,330 per month in 2026) with assets up to $9,950. The Specified Low-Income Medicare Beneficiary (SLMB) program covers Part B premiums for individuals at 120% FPL ($1,596 per month). The Qualifying Individual (QI) program covers Part B premiums for individuals at 135% FPL ($1,796 per month). About 12 million Americans are dual-eligible for both Medicare and Medicaid; South Carolinians who are dual-eligible may qualify for full Healthy Connections in addition to Medicare. Apply through SCDHHS at apply.scdhhs.gov or call 1-888-549-0820.

Read the Medicare eligibility and dual-eligible guide

Frequently Asked Questions