South Carolina children who do not qualify for full Medicaid may still get free or low-cost health coverage through Partners for Healthy Children, the state's combined Medicaid and CHIP program administered by the South Carolina Department of Health and Human Services (SCDHHS). Partners for Healthy Children covers children under 19 whose household income is at or below 208% of the 2026 Federal Poverty Level. For a family of four, that threshold is $68,640 per year in 2026.
This page covers the 2026 Partners for Healthy Children income limits by household size, what the program covers, how to apply, what documents you need, and what to do if your application is denied. South Carolina has not expanded Medicaid for adults under the ACA, but CHIP coverage for children remains available year-round with no enrollment deadline.
Quick Answer: Who Qualifies for CHIP in South Carolina (2026)
Yes. South Carolina children under age 19 qualify for Partners for Healthy Children if household income is at or below 208% of the 2026 Federal Poverty Level. For a family of four, that is $68,640 per year ($5,720 per month) in 2026. The child must be a South Carolina resident, a U.S. citizen or qualifying immigrant, and not already enrolled in Medicaid. Partners for Healthy Children is free or very low cost. Enrollment is open year-round.
Partners for Healthy Children Income Limits by Household Size (2026)
South Carolina sets the Partners for Healthy Children income limit at 208% of the Federal Poverty Level for 2026, based on family size. The SCDHHS updates these thresholds each year when HHS publishes revised poverty guidelines, with the 2026 figures taking effect March 1, 2026. Children whose family income falls below the Medicaid threshold (approximately 138% FPL for children in most categories) are enrolled in standard Medicaid rather than CHIP, at no cost.
Income is measured using MAGI (Modified Adjusted Gross Income). MAGI counts wages, salaries, tips, self-employment income, unemployment compensation, Social Security benefits (if taxable), and most other income. MAGI does not count child support received, SSI payments, workers compensation, or most veterans benefits. South Carolina does not apply an asset test for Partners for Healthy Children eligibility.
What Partners for Healthy Children Covers in South Carolina
Partners for Healthy Children provides comprehensive health coverage to enrolled South Carolina children. The benefit package includes well-child checkups and immunizations, sick visits and specialist referrals, inpatient and outpatient hospital care, prescription drugs, laboratory tests and X-rays, emergency services, mental health and substance use disorder treatment, and dental and vision benefits. Dental coverage is administered by DentaQuest and includes up to $750 per year for covered services such as cleanings, X-rays, and fillings, plus free emergency dental care when medically necessary. Vision benefits are administered by VSP and include one eye exam and one pair of eyeglasses every 12 months.
South Carolina children enrolled in Partners for Healthy Children are assigned to a managed care organization: currently Healthy Blue of South Carolina or Molina Healthcare of South Carolina. Most services require using in-network providers through the assigned plan. Emergency care is always covered regardless of network. Children may also access services at Federally Qualified Health Centers (FQHCs) across South Carolina.
How to Apply for Partners for Healthy Children in South Carolina
South Carolina families can apply for Partners for Healthy Children online at apply.scdhhs.gov, by calling 1-888-549-0820, by visiting a local SCDHHS county office, or by mailing a paper application. The online portal at apply.scdhhs.gov is the fastest route because it allows digital document upload and provides a confirmation number immediately. South Carolina processes most CHIP applications within 2 to 4 weeks; the federal deadline is 45 days from the date of a complete application.
South Carolina also accepts CHIP applications submitted through HealthCare.gov. When a family applying for a marketplace plan includes children, the federal portal automatically screens for CHIP eligibility and transfers the child's application to SCDHHS if the child appears to qualify. This screening is automatic and does not require any additional action from the family.
Is South Carolina a Medicaid Expansion State?
South Carolina has not expanded Medicaid under the Affordable Care Act. As of 2026, South Carolina is one of 10 non-expansion states (along with Alabama, Florida, Georgia, Kansas, Mississippi, Tennessee, Texas, Wisconsin, and Wyoming). This means working-age adults in South Carolina generally do not qualify for full Medicaid unless they are pregnant, have a disability, or care for a dependent child and fall below a very low income threshold (approximately 67% FPL for parents).
South Carolina's non-expansion status creates a coverage gap for adults earning between roughly $9,000 and $19,320 per year in 2026: too much income to qualify for traditional Medicaid, but below the 100% FPL threshold required to claim ACA marketplace subsidies. This ACA gap affects adults only. South Carolina children are protected: Partners for Healthy Children covers children up to 208% FPL regardless of adult expansion status. South Carolina parents in the coverage gap may wish to explore whether their employer offers coverage or whether they qualify for community health center sliding-scale care.
Common Reasons South Carolina CHIP Applications Are Denied
South Carolina SCDHHS denies Partners for Healthy Children applications most often because the household income exceeds 208% of the 2026 Federal Poverty Level for the household size. Additional denial reasons include missing income documentation, failure to confirm South Carolina residency, identity verification failure for the child, or the child already having minimum essential coverage through a parent's employer plan. If the employer plan is considered unaffordable (the child's portion of premium exceeds a specific threshold), families may still qualify for CHIP despite the employer plan.
- Income above 208% FPL for the household size (most common reason in South Carolina in 2026)
- Missing or incomplete income documentation
- Unable to verify South Carolina residency
- Child is age 19 or older
- Child already has qualifying health coverage through an employer plan
How to Appeal a Denial of Partners for Healthy Children
South Carolina families who are denied Partners for Healthy Children have the right to appeal. SCDHHS must provide a written notice of denial that states the specific reason and your appeal rights. Families have 30 days from the date of the denial notice to request a fair hearing by contacting SCDHHS in writing or calling 1-888-549-0820. Families may also request a supervisor review before filing a formal appeal.
South Carolina Legal Services provides free legal assistance to low-income families appealing CHIP or Medicaid denials. Community health workers at Federally Qualified Health Centers across South Carolina can also help families gather missing documents and navigate the appeals process at no cost. If the denial was due to income, families should verify whether the income calculation used MAGI rules correctly, as common errors include counting non-MAGI income such as SSI or child support.
About Partners for Healthy Children in South Carolina
Partners for Healthy Children is the umbrella brand for South Carolina's combined Medicaid and CHIP program for children and certain adults. The program is administered by the South Carolina Department of Health and Human Services (SCDHHS). South Carolina operates Partners for Healthy Children as a Medicaid expansion for children (separate CHIP), which means the federal government reimburses a higher share of costs than for standard Medicaid. The enhanced CHIP matching rate in South Carolina for fiscal year 2026 is approximately 88%, meaning the federal government pays about $0.88 for every $1.00 spent on eligible children.
South Carolina must reauthorize CHIP funding through federal legislation. Congress most recently reauthorized CHIP through fiscal year 2027 as part of broader federal health legislation. Families enrolled in Partners for Healthy Children should be aware that enrollment is subject to annual renewal: SCDHHS sends renewal notices by mail, and families must verify that income and household composition have not changed beyond the eligibility threshold. Failure to return renewal paperwork is the most common reason children lose coverage, even when they remain income-eligible.
Frequently Asked Questions
What is the income limit for a family of 4 for CHIP in South Carolina in 2026?
For a household of four in South Carolina, the 2026 Partners for Healthy Children income limit is $68,640 per year ($5,720 per month). This equals 208% of the 2026 Federal Poverty Level. Families earning above this amount do not qualify for CHIP but may be able to purchase a subsidized plan through HealthCare.gov if adult income falls within ACA subsidy range.
What counts as income for Partners for Healthy Children (MAGI)?
Partners for Healthy Children uses MAGI (Modified Adjusted Gross Income) to measure income. MAGI includes wages, salaries, tips, self-employment net income, alimony received (if the divorce decree predates 2019), rental income, unemployment compensation, and taxable Social Security benefits. MAGI does not count SSI payments, child support received, workers compensation, veterans benefits that are not taxable, or Supplemental Nutrition Assistance Program (SNAP) benefits.
What documents do I need to apply for Partners for Healthy Children?
South Carolina SCDHHS requires proof of income (pay stubs from the past 30 days, a tax return, or an employer letter), a birth certificate or hospital record for the child, Social Security numbers for all applicants, proof of South Carolina residency (utility bill, lease, or school letter), and immigration documents for any non-citizen applicants. Gathering these before starting the online application at apply.scdhhs.gov reduces processing time.
What happens if my child's CHIP application in South Carolina is denied?
If South Carolina denies your Partners for Healthy Children application, SCDHHS must send a written denial notice with the specific reason. You have 30 days to request a fair hearing by calling 1-888-549-0820 or writing to SCDHHS. You may also seek free help from South Carolina Legal Services or a community health worker at a Federally Qualified Health Center. If the denial was an income calculation error, check whether non-MAGI income (such as SSI or child support) was incorrectly counted.
Can my child get CHIP in South Carolina if I have private health insurance through work?
Possibly. South Carolina CHIP has a 5-year waiting period for children who voluntarily dropped employer-sponsored insurance, but exceptions apply if the employer plan is unaffordable (the child's share of the premium is too high) or if the child lost the employer plan involuntarily. If your employer plan is considered unaffordable under federal rules, your child may qualify for Partners for Healthy Children even if an employer option technically exists.
Is South Carolina a Medicaid expansion state in 2026?
No. South Carolina has not expanded Medicaid under the ACA. South Carolina is one of 10 non-expansion states as of 2026. Adults without disabilities or dependent children generally do not qualify for Medicaid regardless of income, creating an ACA coverage gap for adults earning between roughly $9,000 and $19,320 per year. Children, however, are protected: Partners for Healthy Children covers eligible children up to 208% FPL regardless of the adult expansion status.
How long does the Partners for Healthy Children application take in South Carolina?
Most South Carolina families receive a determination within 2 to 4 weeks of submitting a complete application. The federal maximum is 45 days (90 days if disability documentation is required). Applications submitted online at apply.scdhhs.gov with all documents uploaded tend to process fastest. You can check your status at any time by calling 1-888-549-0820 or logging into your apply.scdhhs.gov account.
Does CHIP in South Carolina cover dental and vision for children?
Yes. Partners for Healthy Children covers dental and vision. Dental coverage is managed by DentaQuest and includes up to $750 per year for preventive and restorative services such as cleanings, X-rays, and fillings, plus free emergency dental care when medically necessary. Vision benefits are through VSP and include one comprehensive eye exam and one pair of eyeglasses (frames and lenses) every 12 months.
