Medicaid in South Carolina (2026): Eligibility and How to Apply

What Is Healthy Connections Medicaid?

Medicaid is a joint federal-state health insurance program that provides free or low-cost coverage to people who meet income and eligibility requirements. In South Carolina, the Medicaid program is called Healthy Connections Medicaid. It is administered by the state but jointly funded by state and federal governments.

South Carolina Has NOT Expanded Medicaid

South Carolina has not expanded Medicaid under the ACA. Medicaid eligibility for non-disabled, non-pregnant adults without children remains very limited — generally below approximately $9,326 per year. Most low-income adults in South Carolina who do not fit a traditional Medicaid eligibility category must use the ACA marketplace for coverage.

Adults earning below 100% FPL in non-expansion states like South Carolina fall into the "coverage gap" — they earn too little to qualify for marketplace subsidies (which start at 100% FPL) but too much for their state’s Medicaid program. The ARP and IRA enhanced subsidies expired on 31 December 2025, and the coverage gap remains a significant issue in non-expansion states.

Healthy Connections Medicaid Eligibility Categories

Beyond the general adult expansion (in states that expanded), Medicaid covers several other groups:

• Children: All states cover children in families at much higher income thresholds than adult Medicaid, often up to 200-300% FPL or more through CHIP
• Pregnant women: Covered at higher income thresholds (typically 185-250% FPL) in all states
• People with disabilities: SSI recipients and people with qualifying disabilities are eligible in all states
• Elderly adults: Adults 65+ with limited income and resources qualify through the Medicare Savings Programs

Marketplace as Alternative in South Carolina

If you don’t qualify for Healthy Connections Medicaid, the ACA marketplace is your primary option. South Carolina marketplace carriers include: Ambetter from Absolute Total Care, BlueCross BlueShield of South Carolina, First Choice Next, InStil Health, Molina Healthcare and UnitedHealthcare. ACA premium tax credits are available for households earning between 100% and 400% FPL (~$15,960–$63,840 for a single adult in 2027).