South Carolina Medicaid income limits come in two versions, and which one applies depends on why you need coverage. For long-term care in 2026, a single applicant's gross monthly income must be at or below $2,982, and the state draws that line hard: over the cap, you do not spend down the difference, you route your income through an income trust. For children, pregnant women, and parents or caretaker relatives, a different test applies instead: Modified Adjusted Gross Income (MAGI), written as a percentage of the poverty level, with no asset test at all.,

This guide covers both tests for South Carolina Medicaid (Healthy Connections): the 2026 long-term-care rules, including what the spouse at home is entitled to protect, and the 2026 MAGI limits.,

In This Guide

How South Carolina Medicaid income limits work: the income cap

South Carolina sets its 2026 income limit for nursing-facility and home- and community-based waiver coverage at $2,982 per month, 300% of the 2026 Supplemental Security Income (SSI) Federal Benefit Rate of $994, effective January 1, 2026.,

South Carolina is an income-cap state. SCDHHS's eligibility manual instructs its long-term-care workers that when an applicant's income exceeds the Medicaid Cap, the way to qualify is to set up an Income Trust. That is a different posture from a spend-down state, where an applicant over the standard incurs medical costs equal to the excess and Medicaid covers the rest. Here $2,982 is a true ceiling, and a single dollar above it shuts an applicant out unless they take one specific step.

The income trust: how over-income applicants still qualify

The step is a Qualified Income Trust, also called a Miller Trust or an income trust, the workaround federal rules build in for income-cap states like this one. The applicant funds it by depositing income into a dedicated trust account each month, and income that flows through the trust does not count toward the Medicaid Cap. SCDHHS is explicit that there is no upward income limit for Income Trust cases. This is not the same as depositing only the amount over the cap; the eligibility worker sets what the trust has to receive on your case. The trust pays out mostly toward the cost of care, with the state named as remainder beneficiary.

Sign it early: the trust does not reach backward. SCDHHS's own form says eligibility cannot be established before the month the trust document is signed. Every month of delay is a month of nursing-facility or waiver care the trust cannot cover, and there is no way to recover it afterward. The applicant also has to appoint a trustee and cannot serve as their own.

It then has to be funded every month or eligibility breaks: it is irrevocable, the language has to satisfy the state, and a missed deposit can cost a month of coverage. This is one of the clearest cases where an elder-law attorney earns their fee.

South Carolina Medicaid income limits under MAGI: the other income test

Everything above sits on the SSI-related aged, blind, and disabled (ABD) side of the system, and $2,982 is the right number only for someone seeking long-term care., Most people searching for a South Carolina Medicaid income limit are not in that group.

The other test is MAGI, or Modified Adjusted Gross Income. It governs children, pregnant women, and parents or other caretaker relatives, and it is written as a percentage of the Federal Poverty Level (FPL) rather than a flat dollar cap. Household size under MAGI generally follows the federal income-tax household rather than who lives under the roof, so the same family can be counted differently on the two tracks. Generally, not always: CMS sets the tax-household rules aside entirely for someone who does not expect to file and will not be claimed as a dependent, and uses non-filer rules instead. You do not have to file a tax return to apply.,,

Group SCDHHS 2026 chart medicaid.gov national table
Children up to age 19 (Partners for Healthy Children) 213% FPL (gross) 208% FPL (net)
Pregnant women and infants under age 1 199% FPL (gross) 194% FPL (net)
Parents and other caretaker relatives 67% FPL (gross) 62% FPL (net)
Separate CHIP program None (CHIP runs through Medicaid) N/A
Non-disabled, non-pregnant adults without dependent children No MAGI pathway No

Those percentages convert to dollars against the 2026 federal poverty guidelines: 100% of FPL is $15,960/year for one person and $33,000/year for a family of four in the 48 contiguous states and DC.

Two sets of numbers, one standard. South Carolina's chart states these limits as gross percentages of FPL, before the 5-percentage-point MAGI disregard: 213% for children, 199% for pregnant women, 67% for parents and caretaker relatives. The medicaid.gov national table reports the same standards net of that disregard, so every figure there sits exactly 5 points lower. Neither source is wrong. Read the disregard narrowly, though: the rule applies it only when testing income against the highest MAGI standard available for the family size, not group by group, so do not assume it adds 5 points to whichever standard you are checking.,

South Carolina covers children up to age 19 through Partners for Healthy Children and runs CHIP as a Medicaid expansion rather than a separate program, which is why the separate-CHIP column reads N/A. Pregnant women and infants under age one qualify at 199% FPL gross, and that coverage continues for 12 months postpartum. Both figures sit well above the federal floor, which requires states to cover children under 19 at a minimum of 133% FPL.

Parents and caretaker relatives: 67% of the poverty level

For readers of this guide, this is the pathway that matters before 65, and a grandparent raising a grandchild is the classic case. South Carolina covers the group at 67% of FPL gross, about $22,110 a year for a family of four against the 2026 federal poverty guidelines ($33,000/year for four). HHS publishes those guidelines as annual figures only, so treat any monthly version as your own arithmetic, and ask SCDHHS how it counts your income before concluding anything., Whether a particular grandparent, aunt, or older sibling meets the caretaker-relative definition is SCDHHS's call.

That the standard sits below the poverty line is federal mechanics, not a 2026 South Carolina choice. Parents and caretaker relatives are federally mandatory, but unlike children (a floor of 133% FPL) and the ACA new adult group (effectively 138% FPL), they are covered at the state's own standard, set between a federal floor and a federal ceiling. The floor is the state's pre-welfare-reform AFDC income standard converted to a MAGI equivalent, typically far below the poverty level, and it does the most work in non-expansion states, where no broader adult pathway sits above it. What decides a household's answer is the state figure, so read it off the SCDHHS chart for your household size.,,

Adults without dependent children

South Carolina has not adopted the ACA Medicaid expansion, which created the new adult group: people under 65, not pregnant, and not enrolled in Medicare, with income up to an effective 138% FPL. In the 41 states including DC that adopted it, that group covers a low-income adult who is not disabled and has no dependent children. South Carolina is one of the 10 that did not, so there is no statewide expansion pathway here.,

That "No" is not quite the whole answer. The footnote attached to it on the national table records that South Carolina runs a section 1115 demonstration providing Medicaid to some additional low-income adults, with limits on who qualifies, what is covered, where it is offered, and how many may enroll. It is worth an application rather than an assumption. Short of that, adults below the poverty level can fall into the coverage gap: too much income for Medicaid, too little for Marketplace premium subsidies.

The MAGI groups have no asset test

Federal law bars a state from applying any asset or resource test to the MAGI groups, and expressly excepts the SSI-related ABD and long-term-care pathways from that bar. So a parent or caretaker relative is judged on income alone: a savings account, a second vehicle, or an investment does not count against them at any amount, and the resource limits described elsewhere on this page never reach them. That is federal law, not a South Carolina choice.

What changes at 65 in South Carolina

In an expansion state, turning 65 closes the new adult group, which is written for people under 65 who are not enrolled in Medicare. South Carolina has no such group, so the transition runs the other way here. At 65 the aged, blind, and disabled track opens on the basis of age, and the yardstick becomes the SSI Federal Benefit Rate, $994/month for an individual in 2026, or 300% of that rate ($2,982/month) for nursing-facility and waiver coverage., A resource test appears too, the one federal law bars on the MAGI side. For a South Carolinian who spent their working years with no MAGI pathway, 65 is the year the door opens, and what comes with it is an asset test that never applied before.

The asset limit

Get this figure from SCDHHS by name. The only resource limit SCDHHS states on a page we can cite is $9,950, and it belongs to the agency's Aged, Blind or Disabled coverage group, not to nursing-facility or waiver coverage, which is lower. An applicant who assumes $9,950 covers them will be denied on resources they thought were safe.

The test is written per individual, not as a couple's limit. Where one spouse needs care and the other stays home, SCDHHS totals the couple's countable resources and protects the community spouse's share before the remainder is measured. How much that share is, and why $66,480 is not the answer most families are given, is the next section.

The home sits under a separate federal rule. Under 42 U.S.C. 1396p(f) the equity test does not apply at all while a spouse, a child under age 21, or a blind or permanently and totally disabled child lawfully lives in the home, whatever the house is worth. Where nobody in that list lives there, equity above the 2026 federal minimum of $752,000 bars long-term-care coverage, unless the state has elected a higher limit (up to $1,130,000). Being over it is not permanent: the same statute preserves the use of a reverse mortgage or home equity loan to bring equity below the line, and requires a waiver process for demonstrated hardship.

The five-year look-back

South Carolina reviews asset transfers made in the 60 months before a long-term-care application. Giving away money or property for less than fair market value inside that window, signing a house over to a child for a dollar or gifting a grandchild a down payment, can trigger a penalty period during which Medicaid won't pay for long-term care even after the applicant is otherwise eligible. There are real exceptions (transfers between spouses, to a disabled child, certain caregiver-child home transfers), but anything inside the five-year window deserves an attorney's review first. For the broader toolkit, see our guide to Medicaid planning strategies.

Long-term care: what a nursing-home resident keeps

When South Carolina Medicaid pays for nursing-facility care, most of the resident's monthly income goes toward the cost of care. What they keep is the Personal Needs Allowance (PNA), money reserved for clothing, a haircut, a phone bill. South Carolina raised its PNA to $60/month, effective October 1, 2025, up from the long-standing $30, with $100 instead for a resident in a work-therapy program under the plan of care., The waiver side works differently: someone receiving home and community-based services is allowed the full Medicaid Cap, $2,982/month.

Not everything above the $60 goes to the facility. South Carolina's approved State Plan deducts, on top of the allowance, the health-care expenses the resident incurs and no third party pays: Medicaid, Medicare, and other health-insurance premiums, deductibles, coinsurance, and copayments. Federal rules also require a maintenance allowance for a spouse or family still at home, and permit a home-maintenance allowance for up to six months where a physician certifies the resident is likely to return home. Ask for each one by name; they are subtracted, not volunteered. For the national picture on how the PNA is set, see our explainer on the Medicaid personal needs allowance.

Protecting the spouse who stays home

When one spouse needs long-term care and the other remains in the community, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. South Carolina's number here is widely misread, and the misreading costs families real money.,

Under State Plan Amendment SC-25-0011, effective October 1, 2025, South Carolina elects a community-spouse resource standard of $66,480, which its own plan page describes as neither the federal minimum nor the federal maximum but an amount between the two. That standard is a floor, not a cap. Federal law makes the Community Spouse Resource Allowance the greatest of four amounts: the state's standard; the lesser of the spousal share (half the couple's countable resources at the start of institutionalization) or the 2026 federal maximum of $162,660; an amount set at a fair hearing; and an amount transferred by court order. The last two carry no dollar limit at all. So a couple with $260,000 in countable resources does not protect $66,480: the spouse's half-share is $130,000, greater than the state standard and below the federal maximum, and $130,000 is what the allowance protects. If someone tells you $66,480 is the ceiling, ask them to work the greatest-of rule.,

Protection South Carolina 2026 amount Federal figure
Community-spouse resource standard $66,480 (a floor, not a cap) $32,532 minimum, $162,660 maximum
Community Spouse Maintenance Needs Allowance $4,066.50/month $4,066.50/month maximum
Home-equity limit $752,000 (federal minimum) up to $1,130,000 by state election

On the income side South Carolina elected the federal maximum outright: its State Plan sets the maintenance needs standard for every community spouse at $4,066.50/month, the ceiling §1924(d)(3)(C) permits, so income can be shifted from the applicant spouse up to that figure and no further., One catch rides with the fair-hearing route on assets: the mandatory "income first" rule requires the state to treat all of the institutionalized spouse's available income as made available to the community spouse before it allocates any extra resources, which narrows how often a hearing yields more.

After death: estate recovery

After a recipient who was 55 or older when they received long-term-care services dies, SCDHHS may seek repayment of what Medicaid correctly paid from the estate. The survivor protections are a timing bar, not a permanent exemption: recovery may be made only after the death of a surviving spouse, and only when the decedent has no surviving child under age 21 and no child who is blind or permanently and totally disabled. A family is shielded while one of those people is living, but the claim waits rather than disappears.,

South Carolina defines the recoverable "estate" by cross-reference to its Probate Code, which reaches the decedent's property and expressly names trust property. Do not assume a joint account, a transfer-on-death designation, or a funded trust puts an asset out of reach here; ask SCDHHS or an attorney about the specific asset rather than acting on a general rule.

The hardship waiver is mandatory, and SCDHHS publishes three grounds. Recovery must be waived on proof of undue hardship, claimed by an heir or devisee. The grounds are a home of modest value (50% or less of the county average) still lived in by a sibling with an equity interest who was there a year before institutionalization, or by a child who was there two years and gave care that delayed it; the home and one acre where an immediate family member has lived two years, still lives there, owns no other real property, and has income at or below 185% of the poverty guidelines; and a sole income-producing asset whose loss would push such a family member below the poverty guidelines. A family that reads only the words "undue hardship" will not know it may qualify. For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in South Carolina

South Carolina Medicaid runs as Healthy Connections, administered by SCDHHS. There are three ways to apply.

1
Step 1

Apply online

Use the Healthy Connections portal at apply.scdhhs.gov, the fastest route for most applicants.

2
Step 2

Apply by phone

Call the member contact number on the SCDHHS website and apply with a representative.

3
Step 3

Apply by paper

Download or request a paper application and submit it to SCDHHS by mail or in person.

Long-term-care applicants also go through a level-of-care screening. If income runs over the $2,982 cap, sign the Income Trust first: eligibility cannot start before the month it is signed.

Where to get help

SC Healthy Connections (SCDHHS) Eligibility rules, income limits, and program information. www.scdhhs.gov/members/program-eligibility-and-income-limits
Healthy Connections Application Portal Start or check the status of a Medicaid application online. apply.scdhhs.gov

Frequently Asked Questions

What is the South Carolina Medicaid income limit in 2026?

It depends which coverage you need. For nursing-facility and waiver coverage the 2026 limit is $2,982/month, 300% of the SSI Federal Benefit Rate, and an applicant over it needs an Income Trust., For children, pregnant women, and parents or caretaker relatives, the MAGI test applies instead: on the state's 2026 chart, 213% of the federal poverty level for children up to age 19, 199% for pregnant women, and 67% for parents and caretaker relatives.

Can an adult without children get Medicaid in South Carolina?

Not through the ACA expansion, which South Carolina has not adopted., But the state does run a section 1115 demonstration covering some additional low-income adults, subject to limits on eligibility, benefits, geography, and enrollment, so apply rather than assume. Short of that, adults below the poverty level can fall into the coverage gap. The aged, blind, and disabled track opens at 65, or earlier on the basis of blindness or disability.

Does South Carolina require a Miller Trust (income trust)?

Yes, for over-income applicants. SCDHHS's policy is that someone whose gross income runs over $2,982/month qualifies only by setting up an Income Trust and depositing income into it each month. Eligibility cannot start before the month the trust is signed, so sign it early.

What is the South Carolina Medicaid asset limit?

Get the number from SCDHHS. The only resource limit the agency states on a citable page is $9,950, and that belongs to its Aged, Blind or Disabled coverage group, not to nursing-facility or waiver coverage, which is lower. The home is exempt from the equity test entirely if a spouse, a child under 21, or a blind or disabled child lives there; otherwise equity over $752,000 bars long-term-care coverage unless the state elected a higher limit. None of this reaches the MAGI groups: federal law bars any asset test for children, pregnant women, and parents or caretaker relatives.

How much can a spouse keep when the other spouse goes into a nursing home?

More than the $66,480 figure suggests. That is the resource standard South Carolina elected, and it is a floor. The allowance is the greatest of four amounts, including half the couple's countable resources up to the 2026 federal maximum of $162,660, so a spouse whose half-share exceeds $66,480 keeps the larger figure. Amounts set at a fair hearing or by court order carry no dollar limit. The community spouse may also keep up to $4,066.50/month in income.,

What does a nursing-home resident on South Carolina Medicaid keep?

A Personal Needs Allowance of $60/month, raised from $30 effective October 1, 2025. The rest of the resident's monthly income goes toward the cost of care, after deductions for a community spouse and certain health-insurance premiums.

Learn More

MedicaidMedicaid Income Limits by State: Which Number Applies to YouMedicaid income limits depend on your pathway: expansion adults, aged and disabled, or nursing-home care. See the 2026 figures and your state's exact limits. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. MedicaidHow Medicaid Estate Recovery WorksMedicaid estate recovery explained: federal law, 51-state matrix, categorical protections, hardship waivers, and 2025-2026 reform updates. Verify before acting. MedicaidThe Medicaid Personal Needs Allowance, ExplainedHow the Medicaid Personal Needs Allowance works in 2026: the $30 federal floor, state figures from $30 to $200, and how patient liability is calculated. MedicaidSouth Carolina Medicare Savings Programs: Help Paying Medicare CostsSouth Carolina Medicare Savings Programs 2026: QMB, SLMB, and QI income limits, what each pays, Part D Extra Help, and how to apply through SCDHHS. MedicaidSouth Carolina Medicaid Spousal Impoverishment RulesSouth Carolina Medicaid spousal impoverishment rules for 2026: the state-specific $66,480 CSRA, the $4,066.50 MMMNA, income trust rules, and exempt assets.

Find personalized help working through South Carolina Medicaid income limits and the income trust for your family at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.