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 the excess 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). It walks through the 2026 long-term-care rules (the income cap, the income trust that over-income applicants must set up, the asset limit, what a nursing-home resident keeps, and the unusually low cap on what a spouse at home can hold) and the 2026 MAGI limits, including South Carolina's 67%-of-poverty standard for parents and caretaker relatives and why the state offers no pathway at all to adults without dependent children.,

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, which is 300% of the 2026 Supplemental Security Income (SSI) Federal Benefit Rate of $994., The figure took effect January 1, 2026.

South Carolina is an income-cap state. It does not run a medically needy spend-down for long-term care. In a spend-down state, being over the income standard isn't disqualifying: you incur medical costs equal to the excess and Medicaid covers the rest. South Carolina has no such pathway for long-term care. The $2,982 figure is a true ceiling, and a single dollar of monthly income 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. It's the workaround the federal rules build in for income-cap states, and in South Carolina it is the only way an over-income applicant gets long-term-care Medicaid.

The mechanics are narrow but specific. Each month, the applicant deposits the income above the $2,982 cap into the trust. Money inside the trust doesn't count toward that limit, so the applicant qualifies. The trust then pays out under tight federal rules, mostly toward the cost of care, with the state named as remainder beneficiary to recover what it spent after the applicant dies.

An income trust has to be set up correctly and funded every single month, or eligibility breaks. This is one of the clearest cases where an elder-law attorney earns their fee. The trust is irrevocable, the language has to satisfy the state, and a missed monthly deposit can cost a month of coverage.

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

Everything above describes one of South Carolina's two income tests. The $2,982/month figure is the long-term-care number: 300% of the SSI Federal Benefit Rate, the special income level South Carolina applies to nursing-facility and waiver coverage. It sits on the SSI-related aged, blind, and disabled (ABD) side of the system, and it 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 follows the federal income-tax household, not who lives under the roof, so the same family can be counted differently on the two tracks. The two tests also use different rules about assets.,

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 pathway No

Those percentages convert to dollars against the 2026 federal poverty guidelines, under which 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 the District of Columbia.

Two sets of numbers, one standard. South Carolina's own eligibility chart states these limits as gross percentages of FPL, before the mandatory 5-percentage-point MAGI income 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, and the underlying eligibility standards are identical. The national table also splits the children's group into ages 0-1, 1-5, and 6-18 and lists all three at the same 208%, while South Carolina's chart states it as a single band up to age 19.

South Carolina covers children up to age 19 through Partners for Healthy Children and runs CHIP as a Medicaid expansion rather than as a separate CHIP program, which is why the separate-CHIP column on the national table reads N/A for South Carolina. 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. A grandparent raising a grandchild is one of the situations that would look to the parent-and-caretaker-relative group, and South Carolina covers that group at 67% of FPL gross, which the state's 2026 chart puts at $1,842.50/month for a family of four. Whether a particular grandparent, aunt, or older sibling meets the definition of a caretaker relative for a dependent child is a determination SCDHHS makes, so ask before assuming the answer either way.

That the standard sits below the poverty line is federal mechanics rather than a 2026 South Carolina choice. Parents and caretaker relatives are a federally mandatory Medicaid group, but unlike children (mandatory at a floor of 133% FPL) and the ACA new adult group (effectively 138% FPL), they are covered only at the state's own income standard, and federal rules set the minimum for that standard at the state's old cash-welfare level: the AFDC income standard the state had in effect before welfare reform, converted to a MAGI equivalent. That federal minimum is typically far below the poverty level, and it does the most work in states that did not adopt the ACA expansion, where no broader adult pathway sits above it.,,

The AFDC peg is a floor, not a ceiling: a state may set its parent and caretaker standard higher. What decides a South Carolina household's answer is the state's own figure, so read it off the SCDHHS chart for your household size.

There is no MAGI pathway for adults without dependent children

South Carolina has not adopted the ACA Medicaid expansion. The medicaid.gov national table lists the expansion-adult column for South Carolina as "No." It is one of 10 states that have not adopted it. The expansion created the new adult group: people under 65, not pregnant, and not entitled to or enrolled in Medicare, with income up to an effective 138% FPL (133% under the statute, plus the 5-percentage-point disregard). In the 41 states including the District of Columbia that adopted it, that group is what covers a low-income adult who is not disabled and has no dependent children.

South Carolina did not adopt it, so there is no Medicaid pathway here for a non-disabled, non-pregnant adult without dependent children on the basis of income alone, at any income. 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. A parent or caretaker relative in South Carolina is judged on income alone: a savings account, a second vehicle, or an investment does not count against them at any amount. The $2,000 countable-asset limit described elsewhere on this page never reaches them.

That is not a South Carolina choice either. The statute writes the no-asset-test rule for the MAGI groups and then expressly excepts the SSI-related ABD and long-term-care pathways, which is exactly why the $2,000 test governs the long-term-care numbers on this page and nothing on the MAGI side.

What changes at 65 in South Carolina

In an expansion state, turning 65 closes the new adult group, because that group is written for people under 65 who are not entitled to or enrolled in Medicare. South Carolina has no such group, so there is no 138% FPL adult benefit to lose here.

The transition runs the other way. Before 65, a South Carolina adult who is not disabled, not pregnant, and not caring for a dependent child has no pathway at any income. At 65, the SSI-related aged, blind, and disabled track opens on the basis of age.,

That track runs on different arithmetic. The income 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., And a resource test appears, the one federal law bars on the MAGI side, at $2,000 in countable assets for a single applicant., For a South Carolinian who spent their working years with no pathway at all, 65 is the year the door opens. What comes with it is an asset test that never applied before.

The asset limit

Long-term-care Medicaid in South Carolina holds a single applicant to $2,000 in countable assets. When both spouses apply, the limit is $3,000, the SSI couple resource standard. These are the long-standing federal baseline figures, unlike a handful of states that have raised their asset limits well above $2,000.

What matters is which assets count. South Carolina, like every state, exempts a long list from the tally: the primary home (within the federal home-equity limit, which starts at a $752,000 minimum in 2026 and which most states apply), one vehicle, household goods and personal effects, and a prepaid irrevocable burial arrangement., So the $2,000 applies to bank accounts, investments, and second properties, not the roof over the applicant's head.

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, gifting a grandchild a down payment, can trigger a penalty period during which Medicaid won't pay for long-term-care services, even after the applicant is otherwise eligible.

There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) and legitimate planning approaches. But anything done inside the five-year window deserves an elder-law attorney's review first. If long-term care is on the horizon for someone in your family, talk to a professional before moving assets. 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, the resident contributes almost all of their monthly income toward the cost of care. What they keep is the Personal Needs Allowance (PNA), money reserved for the resident's own small expenses such as clothing, a haircut, or a phone bill. South Carolina raised its PNA to $60/month, effective October 1, 2025, up from the long-standing $30.,

For an over-income resident, the income trust and the PNA work together: trust income pays toward care, while the $60 allowance and certain deductions (a spousal allowance, health-insurance premiums) come off the top. 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. This is where South Carolina diverges sharply from most of the country.,

The federal range lets a state set the community spouse's protected assets anywhere up to $162,660 in 2026, and many states elect that maximum. South Carolina does not. Under State Plan Amendment SC-25-0011 (SC-25-0011), effective October 1, 2025, the state sets a single fixed Community Spouse Resource Allowance (CSRA) of $66,480. That's the most an at-home spouse can protect, period, and it sits well below the $162,660 a state electing the federal maximum would allow.

The table below sets South Carolina's 2026 standards against the federal maximums.,,

Protection South Carolina 2026 amount Federal maximum
Community Spouse Resource Allowance (CSRA) $66,480 (single fixed standard) Up to $162,660
Community Spouse Maintenance Needs Allowance $4,066.50/month $4,066.50/month
Home-equity limit $752,000 (federal minimum) $1,130,000

The income side is more generous than the asset side. The community spouse may keep up to $4,066.50/month in income (the maintenance needs allowance), and income can be shifted from the applicant spouse to reach that floor. But on assets, a married South Carolina couple is in a notably tighter spot than a couple in a state that uses the federal CSRA range. If your countable assets sit between $66,480 and $162,660, that gap is real money, and it makes early planning worth a conversation with an attorney.,

After death: estate recovery

Like every state, South Carolina runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, the South Carolina Department of Health and Human Services may seek repayment from the estate., Federal exceptions apply (a surviving spouse, or a minor, blind, or disabled child), and an undue-hardship waiver exists.

Where South Carolina is narrower than it could be: the state recovers from the probate estate only. Its statute defines "estate" by cross-reference to the South Carolina Probate Code, and South Carolina has not adopted the optional expanded-estate definition federal law allows. Assets that pass outside probate (joint tenancy with right of survivorship, payable-on-death and transfer-on-death accounts, life insurance and retirement accounts paid to a named beneficiary, and property in a properly funded trust) are not reachable. 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 under the brand Healthy Connections, administered by the South Carolina Department of Health and Human Services (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 listed on the SCDHHS website and complete the application 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 to confirm they need nursing-facility-level services. If income runs over the $2,982 cap, get the Qualified Income Trust set up before or alongside the application, because South Carolina won't approve an over-income applicant without it.

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 on which coverage you need, because South Carolina runs two income tests. For nursing-facility and home- and community-based waiver coverage, the 2026 limit is $2,982/month, equal to 300% of the SSI Federal Benefit Rate; South Carolina is an income-cap state, so an applicant whose gross income exceeds that figure must route the excess through a Qualified Income Trust to qualify., 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 other caretaker relatives.

Can an adult without children get Medicaid in South Carolina?

Not on the basis of income alone. South Carolina has not adopted the ACA Medicaid expansion, so there is no "new adult group" pathway here for a non-disabled, non-pregnant adult without dependent children, at any income., Adults below the poverty level can fall into the coverage gap: too much income for Medicaid, too little for Marketplace premium subsidies. The aged, blind, and disabled track becomes available 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. Because South Carolina is an income-cap state with no medically needy spend-down for long-term care, an applicant earning more than $2,982/month can only qualify by establishing a Qualified Income Trust (also called a Miller Trust) and depositing the excess income into it each month.

What is the South Carolina Medicaid asset limit?

$2,000 in countable assets for a single applicant, and $3,000 for a couple when both spouses apply. The home (within the federal home-equity limit, a $752,000 minimum in 2026), one vehicle, household goods, and a prepaid irrevocable burial arrangement are exempt from the count. That limit applies only to the long-term-care and ABD track: federal law bars any asset test for the MAGI groups, so children, pregnant women, and parents or caretaker relatives are judged on income alone.

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

South Carolina sets a single fixed Community Spouse Resource Allowance of $66,480 in 2026, far below the $162,660 federal maximum. 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.