Greenville Senior AdvisorDoes Medicaid pay for nursing homes in South Carolina?
Yes. South Carolina Healthy Connections Medicaid, run by SCDHHS, pays for long-term nursing home care for residents who meet nursing facility level of care and Medicaid's income and resource limits, in nursing homes that accept Medicaid.
Nearly every certified nursing home in the four counties takes Medicaid, but a home may limit how many Medicaid beds it has, so ask how Medicaid beds are assigned and whether a private-pay resident can stay in place after converting. The resident's own income, minus a small personal allowance and certain deductions, goes toward the cost each month, and Medicaid pays the rest.
What are the 2026 income and asset limits for nursing home Medicaid in South Carolina?
For long-term care Medicaid in 2026, South Carolina generally uses an income limit of $2,982 a month (300% of the $994 SSI federal benefit rate) and a countable resource limit of $2,000 for an individual, with a home equity limit of $752,000.
South Carolina is an income-cap state, so a person whose income is above $2,982 can still qualify by directing the excess into a qualified income trust (often called a Miller trust) each month. The home, one car, personal belongings and certain burial funds are generally not counted. When one spouse stays at home, federal spousal rules protect a share of the couple's assets and income for that spouse.
What is the Medicaid look-back period in South Carolina?
Medicaid looks back 60 months (five years) from the application date for gifts or transfers of assets for less than fair value, and a transfer in that window can trigger a penalty period during which Medicaid will not pay for nursing home care.
Paying for care, paying off debts at fair value, home repairs and buying exempt items are generally allowed. Giving money to children, adding a child to a deed, or selling property to a relative below market value are the transactions that cause trouble. Keep receipts for every large payment, and talk to an elder law attorney before moving money.
How do we apply for nursing home Medicaid in South Carolina?
Apply through SCDHHS's Healthy Connections application at apply.scdhhs.gov or by calling the Member Contact Center at (888) 549-0820, and have the nursing home's business office help with the level-of-care documentation; SCDHHS may ask for up to 60 months of financial records.
Start early: a complete application with bank statements, income records, insurance policies and property records is the fastest one. Many Upstate nursing homes have staff who help families assemble the paperwork. If the person is in the hospital, ask the hospital social worker to start the level-of-care process before discharge.
What happens when Medicare's nursing home coverage ends?
Medicare covers at most 100 days of skilled nursing care per benefit period after a qualifying three-day inpatient hospital stay, and only while the patient needs daily skilled care; after that the resident pays privately or, if eligible, Medicaid begins paying for a long-term stay.
Many families learn about the difference only when a rehab stay ends. If a parent is unlikely to return home, start the Medicaid application during the Medicare-covered stay so coverage can begin when Medicare stops. See short-term rehab vs. long-term nursing.
At a glance
| Nursing home Medicaid in South Carolina | Nursing home Medicaid in South Carolina is not | |
|---|---|---|
| Income | Capped at $2,982/month in 2026, with a qualified income trust above it | Barred to everyone above the cap |
| Assets | $2,000 countable for an individual; the home often exempt | A requirement to sell the house first in every case |
| Look-back | 60 months for transfers below fair value | A penalty on paying for care |
| Coverage | Long-term nursing home care | Coverage for assisted living rent |
Sources include S.C. Code Regs. 60-84, DPH Healthcare Quality and SCDHHS pages and bulletins, CareScout, CMS and VA rate tables as cited above; see our editorial standards.
