How Medicaid Can Help Pay for Long-Term Care in South Carolina

Q: How much can a non-applicant spouse keep in South Carolina?

$66,480 — a fixed amount, not a range. This is well below the $162,660 federal maximum many other states use, meaning a spouse in South Carolina generally protects less than a spouse in most other states.

Q: What changed for dual-eligible Medicare/Medicaid recipients in South Carolina in 2026?

As of January 1, 2026, South Carolina ended its Healthy Connections Prime plan for dual-eligible individuals and moved them into standard Medicaid managed care organizations instead.

Q: What is South Carolina's asset limit for long-term care Medicaid?

$2,000 for a single applicant applying for nursing home Medicaid or the Community Choices Waiver — different from the higher $9,950 limit used for regular ABD Medicaid, which doesn't cover long-term care.

Published August 28, 2026 How we keep this accurate

This page is South Carolina-specific. Medicaid long-term care rules vary significantly by state. See our national Medicaid Waivers Explained guide if you're elsewhere.

A meaningfully lower spousal protection

When one spouse needs long-term care Medicaid, the non-applicant spouse is normally protected by a Community Spouse Resource Allowance (CSRA). In South Carolina, this is a fixed $66,480 — not the up-to-$162,660 range many other states use.

This is a real planning difference, not a technicality. A couple with substantial joint savings will protect meaningfully less for the at-home spouse in South Carolina than in a state using the federal maximum. If you're married and planning ahead, this figure should factor into the conversation early, ideally with an elder law attorney.

A real 2026 structural change

As of January 1, 2026, South Carolina ended its Healthy Connections Prime plan — the state's previous dedicated program for people dually eligible for Medicare and Medicaid — and moved those individuals into standard Medicaid managed care organizations instead. If you or a family member was previously on Healthy Connections Prime, your coverage structure has genuinely changed.

Two different asset limits — don't confuse them

	Nursing Home / Community Choices Waiver	Regular ABD Medicaid
2026 asset limit	$2,000 (single)	$9,950 (single)
Covers long-term care?	Yes	No

Source: South Carolina Department of Health and Human Services (SCDHHS); figures effective 2026.

The Community Choices Waiver

South Carolina's primary HCBS program is the Community Choices (CC) Waiver, administered through SCDHHS's Community Long Term Care division. It covers personal care assistance, adult day health care, home modifications, and respite care. It's not an entitlement — enrollment slots are limited and waitlists do form, since home-based care costs roughly half what institutional care does, and demand consistently outpaces available capacity.

If you're placed on the CC Waiver waitlist, contact your local Area Agency on Aging at 1-800-868-9095 to explore interim options rather than waiting passively.

If your income is over the limit

South Carolina is an income-cap state — exceeding $2,982/month requires a Qualified Income Trust (Miller Trust), with excess income deposited monthly. Given how much scrutiny these trust documents receive, a single drafting error can genuinely cost you eligibility — this is worth having an elder law attorney handle, not a DIY template.

How to actually start

Apply through Healthy Connections online, by phone, or on paper — confirm whether you're being evaluated for the Community Choices Waiver or nursing home Medicaid, since the process and expectations differ.

If married, understand the $66,480 spousal protection figure before assuming a higher federal maximum applies — see Questions to Ask an Elder Law Attorney for how to plan around this.

Common Questions

How much can a non-applicant spouse keep in South Carolina?

$66,480 — a fixed amount, well below the $162,660 federal maximum many other states use.

What changed for dual-eligible Medicare/Medicaid recipients in South Carolina in 2026?

Healthy Connections Prime ended January 1, 2026; dual-eligible individuals moved into standard managed care organizations.

What is South Carolina's asset limit for long-term care Medicaid?

$2,000 for nursing home Medicaid and the Community Choices Waiver — different from the $9,950 limit used for regular ABD Medicaid, which doesn't cover long-term care.