Healthcare Coverage
Where do I look for help with healthcare?
Depending on your child’s needs, there are several options for health care coverage and services. Explore the resources below to find the support that’s right for your family.
For one-on-one help, call our Support and Information Line at 1-800-578-8750 to speak with our health care team.
New to South Carolina? Download A Guide to Health Care Coverage for Children with Disabilities
What is Medicaid?
Medicaid is South Carolina’s program where federal and state governments share the cost of providing medical care for individuals who meet eligibility criteria.
SC Department of Health & Human Services (SCDHHS) manages Healthy Connections, South Carolina’s Medicaid program. It is not affiliated with Family Connection of South Carolina.
To view a full listing of medicaid eligibility categories, visit SCDHHS Getting Started.
Medicaid Eligibility Categories
TEFRA/Katie Beckett is a category of eligibility for Medicaid coverage for children under age 19 who meet the Supplemental Security Income (SSI) childhood disability definition and level of care and can be provided care at home more economically than in a hospital or community home. This eligibility is based on the child’s income and resources, not family income.
Partners for Healthy Children is for children under age 19 in families with low incomes. Coverage is reviewed and renewed annually.
Aged, Blind and Disabled (ABD) is an eligibility category for individuals age 65 or older, blind, or living with a disability.
Supplemental Security Income (SSI) pays benefits to children and adults who are blind or disabled and have limited income and resources. If determined eligible for SSI, the child or adult will be automatically eligible for Medicaid.
Phone: 1(800)772-1213
Choosing a Medicaid Health Plan
Healthy Connections Choices – the health plan selection website for South Carolina Healthy Connections Choices. South Carolina Healthy Connections Choices is a program that helps eligible Medicaid members enroll in health plans.
1-877-552-4642
TTY: 1-877-552-4670
Here you can:
• Choose a health plan and doctor.
• Review and update your information.
• Compare health plans.
• Find a doctor.
• Watch video clips and find materials that help you choose a health plan and doctor.
• Find meetings in your area to learn more about the health plans.
Other Programs for Families Enrolled in Medicaid
Health Insurance Premium Payment (HIPP) Program
The HIPP Program was created to assist families of Medicaid beneficiaries with the cost of health insurance that covers the client. The goal is to help beneficiaries maintain their private insurance to ensure Medicaid payment as a last resort. Private plans pay first for medical services and Medicaid is secondary. A program brochure, questions and answers, and the referral form are available on the website. The referral form must be printed, completed and submitted to the address on the form.
Medicaid Waivers
What is a Medicaid Waiver?
South Carolina offers seven Medicaid waivers for specific populations, including children and young adults with disabilities and special health care needs, to receive specialized services beyond general Medicaid coverage.
Update on Medically Complex Children’s Wavier
from SC Department of Health and Human Services:
Self-directed children’s attendant care is a home-based service for MCC waiver participants ages one to age 21. It allows the option for eligible parents, relatives or guardians to be paid hourly to deliver the extraordinary care their child needs for day-to-day activities. This option is self-directed and would be used instead of an in-home care agency and personal care aide (PCA).
Interested families who have a child who is covered by the MCC waiver can begin requesting the service on July 1, 2025, by contacting their waiver nurse case manager.
Questions? Call our Support and Information Line at 1-800-578-8750
Private Health Insurance
Private health insurance is coverage through an employer or that’s purchased by an individual from a private health insurance company.
Healthcare.gov
This is the official site to learn more about applying for coverage under the Health Insurance Marketplace.
Prisma Health Center for Adults with Developmental Disabilities (CADD) provides primary care services tailored specifically for adults with intellectual and developmental disabilities. 803-434-4153
Disability Rights of South Carolina Guide to Medicaid and Medicaid Waivers in South Carolina guide to Medicaid resources and benefits in South Carolina for individuals with disabilities.