Looking for more information or additional resources? The following agencies and organizations may be able to help.
To apply for Medicaid eligibility based on household income, online from the SC DHHS homepage, visit this Apply for South Carolina Medicaid webpage.
Medicaid Eligibility Categories:
*This is a partial listing. Visit SCDHHS’ Getting Started page for a full listing.
Partners for Healthy Children is for children under age 19 in families with low incomes. Coverage is reviewed and renewed annually.
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 who can more economically be provided care at home than in a hospital or community home. This eligibility is based on the child’s income and resources rather than family income.
Aged, Blind and Disabled (ABD) is an eligibility category for individuals age 65 or older, blind or disabled and have low income.
Supplemental Security Income (SSI) pays benefits to children and adults who are blind or disabled and who have limited income and resources. If determined eligible for SSI, the child or adult will be automatically eligible for Medicaid.
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. 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.
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 of the program 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.
Community Long Term Care (CLTC) operates home and community-based waiver programs for people eligible for nursing home care but who prefer to receive their services in the community.
Medically Complex Children’s Waiver (MCC) is a statewide program to serve children from birth to age 18 who meet either Nursing Facility or Intermediate Care Facility-Intellectually Disabled level of care and medical criteria.
South Carolina Department of Disabilities and Special Needs (DDSN) provides home and community-based waiver services. From this DDSN webpage, click on the links for more information on waivers provided by DDSN. Each link also will give you information on how to obtain each waiver.
Children’s Specialized Hospital –Health Insurance Education
Information on health insurance is provided here to ensure you have the information and resources needed to select the best health plan for your family.
This official site of the Affordable Care Act provides health coverage choices, ways to stave and how the law affects you. You can also enroll in health coverage.
South Carolina Health Insurance Pool (SCHIP)
The South Carolina Health Insurance Pool (SCHIP) was created by the South Carolina General Assembly by Act 127 of 1989 to make health insurance coverage available to residents of South Carolina who are either unable to obtain health insurance because of a medical condition or whose premium for health coverage exceeds 150% of the pool rate.
South Carolina chose to enhance SCHIP so that it meets the requirements of an acceptable alternative mechanism. This is known as the state alternative mechanism (SAM). SCHIP coverage is not an insurance policy nor is it a Blue Cross Blue Shield of South Carolina policy. SCHIP coverage is administered by Blue Cross Blue Shield of South Carolina.
Affordable Care Act
The Affordable Care Act And You: What Your Family Needs To Know:
The American Academy of Pediatrics has created this list to explain some key things you should know about the Affordable Care Act.
Visit the Health Insurance Marketplace for information to take health care into your own hands, explore insurance coverage options and learn how the Affordable Care Act impacts you.
Healthcare Rights and Protections
Whether you need health coverage or have it already, the health care law offers new rights and protections that make coverage fairer and easier to understand. Some rights and protections apply to plans in the Health Insurance Marketplace or other individual insurance, some apply to job-based plans, and some apply to all health coverage. Use this guide to learn about your rights and protections today.\
A quick guide to the Marketplace
Here’s a quick rundown on the most important things to know about the Health Insurance Marketplace, sometimes known as the health insurance “exchange.”
10 health care benefits covered in the Health Insurance Marketplace
Every health insurance plan sold in the Marketplace will offer 10 essential health benefits.
Video titled The Value of Health Insurance. No one plans to get sick or hurt, but most people need medical care at some point. Health insurance covers these costs and protects you from very high expenses.
Protect Yourself from Fraud in the Health Insurance Marketplace
When you apply for health coverage through the Health Insurance Marketplace, you can protect yourself from fraud by following a few simple guidelines.
Kaiser Family Foundation’s Health Insurance Marketplace Calculator
The Health Insurance Marketplace Calculator provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance. You can also use this tool to estimate your eligibility for Medicaid. As eligibility requirements may vary by state, please contact your state’s Medicaid office or Marketplace with enrollment questions.
Comparing Health Plan’s Benefits and Coverage Summaries Fact Sheet
This fact sheet is intended to help answer specific questions that people with disabilities might ask about benefits and coverage available through the Health Insurance Marketplace.
Family Voices National Center for Family Professional Partnerships (NCFPP)
The NCFPP is charged with helping families and professionals understand the ACA and helping families access the benefits of the ACA. This site provides an index of information cataloged on the site, including the ACA blog and background, benefits of the ACA and resources for people with disabilities.
Coverage to Care
From Coverage to Care is an initiative to help people with new health care coverage understand their benefits while getting connected to primary care and the preventive services so they can live a long and healthy life.
Sign up SC: Information About the Marketplace
This website provides information about Health Insurance basics, the Marketplace, events in South Carolina, and how to find local help.
Where do I look for help with healthcare?
Various programs may provide assistance depending on the situation. Several state programs provide services based on area of need. Grant opportunities are available that pay for some care not included in state programs and not covered by insurance. The programs listed here could help by providing health care or through financial assistance.
BabyNet is South Carolina’s early intervention system for infants and toddlers under three years of age with developmental delays or conditions associated with developmental delays. BabyNet services are provided at no cost to the family. Be sure to visit the Early Childhood portion of our Roadmap for more details on BabyNet.
South Carolina Continuum of Care is a South Carolina state program that serves children with serious emotional or behavioral health diagnoses whose families need help keeping them in their home, school or community. The Continuum helps children and families using Wraparound, a team-based approach to caring for families with complicated needs.
South Carolina Department of Disabilities and Special Needs (DDSN) serves individuals with intellectual disabilities, autism, head and spinal cord injuries, and conditions related to these disabilities. Services are delivered through local county Disabilities and Special Needs (DSN) Boards. DDSN also provides early intervention services to children birth to age six years of age.
South Carolina DHEC Division of Children’s Health, located in the Maternal and Child Health Bureau, promotes and protects the health of children and their families in all 46 counties of South Carolina. Programs managed through this division include Children with Special Health Care Needs. Services include information and referrals, care coordination and financial assistance from DHEC.
South Carolina Department of Mental Health (DMH) provides a full range of community and inpatient services to people of all ages who are affected by serious mental illness and significant emotional disorders. These services are provided through a network of 17 community mental health centers that serve the state’s 46 counties.
Early Hearing Detection and Intervention: Health Resources and Services Administration’s Early Hearing Detection and Intervention (EHDI) program enables states, territories, families, and providers to develop complete and coordinated systems of care so that newborns, infants and young children who are deaf or hard of hearing are identified and get the care they need when they need it.
IMPACT is a project of national Family Voices and promotes a holistic approach to health and wellness for all families and children including those with special healthcare needs and disabilities. It also promotes health and wellness by developing materials and tools and sharing other resources that help families learn skills to build healthy relationships, healthy families and healthy communities.
NeedyMeds is a national nonprofit information resource dedicated to helping people locate assistance programs to help them afford their medications and other healthcare costs.
Partnership for Prescription Assistance helps qualifying patients without prescription drug coverage get the medicines they need for free or nearly free.
Pfizer RXPathways connects eligible patients to a range of assistance programs that offer insurance support, co-pay help and medicines for free or at a savings. Enter the name of the medicine you’ve been prescribed. You can search one medicine at a time. Then answer a few questions to see which available program(s) may be right for you.
RX Outreach is a nonprofit pharmacy committed to helping people get the medications they need at an affordable price.
SignIt is an online beginning American Sign Language (ASL) course with 10 units that teach beginning conversational ASL (vocabulary, sentences, grammar and syntax) and Deaf culture. The self-paced curriculum is estimated to take 25–30 hours to complete. The curriculum is free to parents of birth to 36-month-old children who are deaf or hard hearing ages 0–3. Visit the NCHAM website.
United Healthcare Children’s Foundation is a nonprofit charity dedicated to facilitating access to medical-related services that have the potential to significantly enhance either the clinical condition or the quality of life of the child and that are not fully covered by the available commercial health benefit plan. This “support” is in the form of a medical grant to be used for medical services not covered or not completely covered by commercial health benefit plans. Visit the United Healthcare Children’sFoundation website to read more about the grants and how to apply.
Welvista is a unique private-public partnership of non-governmental healthcare intervention that, since 1993, has helped thousands of uninsured residents in South Carolina.
Community Health Centers are community-based, nonprofit organizations that provide comprehensive, high-quality, patient-focused health care services in a culturally appropriate manner. With a focus on primary care, prevention, education and case management, health centers accept most health insurance plans, including Medicare and Medicaid. For those patients without insurance, services are provided on a sliding fee scale based on the patient’s income.
Hands of Hope Pediatric Palliative Care
Palliative care focuses on children, prenatal to age 21, with complex or serious conditions and their families, enhancing quality of life in partnership with the existing care team. Hands of Hope Pediatric Comfort and Palliative Care is provided by the only nationally board certified interdisciplinary team available to serve any child living in or visiting South Carolina.
RiteCare Scottish Rite Childhood Language Program provides provides professional speech and language therapy to children with speech and language disorders.
Shriners Hospitals for Children– Greenville is a pediatric hospital providing comprehensive care to children with orthopedic and neuromusculoskeletal disorders and diseases.
Special Needs Directory of Dentists for South Carolina– This directory identifies dental offices and clinics who have reported that they are comfortable providing care to patients with special health care needs. Click for More Details.
Hear to Learn With the goal of advancing understanding of spoken language for young children who are deaf or hard of hearing, the website offers user-friendly materials for parents, caregivers, and teachers, for parents and other professionals -in English and Spanish.