Columbia Senior AdvisorDoes Medicaid cover long-term nursing home care in South Carolina?
Yes. Healthy Connections Medicaid, administered by SCDHHS, pays for long-term nursing home care when a resident meets nursing facility level of care and Medicaid's income and resource limits, in homes that participate in Medicaid.
Almost every certified nursing home in the six Midlands counties accepts Medicaid, but a home may cap its Medicaid beds. Ask how Medicaid beds are assigned and whether a private-pay resident can stay in the same room after converting. Each month the resident's own income, minus a small personal allowance and certain deductions, goes to the home and Medicaid pays the balance.
What are the 2026 income and asset limits for nursing home Medicaid?
For long-term care in 2026, South Carolina generally applies an income cap of $2,982 a month (300% of the $994 SSI rate), a countable resource limit of $2,000 for one person and a home equity limit of $752,000.
South Carolina is an income-cap state, so someone over $2,982 can still qualify by routing the excess into a qualified income trust, often called a Miller trust, every month. The home, one vehicle, personal belongings and certain burial funds are usually excluded. When a spouse remains at home in Irmo or Camden, federal spousal rules protect a share of the couple's income and assets for that spouse.
What is South Carolina's Medicaid look-back?
Medicaid reviews the 60 months (five years) before the application for gifts or transfers below fair value, and a transfer inside that window can set off a penalty period during which Medicaid will not pay for nursing home care.
Paying for care, settling debts at fair value, home repairs and buying exempt items are generally fine. Gifts to children, adding a child to the deed or selling property to a relative below market are what cause trouble. Keep receipts for large payments, and see an elder law attorney before moving money.
How do we apply for nursing home Medicaid from Columbia?
Apply through Healthy Connections at apply.scdhhs.gov or the Member Contact Center at (888) 549-0820, and ask the nursing home's business office to help with level-of-care paperwork; SCDHHS may request up to 60 months of financial records.
A complete file moves fastest: bank statements, income records, insurance policies and property records. Many Midlands nursing homes have staff who help assemble it. If your parent is still at Prisma Health Richland, Prisma Health Baptist, Lexington Medical Center or MUSC Health Columbia, ask the hospital social worker to start the level-of-care process before discharge.
What happens when Medicare stops paying for a nursing home stay?
Medicare covers no more than 100 days of skilled nursing care per benefit period after a qualifying three-day inpatient stay, and only while daily skilled care is needed; after that the resident pays privately or Medicaid begins paying for a long stay if the resident qualifies.
Families often discover the difference on the day a rehab stay ends. If your parent is unlikely to go home, start the Medicaid application during the Medicare-covered stay so coverage can pick up when Medicare stops. See short-term rehab versus long-term care.
Side by side
| Nursing home Medicaid in South Carolina | Nursing home Medicaid in South Carolina is not | |
|---|---|---|
| Pays | Long stays for eligible residents in participating homes | Short rehab stays (Medicare's job) |
| Income | Capped at $2,982 a month, with trusts for excess | Closed to anyone over the cap |
| Assets | $2,000 countable for an individual | Counted without home and car exclusions |
| Look-back | 60 months of transfers reviewed | Satisfied by gifts made last year |
Drawn from S.C. Code Regs. 60-84, DPH Healthcare Quality and SCDHHS publications, CareScout, CMS, the VA and the regional aging agencies cited in the text; our editorial standards explain how we check them.
