A child can stay on Medicaid in SC from birth through the end of the month they turn 19, as long as the household continues to meet the income limit at each yearly review. Former foster youth are the exception: they can keep Healthy Connections coverage through the month they turn 26, with no income test at all.
The Age 19 Cutoff
South Carolina’s Healthy Connections program treats anyone under 19 as a child for this coverage category, under the authority of Titles XIX and XXI of the Social Security Act.1SCDHHS. Program Eligibility and Income Limits School enrollment and health status do not change that boundary. It is a fixed age.
Coverage runs through the end of the birthday month. A teenager who turns 19 on June 10 stays covered through June 30, and the case closes the following month.2South Carolina Department of Health and Human Services. Chapter 204 – Healthy Connections Plans for Children Under Age 19
The Income Limit That Keeps a Child Eligible
Financial eligibility for most children uses Modified Adjusted Gross Income, which is broadly the household’s adjusted gross income as calculated for tax purposes. The limit is 208% of the federal poverty level.3SC DHHS. Section 200 – MAGI Related Programs In 2026 dollars, that comes out to:4ASPE. 2026 Poverty Guidelines
- Family of 2: about $45,011 per year
- Family of 3: about $56,826 per year
- Family of 4: about $68,640 per year
- Family of 5: about $80,454 per year
These figures update each January when new federal poverty guidelines come out. Household size matters too. When someone leaves the home, the income-to-person ratio shifts and can affect eligibility at the next review.
The 12-Month Protection Once Approved
Once your child is approved, federal law requires South Carolina to keep them enrolled for a full 12 months, even if the household’s income rises or other circumstances change during that year.5eCFR. 42 CFR 435.926 – Continuous Eligibility for Children This continuous eligibility rule became mandatory nationwide on January 1, 2024.6Medicaid.gov. Continuous Eligibility for Medicaid and CHIP Coverage
A raise in the middle of the year, a new job, or a change in who lives in the home will not cut your child’s Medicaid short during that 12-month window. The state reassesses income and eligibility at the annual review, not in between.
Only a short list of situations can end coverage before the 12 months are up:
- The child turns 19 and ages out of the children’s category
- The child moves out of South Carolina
- The child or their representative asks to end coverage
- The state determines eligibility was granted due to fraud or an agency error
- The child dies
Coverage to Age 26 for Former Foster Youth
Federal law requires every state to provide Medicaid to former foster youth until their 26th birthday, with no income test. South Carolina runs this under Healthy Connections as its Former Foster Care category.1SCDHHS. Program Eligibility and Income Limits To qualify, the individual must have been enrolled in Medicaid when they aged out of foster care and must remain a South Carolina resident. Coverage lasts through the end of the month they turn 26.
For young adults who turned 18 on or after January 1, 2023, the rule is broader: the person can qualify based on having been in foster care in any state and enrolled in Medicaid in any state during that care.7Medicaid.gov. Mandatory Coverage Former Foster Care Children
What Happens When a Child Turns 19
Outside the former foster care group, Healthy Connections closes the children’s case the month after the 19th birthday.2South Carolina Department of Health and Human Services. Chapter 204 – Healthy Connections Plans for Children Under Age 19 The transition is not automatic. The young adult has to take steps to enroll in something else, and there are a few paths:
- An adult Medicaid category, if the person is pregnant, has certain disabilities, or qualifies as a parent or caretaker relative
- The Former Foster Care category, if the person aged out of foster care while on Medicaid
- A parent’s employer-sponsored health plan, which under the Affordable Care Act can cover an adult child up to age 26
- Subsidized coverage through the Health Insurance Marketplace at healthcare.gov
It helps to sort out the next step a few months before the birthday, because coverage does not carry over on its own.
Keeping Coverage Through the Annual Review
Even with the 12-month protection, Healthy Connections has to be renewed each year.8South Carolina Department of Health and Human Services. Annual Reviews The state first tries to verify eligibility on its own, using wage records and tax data. When that works, your child’s coverage renews automatically without any paperwork on your end.
When it does not work, the state mails you an annual review form asking about household members, income, residency, and any private health insurance. You can also complete it online at apply.scdhhs.gov. If you are missing some of the information, sign and return the form anyway. The state will follow up for what is missing. Failing to return the form is what causes children who still qualify to lose their coverage.
You can submit the completed review several ways:8South Carolina Department of Health and Human Services. Annual Reviews
- Online at apply.scdhhs.gov
- By mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101
- By fax to (888) 820-1204
- By email to 8888201204@fax.scdhhs.gov
- In person at your local county Medicaid office
Your child’s Medicaid stays active while the review is being processed. Once the state finishes, you get a written notice either confirming continued coverage or explaining why the child no longer qualifies. If the decision goes against you, that notice will spell out how to appeal.9SCDHHS. File an Appeal