What Is the Income Limit for Medicaid in South Carolina?

The income limit for Medicaid in South Carolina depends on which category you fall into, ranging from 67% of the Federal Poverty Level (FPL) for parents and caretaker relatives up to 208% FPL for children. South Carolina has not expanded Medicaid under the Affordable Care Act, so the program, known as Healthy Connections, only covers specific groups of residents rather than all low-income adults.1SCDHHS. Palmetto Pathways to Independence Waiver

Income Limits by Category

South Carolina sets each limit as a percentage of the federal poverty guidelines, which are updated every January.2Federal Register. Annual Update of the HHS Poverty Guidelines Most categories use Modified Adjusted Gross Income (MAGI) rules, which include a built-in 5-percentage-point disregard that effectively raises the stated threshold slightly.3SCDHHS. Medicaid Eligibility Programs Effective January 1, 2026

  • Children under 19 (Partners for Healthy Children): family income at or below 208% FPL, or roughly 213% with the disregard.
  • Pregnant women and infants under one: income at or below 194% FPL, roughly 199% with the disregard. Coverage for the mother continues 12 months after the pregnancy ends.4SCDHHS. Improving Maternal Health and Extending Postpartum Coverage in Medicaid and Childrens
  • Parents or caretaker relatives: family income at or below 67% FPL, roughly 72% with the disregard. This is one of the lowest thresholds in the program.
  • Aged, Blind, or Disabled (ABD): income at or below 100% FPL. This group does not use MAGI and gets no 5% disregard.
  • Family planning only (limited benefits, not full Medicaid): income at or below 194% FPL.5SCDHHS. Family Planning

All of these thresholds come from the South Carolina Department of Health and Human Services.6SCDHHS. Program Eligibility and Income Limits

What Those Percentages Mean in Dollars

The 2026 federal poverty guidelines set 100% FPL at $15,960 per year for one person and $33,000 for a family of four in the 48 contiguous states.7ASPE. 2026 Poverty Guidelines – 48 Contiguous States Converted into approximate monthly income limits:

  • Children (208% FPL): about $2,766/month for a household of 1; $4,736 for a household of 3; $5,720 for a household of 4.
  • Pregnant women (194% FPL): about $2,580/month for an individual; $4,417 for a household of 3; $5,335 for a household of 4.
  • Parent or caretaker (67% FPL): about $1,208/month for a household of 2; $1,526 for a household of 3; $1,843 for a household of 4.
  • ABD (100% FPL): about $1,330/month for an individual; $1,803 for a couple.

South Carolina usually publishes its own dollar chart shortly after the federal guidelines come out, and there can be a brief lag. Check the SCDHHS eligibility page for the current posted figures before applying.6SCDHHS. Program Eligibility and Income Limits

How Household Size Is Counted

Because the dollar limit climbs with household size, getting the count right matters. Under MAGI, household size follows tax-filing relationships, not who lives under the roof.8SCDHHS. SC Medicaid Policy and Procedures Manual – Section 200, MAGI Related Programs

  • If you file taxes, your household is you, your spouse if filing jointly, and anyone you claim as a dependent.
  • If you are claimed as a tax dependent, your household is generally the same as the filer’s, with exceptions for a child under 19 claimed by a non-custodial parent or parents in the home who do not file jointly.
  • If you do not file and no one claims you, your household is you, your spouse, and your children under 19 who live with you.

ABD applicants do not use MAGI. For that category, the household is generally just the individual, or the individual and spouse.9SCDHHS. SC Medicaid Policy and Procedures Manual – Eligibility Structure

What Counts as Income

For the MAGI groups (children, pregnant women, parents), countable income includes wages, salaries, self-employment net income after business expenses, taxable Social Security benefits, unemployment compensation, and pension payments.10SCDHHS. SC Medicaid Policy and Procedures Manual – Chapter 201, FI Related Income Policy If you are self-employed, you report net profit, meaning gross receipts minus allowable business expenses, not total revenue.11Medicaid.gov. Building MAGI Knowledge Part 2 – Income Counting

Several income sources are excluded under MAGI. Child support you receive does not count. Most Veterans Affairs benefits, including disability compensation, pensions, and education allowances, are excluded because they are not part of adjusted gross income.12Medicaid.gov. Will Veterans Administration Benefits Be Counted as Income for Medicaid Eligibility Supplemental Security Income (SSI) and certain educational financial aid are also not counted.10SCDHHS. SC Medicaid Policy and Procedures Manual – Chapter 201, FI Related Income Policy

ABD applicants face different rules. Child support counts (though the first $50 per month is disregarded), and most veterans’ benefits count as well, with aid-and-attendance payments excluded.10SCDHHS. SC Medicaid Policy and Procedures Manual – Chapter 201, FI Related Income Policy If you are applying under ABD, expect more of your income to count than it would under a MAGI category.

Asset Limits Apply Only to ABD

The MAGI categories, which cover children, pregnant women, and parents, have no asset test. Income is the only financial measure.

The ABD category is different. As of 2026, a single ABD applicant can have no more than $9,950 in countable assets, and a couple no more than $14,910.13SCDHHS. Program Eligibility and Income Limits – Section: Aged, Blind or Disabled Countable resources generally include bank accounts, stocks, bonds, and other liquid assets. Your primary home, one vehicle, household goods, and certain burial arrangements are typically excluded. For long-term care Medicaid, a federal home equity limit between $730,000 and $1,097,000 applies depending on the state, with a fixed $1 million cap scheduled to take effect in 2028.

The Coverage Gap for Adults Without Children

Because South Carolina has not expanded Medicaid, adults aged 19 to 64 who are not pregnant, not disabled, and not caring for a minor child generally do not qualify for Healthy Connections at any income level. A proposed limited coverage option, the Palmetto Pathways to Independence waiver, would target parents and caretaker relatives with income between 67% and 100% FPL, filling part of that gap. Eligible individuals would have to complete 80 hours per month of community engagement activities such as employment or job training.1SCDHHS. Palmetto Pathways to Independence Waiver The waiver still requires federal approval, so check the SCDHHS site for its current status before counting on it.