South Carolina Medicaid Office
Below is the contact information for the Medicaid office in South Carolina. They can assist you with questions or concerns about the South Carolina Medicaid program, including the eligibility requirements and Medicaid enrollment in South Carolina. You can view their site online at scdhhs.gov. To find out if you are eligible for this program, South Carolina Medicaid eligibility.
The Medicaid program in South Carolina covers basic medical care. This may include doctor services, inpatient hospital care, laboratory and x-ray services, inpatient short-term skilled nursing or rehabilitation-facility care, outpatient hospital or clinic care, short-term home healthcare, ambulance service and prescription drugs for people not covered by Medicare. We suggest contacting the Medicaid office to find out specifically what coverage is provided as it can be different in each state.
South Carolina Medicaid Doctors
To find a doctor or other provider near you who accepts your SC Medicaid plan, use the SC Choices provider search tool. Enter your city, county, and zip code, the plan you have or would like to enroll in, and the type of doctor you are looking for. You can also type in a specific doctors name to see if they accept your plan. We would recommend calling ahead and making sure that the doctor you want to schedule an appointment with will accept your plan.
Sc Healthy Connections Dental Program & Vision Coverage
Adults in the SC Healthy Connections Dental Program can receive preventative services of up to $750 in value per year. This includes annual cleanings and exams, x-rays, extractions, and fillings. Most people will pay a $3.40 copayment. Kids also get six-month fluoride treatments, one sealant every three years, and one space maintainer. These services are provided through Dentaquest, so you can find a provider at the SC Dentaquest website.
Vision coverage is also much more comprehensive for kids than it is for adults. While kids can get coverage for both exams and glasses, adults can only receive medically necessary exams, like for those pertaining to eye diseases like glaucoma.
Also Check: Urologist In Baton Rouge That Accept Medicaid
How To File An Appeal
You can ask for an appeal if your Medicaid coverage has changed, ended or been denied. You can also ask for an appeal if a medical service you need has been denied or delayed. For more information about the appeal process go to www.scdhhs.gov/appeals or call 1-800-763-9087.
To ask for an appeal, submit a request within 30 days from the date on your closure or other notice with your contact information , a copy of the denial or other notice received and a description of what and why you are appealing. You can submit an appeal:
South Carolina Medicaid Eligibility Requirements
Medicaid eligibility is not always black and white. The Healthy Connections program includes several categories of eligibility: Aged and blind or disabled, breast and cervical cancer, disabled children, family planning, former foster care, nursing home residents, medically needy, parents and caretaker relatives, partners for healthy children, pregnant women and infants, qualifying Medicare beneficiaries, and working disabled people. The chart below can help you determine whether or not you qualify:
Read Also: Can You Get Plan B For Free With Medicaid
Healthy Connections Medicaid Member Newsletters
The South Carolina Department of Health and Human Services has created a new resource for South Carolina Healthy Connections Medicaid members called Healthy and Connected. This e-newsletter focuses on covered benefits and includes tips and tools to help you and your loved ones live healthier lives. Each edition highlights new topics to help you stay healthy and make sure you are connected to resources.
HEALTHY AND CONNECTED
Medicaid By State: Alternative Names And Contact Information
In the table below are direct links to each states Medicaid office website. For those hoping to qualify for Medicaid and looking for assistance with the application process, it is important to recognize that the state is not always the best resource for application assistance. Often times, private advisors are in a better position to counsel individuals on their Medicaid eligibility and assist in the process. One can use our free service to find the most appropriate and affordable Medicaid planning advisor.
One should also be aware that since Medicaid is administered at the state level, many states refer to their Medicaid programs using alternative names. In addition to the alternative names in the table below, several states refer to their Medicaid program as their State Plan or as Title XIX. One should also be aware that eligibility requirements and available programs differ based on the state in which one resides.
| State |
Recommended Reading: Medicaid Brooklyn Ny Phone Number
Scdhhs Coronavirus Preparation Response Resources And Updates
The South Carolina Department of Health and Human Services is taking proactive steps to protect South Carolina Healthy Connections Medicaid members by ensuring ongoing access to care during the current outbreak of coronavirus disease 2019 . These steps support important social distancing measures, include new resources for Healthy Connections Medicaid members and give more flexibility to help health care providers safely and effectively treat patients.
How Do I Update My Contact Information
You can update your contact information over the phone by contacting the Healthy Connections Medicaid Member Contact Center at 549-0820 from 8 a.m. to 6 p.m. Monday through Friday. You can also visit your county eligibility office for help. For a list of office locations, please click here.
It is important to make certain we have your current contact information so you receive important messages about our program, notices about your Medicaid coverage and your annual review form to ensure you continue receiving Medicaid benefits.
Recommended Reading: Pros And Cons Of Expanding Medicaid
Engage With Scdhhs Online On The Phone And Through The Mail
SCDHHS has provided several ways to apply for Medicaid, complete an annual review form or ask questions about your coverage or Medicaid status that you can use from home. To promote social distancing and to help stop the spread of COVID-19, the agency has temporarily closed its eligibility offices to walk-in traffic. Healthy Connections Medicaid members and the public can still engage with SCDHHS dedicated eligibility team members online, over the phone and through the mail to complete any action that would also be completed in an eligibility office.
What Is Healthy Connections
Healthy Connections is South Carolina’s Medicaid program. It is a medical assistance program that helps pay for some or all medical bills for many people who cannot afford medical care. The program also assists individuals who are over 65 or have a disability with the costs of nursing facility care and other medical expenses. Eligibility is usually based on applicants’ income and assets. Healthy Connections is administered by the South Carolina Department of Health and Human Services and pays medical bills with state and federal tax money.
Please visit our full list of for more information.
Also Check: How To Get Medicaid In Nevada
What You Need When You Apply
Before you apply, you will need to know the following for all the people in your household:
- Date of birth
- Social Security Number
- Income from jobs or training
- Benefits received now , such as Social Security, Supplemental Security Income , veteran’s benefits, or child support
- Amount of money in your checking account, savings account, or other resources you own
- Monthly rent, mortgage payment, and utility bills
- Payments for adult or child care health coverage and/or medical benefits you currently have
You can find more information about the enrollment process and answers to frequently asked questions on the , opens new window
What Is Medicaid
Medicaid is South Carolinas aid program by which the federal and state governments share the cost of providing medical care for people who meet certain eligibility criteria.
The Medicaid program is administered by the South Carolina Department of Health & Human Services . Healthy Connections is South Carolinas Medicaid program. It is a medical assistance program that helps pay for some or all medical bills for eligible candidates who cannot afford medical care. Eligibility is usually based on applicants income and assets. Healthy Connections is administered by the South Carolina Department of Health and Human Services .It is not affiliated with Family Connection of South Carolina.
Don’t Miss: State Of Michigan Medicaid Phone Number
How Do I Apply
To apply for Healthy Connections, you will need to complete and submit an application. You may apply online at apply.scdhhs.gov . SC Thrive is available to assist you with the online Healthy Connections application and can provide an assessment of your household’s most likely health coverage options. Please contact their help line at 726-8774 or visit them online at scthrive.org if you have questions or need assistance.
You may also apply in person at your or contact our main customer service line at 549-0820. In addition, you may apply in person at federally qualified rural health centers and at most hospitals. TTY: 888-842-3620
You can return your application and supporting documents electronically to , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101 or at your .
If you are a pregnant woman, you may be able to receive medical care while you wait for your application to be processed. Please contact Healthy Connections at 549-0820 for more information.
Before you apply, you will need to know the following for all the people in your household:
- Date of birth
- Social Security Number
- Income from jobs or training
- Benefits received now , such as Social Security, Supplemental Security Income , veteran’s benefits or child support
- Amount of money in your checking account, savings accounts or other resources you own
- Monthly rent, mortgage payment and utility bills
- Payments for adult or child care health coverage and/or medical benefits you currently have
Tips For Safety And Not Spreading The Virus
The South Carolina Department of Health and Environmental Control and the Centers for Disease Control and Prevention continue to provide the latest public health information to help prevent the spread of COVID-19, the flu and other respiratory viruses. Tips from CDC and DHEC include:
- Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom before eating and, after blowing your nose, coughing or sneezing.
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose and mouth.
- Stay home when you are sick.
- Cover your cough or sneeze with a sleeve or tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
- Remember that were still in an active flu season, so get your flu shot if you havent already.
For more public health resources, tips and updates, please regularly check DHEC and the CDCs COVID-19 webpages.
Read Also: Will Medicaid Pay For Braces For Adults
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
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.
Important First Choice Numbers
Use these phone numbers to get in touch with First ChoiceSM by Select Health of South Carolina.
Hours are Monday through Friday, 8 a.m. to 6 p.m. Saturday and Sunday, only for members with pharmacy-related calls, 8:30 a.m. to 5 p.m.
- Choosing a doctor
- Using the emergency room
- Adult vision care
- Pharmacy services
- Free language translation services
for questions about:
- Self-care advice
Also Check: Does Medicaid Cover Long Term Care Facilities
Suspension Of Annual Reviews
The Families First Coronavirus Response Act, signed into law on March 18, 2020, authorizes states to suspend annual redeterminations in order to ensure continuity of care during the nations COVID-19 response. Accordingly, Healthy Connections Medicaid members enrolled as of March 18, 2020, will retain their eligibility for Medicaid services until the end of the public health emergency, unless the member requests to withdraw from the program.
SCDHHS will issue additional guidance to beneficiaries prior to resuming annual reviews. Healthy Connections members do not need to take any action at this time.
When To Contact Your State Medicaid Agency
In order to assist you in getting a timely response, please contact your State Medicaid Agency for any questions on the following:
If you need assistance in any of the areas noted, you will need to contact the agency for Medicaid/CHIP in your state of residence or the state you have questions about in order to receive assistance. Please contact your state for all state-related Medicaid questions.
Read Also: When Does Medicaid Enrollment Start
Why Choose Humana Healthy Horizons
We designed Humana Healthy Horizons to provide you with the care and support you need so you have more time to focus on what you love. Now more than ever, your health and healthcare coverage are important. Humana Healthy Horizons makes available to South Carolina Medicaid members access to the high-quality healthcare coverage you want and extras you need.
We have easy ways for you to find a doctor or a specialist. We can send your medicines to your home, so you dont have to go to a pharmacy. And along with your medical care, you get:
- Behavioral and emotional health coverage
- Hearing, prescription, and vision coverage
- Digital tools to help you manage your health care
Here are some things you should know about Medicaid enrollment in South Carolina:
To Apply You Will Need To Have The Following For All The People In Your Household:
- Date of birth
- Social Security Number
- Income from jobs or training
- Benefits received now , such as Social Security, Supplemental Security Income , veteran’s benefits or child support.
- Amount of money in your checking account, savings accounts or other resources you own.
- Monthly rent, mortgage payment and utility bills.
- Payments for adult or child care health coverage and/or medical benefits you currently have.
To schedule an appointment with the Medicaid Eligibility, call or
Also Check: Aged Blind Disabled Medicaid Nj
Eligible For Medicaid Coverage In South Carolina
To complete the Medicaid application process:
How do I apply?
To apply for Healthy Connections, you will need to complete and submit an application. You can submit an application:
Online: , opens new window
SC Thrive is available to help you with the online application and can provide an assessment of your households most likely health coverage options. Call SC Thrive at 1-800-726-8774 or go to
, opens new window or at federally qualified rural health centers and most hospitals.
Return your application and supporting documents electronically to
Send your application and supporting documents to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101.
If you are a pregnant woman, you may be able to get medical care while you wait for Healthy Connections to process your application. Call Healthy Connections at 1-888-549-0820 for more information.
Using The Sc Medicaid Portal
While all options are viable, applying online certainly has unique perks. By using the SC Medicaid Portal, youll be able to see all of your free and affordable health coverage options, plus you can save your work and return to it later. This is important because the application requires a lot of paperwork and documentation that you may not have in front of you all at once. Plus, it takes a while to complete the application properly. It may be easier for you to spend a few minutes at a time working on it.
Also Check: Can You Apply For Medicaid If You Have Insurance
Welcome To Vermont Health Connect
Vermont Health Connect is the State of Vermonts health insurance marketplace. Eligible Vermonters can get financial help paying for coverage when they enroll in a qualified health plan through Vermont Health Connect. Vermont Health Connect also offers Medicaid for Children and Adults to eligible Vermonters, including Dr. Dynasaur.
During an enrollment period, any eligible Vermonter can buy a qualified health plan through Vermont Health Connect. Vermonters with qualifying incomes can also get financial help paying for coverage, but only if they do not have an offer of employer-sponsored insurance or government insurance. If you are offered health insurance through a job, you wont be able to get financial help from Vermont Health Connect unless you can prove that insurance is not adequate or affordable.
To get health insurance, you must sign up during an enrollment period. Vermont Health Connects Open Enrollment starts November 1 and lasts about six weeks. Eligible Vermonters can sign up for a qualified health plan during Open Enrollment. At other times, you can get a 60-day Special Enrollment Period if you have a major life event, such as losing your health insurance. Vermonters who are eligible for Medicaid can enroll at any time.
Medicaid Provider Service Center
The South Carolina Department of Health and Human Services has made important changes to its provider services, support and relations procedures in order to better serve you. SCDHHS consolidated operations to provide a single point of contact through the Medicaid Provider Service Center at 1-888-289-0709 and expanded the ways in which providers can contact us. This will allow us to more effectively respond to your requests and track your needs.
The improvements at PSC will allow us to now handle all provider inquiries related to eligibility, enrollment, education and training, claims and reimbursement status, electronic data interchange, and general customer service needs. Providers should direct all telephone inquiries to the PSC by calling 1-888-289-0709 and following the voice prompts depending on the nature of the call. It is no longer necessary to address inquires or correspondence to an assigned representative. Any available PSC Representative will be able to assist you.
Effective immediately, you can also access provider service requests online. Simply submit an online inquiry at and a provider support representative will then respond to you directly.
Updates and changes will continue to be posted to our website at www.scdhhs.gov as we continue to improve the services that we provide to both Medicaid providers and beneficiaries. Please continue to review your Medicaid Policy manual for additional policy changes and updates.
Also Check: Affordable Braces For Adults With Medicaid
