Medicaid eligibility in South Carolina — income limits for 2025
The number
Healthy Connections covers pregnant women up to 199% of the federal poverty line — $51,380 annual income for a family of three in 2025.
Income limits in dollars (2025)
| Category | % FPL | Household of 1 | Household of 3 | Household of 4 |
|---|---|---|---|---|
| Pregnant women | 199% | $29,970 | $51,380 | $62,090 |
| Children 0-5 | 213% | $32,080 | $55,000 | $66,460 |
| Children 6-18 | 213% | $32,080 | $55,000 | $66,460 |
| Parents / caretakers | 67% | $10,090 | $17,300 | $20,900 |
Who qualifies and how the income limits work
Healthy Connections uses modified adjusted gross income (MAGI) rules to test eligibility. For 2025, the thresholds for a three-person household are: pregnant women up to 199% of the federal poverty line ($51,380), children 0-5 up to 213% ($55,000), children 6-18 up to 213% ($55,000), and parents / caretaker relatives with dependents up to 67% ($17,300).
South Carolina has not adopted Medicaid expansion. Adults 19-64 without dependent children have no path to Medicaid no matter how low their income. Parents earning above 67% FPL ($17,300 for a three-person household) and below 100% FPL fall into the coverage gap — too much for Medicaid, too little for ACA marketplace subsidies. The Kaiser Family Foundation estimates non-expansion states account for nearly all of the 1.5 million Americans in that gap.
Citizenship / immigration status: US citizens and most lawfully present immigrants (with a 5-year waiting period for most categories under PRWORA) qualify if they meet the income test. Pregnant women and children may qualify in narrower circumstances under the CHIPRA 2009 state option. Assets test: no assets / resources test for MAGI-category applicants; a test applies for long-term care and non-MAGI applicants.
South Carolina launched a 24-month Medicaid doula pilot in September 2024 under H 3592 (2023), reimbursing up to $1,000 per package in the Upstate, Midlands, and Lowcountry regions. Charleston Birth Place and Reaching Our Sisters Everywhere (ROSE) coordinate Black birth worker training.
For Black families
Because South Carolina has not expanded Medicaid, Black parents earning between the state's parent ceiling and 100% FPL fall into the coverage gap. KFF estimates Black residents make up a disproportionate share of that gap in every non-expansion state. South Carolina launched a 24-month Medicaid doula pilot in September 2024 under H 3592 (2023), reimbursing up to $1,000 per package in the Upstate, Midlands, and Lowcountry regions. Charleston Birth Place and Reaching Our Sisters Everywhere (ROSE) coordinate Black birth worker training.
Where to get help in South Carolina
- Federally Qualified Health Centers in South Carolina: every FQHC accepts Medicaid, charges on a sliding scale for the uninsured, and has certified application counselors who can help you apply or renew. See our FQHC directory for this state at /clinics/sc/.
- Medicaid-accepting providers in South Carolina: our provider directory lets you filter to providers in this state. See /providers/sc/.
- State health profile for South Carolina: for state-level health outcomes context (maternal mortality, infant mortality, life expectancy, uninsured rate) by race, see /health/south-carolina/.
- Healthy Connections consumer help line: 1-888-549-0820 for application help, renewal questions, and general Medicaid inquiries. Ask for an interpreter if you need one; language access is required under Title VI of the Civil Rights Act.
References & primary sources
- Healthy Connections, state Medicaid portal: https://www.scdhhs.gov/.
- KFF State Health Facts: kff.org/statedata. Medicaid income eligibility + enrollment.
- Medicaid.gov: medicaid.gov. Federal program guidance + state plan amendments.
- HHS 2025 Poverty Guidelines (Federal Register Jan 2025): aspe.hhs.gov/poverty-guidelines.
Data refreshed: