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  Home >> Eligiblity Policy and Oversight >> Download Applications

 Application Download Page
 Checklist for Required Documentation
 Income Limits for the Specific Program


The information below is based on the selected need for coverage made on a previous page.

This page will provide you with:

  • An Application
  • A Checklist Of Required Documentation
  • Income Limits
For the Medicaid program or other coverage programs managed by DHHS.

Note: Coverage is provided under many categories with different income limits. More than one income table may be presented . Not all programs providing coverage are Medicaid programs.


Optional State Supplementation (OSS)
January 1, 2009
Monthly Net Income Limit:
$1,157


Printable Applications
Applications in Adobe PDF Format Form Link Description
FM 910 SC Medicaid Program

What else you will need.
Check List for FM 910
Then Mail Applications to: ¬
(FM 910) Mail to Your County Office




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