Report Fraud

How To Apply

STEP 1: Complete an Application

You may apply for Medicaid and/or Affordable Insurance Programs through the Marketplace by completing an application online or by filling out a paper application. You may also apply in person at the County Offices of the Department of Health and Human Services, federally qualified rural health centers, and at most hospitals. Visit apply.scdhhs.gov to begin your application.

STEP 2: Additional Forms May Be Needed

For some Medicaid programs SCDHHS may need to gather more information from you. You may be requested to fill out a form if you are applying for assistance for certain categories. If you need to complete one of these forms SCDHHS will contact you, or you may fill it out and send it to us.

The 3400A is used by the following groups: Aged, Blind or Disabled (ABD), Breast & Cervical Cancer Program (BCCP), Qualified Medicare Beneficiaries (QMB), Qualifying Individuals (QI), Specified Low Income Medicare Beneficiaries (SLMB), Working Disabled, and Disabled Children (TEFRA).

The 3400B is used by the following groups: Individuals In Nursing Facilities And/Or Receiving Home And Community-Based (Waiver) Services and Optional State Supplementation Program (OSS).

Coverage Group Application Forms
Parent/Caretaker Relatives (formally LIF)
Specified Low Income Medicare Beneficiaries (SLMB) and Qualifying Individuals (QI)
Partners for Healthy Children (PHC)
Pregnant Women and Infants
Family Planning
Medically Indigent Assistance Program (MIAP)
Aged Blind Or Disabled (ABD)
Individuals In Nursing Facilities And/Or Receiving Home And Community-Based (Waiver) Services
Optional State Supplementation Program (OSS)
Qualified Medicare Beneficiaries (QMB)
Working Disabled

3400 Healthy Connections Application and 3400-A Additional Information for Select Medicaid Programs

Disabled Children
Breast & Cervical Cancer Program
Former Foster Care (Up to Age 26)