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Am I eligible?

Medicaid eligibility rules are changing. Beginning January 1, 2014 new rules will be in place. How we determine the household composition and income counting will be different, and it may or may not impact your eligibility. If you are not currently receiving Medicaid benefits please visit apply.scdhhs.gov to find out about your options.

Click here for more information about changes to Medicaid eligibility rules

Healthy Connections (Medicaid) Program Income Charts

The Healthy Connections (Medicaid) program provides coverage under many different eligibility categories with varying income requirements. More than one income table may be applicable if more than one eligibility category appears to be appropriate.

100% Of Poverty Level
March 1, 2013

Family Size Monthly Income Annual Income Resources Below
1 $958 $11,490 $7,080
2 $1,293 $15,510 $10,620

 

 

(200% of the Federal Poverty Level)
March 1, 2013

Family Size Monthly Income Annual Income
1 $1,915 $22,980
2 $2,585 $30,020
3 $3,255 $39,060
4 $3,925 $47,100
5 $4,595 $55,140
6 $5,265 $63,180
7 $5,935 $71,220
8 $6,605 $79,260
Each Additional Member $670 $8,040

 

For each additional family member, add $8,040 to the annual income.
 

 

 

(300% of the Federal Benefit Rate-FBR)
January 1, 2013

Family Size Monthly Income Limit
Individual $2,130
Spousal Allocation $2,898

 

 

Individual Monthly Income Annual Income
1 $1,858.52 $22,290.60

 

 

 

Income is not considered for this coverage group.

 

 

Eligible individuals must meet a special income limit known as the Medicaid Cap. The Medicaid Cap is equal to 300% of the current SSI Federal Benefit Rate (FBR). 300% FBR

March 1, 2014

Family Size Monthly Income Limit
Individual $2,163
Spousal Allocation $2,931

 

If monthly income is greater than the limit, an individual may establish an income trust to become eligible for Medicaid. Contact Healthy Connections to learn more about the income trust provisions. Resource Limits Resources are generally defined as those assets including both real and personal property that an individual owns and can use to meet basic needs of food, clothing and shelter. The value of resources owned by the individual cannot exceed $2,000 (after exclusions).

 

 

Family income cannot exceed 200% of the Federal Poverty Level

Additionally, an applicant’s resources and assets cannot exceed the following thresholds:

Primary Residence (the home you live in)

  • $35,000 limit on equity value
  • A family farm of 50 acres or less on which the applicant or his family has lived for at least 25 years is excluded from resources.

Personal Property

  • Equity interest in real property and taxable personal property (such as motor vehicles) cannot exceed a combined total value of $6,000

Liquid Assets

  • Assets in cash cannot exceed $500

An applicant with excess liquid assets may establish eligibility by spending the family's excess liquid assets on valid debts such as rent/mortgage, utilities and medical expenses.

 

 

Monthly Net Income Limit may not exceed $1,404 per month. The individual’s resources must not exceed $2,000.

 

 

62% of Federal Poverty Level

Family Size 62% FPL Monthly Income
1 $593.65
2 $801.35
3 $1,009.05
4 $1,216.75
5 $1,424.45
6 $1,632.15
7 $1,839.85
8 $2,047.55

 

For family sizes over 8, add $207.70 to $2,047.55 (the monthly net income limit for 8) for each additional person.

 

 

208% of the Federal Poverty Level

Family Size 208% FPL Monthly Income
1 $ 1,992.64
2 $ 2,689.44
3 $ 3,386.24
4 $ 4,083.04
5 $ 4,779.84
6 $ 5,476.64
7 $ 6,173.44
8 $ 6,870.24
Each Additional Member $ 696.80

 

 

194% of the federal poverty level

Family Size Monthly Income Annual Income
1 $ 1,858.52 $ 22,290.60
2 $ 2,508.42 $ 30,089.40
3 $ 3,158.32 $ 37,888.20
4 $ 3,808.22 $ 45,687.00
5 $ 4,458.12 $ 53,485.80
6 $ 5,108.02 $ 61,284.60
7 $ 5,757.92 $ 69,083.40
8 $ 6,407.82 $ 76,882.20
Each Additional Member $ 649.90 $ 7,798.80

 

 

100% of Federal Poverty Level  

Family size Monthly income Annual income Resources Below
1 $957 $11,490 $6,940
2 $1,282 $15,510 $10,410

 

 

Family Size SLMB 120% QI 135%
1 (Individual) $1,149 $1,293
2 (Couple) $1,551 $1,745

 

 

250% Of Poverty Level
March 1, 2013

Family Size Monthly Income Annual Income
1 $2,394 $28,728
2 $3,232 $38,784
3 $4,069 $48,828
4 $4,907 $58,884
5 $5,744 $68,928
6 $6,582 $78,984
7 $7,419 $89,028
8 $8,257 $99,084
Each Additional Member $838 $10,056

For each additional family member, add $10,056 to the annual income.

Divide by 12 and round up to the next whole dollar for the monthly income.