Beware of Medicaid Scams
The South Carolina Department of Health and Human Services is warning about Medicaid renewal scams that may target Healthy Connections Medicaid members.
- Annual Review Forms
Annual reviews will resume April 1, 2023. When it is time to reassess your eligibility for Medicaid, we will send you a review form that you must complete and return to us. The forms, along with descriptions of each form, are below.
Be sure to follow the instructions on the form and return it to us by the listed deadline.
- Annual Review Form (MAGI) (English) (Spanish)
- Beneficiaries who receive coverage due to qualifying income will receive this review form. Categories include coverage for children, pregnant women, parent/caretaker relatives, foster care and adopted children, and family planning services.
- Annual Review Form - Non-Institutional Programs (English) (Spanish)
- Beneficiaries who receive coverage in age or disability-related categories will receive this review form. Non-institutional categories cover a number of beneficiaries, including those who are 65 or older, those who need help paying Medicare premiums, or those who ar qualifying disabled adults, including those who work.
- Annual Review Form - Institutional or In-Home Care (English) (Spanish)
- Beneficiaries in long-term care related categories will receive this review form. Long-term care categories individuals who reside in licensed and certified nursing facilities or who receive long term care services at home.
- Annual Review Form (MAGI) (English) (Spanish)
- Change of Address Online Portal
The South Carolina Department of Health and Human Services (SCDHHS) has launched a new portal at apply.scdhhs.gov that enables members to update their address and contact information online. Through the portal, Healthy Connections Medicaid members can change their address and contact information quickly and at a time convenient for them. To update a home or mailing address online, the member’s Medicaid identification number or Social Security number, date of birth, phone number and new address is needed.
Healthy Connections Medicaid members can also update their address and contact information by calling (888) 549-0820 Monday through Friday from 8 a.m. to 6 p.m. or visiting their local eligibility office.
- Community Connections
SCDHHS, in partnership with Children’s Trust of South Carolina, launched Community Connections, a free 24/7 online database of resources that connects South Carolinians in need with available social and health care services across the state. Individuals can search for free or low-cost services like medical care; employment and job training opportunities; food and financial assistance; and, education, transportation and childcare resources in their communities.
Click to learn more about Community Connections.
- COVID-19 Policy Updates
As a part of the state's preparation and response to coronavirus disease 2019 (COVID-19), the South Carolina Department of Health and Human Services (SCDHHS) implemented several policy changes and resources to protect the health and well-being of South Carolina Healthy Connections Medicaid members by ensuring ongoing access to care. The COVID-related temporary provider policy changes, member coverage, guidance and resources are available on the COVID-19 page.
The information provided is unique to the Healthy Connections Medicaid program and other SCDHHS-administered programs. For the latest public health information, resources and guidance on COVID-19, please visit the South Carolina Department of Health and Environmental Control (DHEC) COVID-19 website at scdhec.gov/covid19.
- Document Upload Tool
SCDHHS' Document Upload tool is an online resource to help you provide requested info, report a change in income, return an annual review or submit other documents. SCDHHS will use the info you give to match your uploaded documents with your Medicaid case or application, if you have one. We will also use contact info you provide to reach out to you if we have any questions about the documents.
- Eligibility Appeals Online Form
Applicants, members, and/or their authorized representatives can file an appeal if Medicaid coverage has changed, ended or been denied. An appeal can also be made if a needed medical service has been denied or delayed. An appeal can be submitted:
- Online here
- By email to firstname.lastname@example.org for eligibility appeals or email@example.com for service or other appeals
- By fax to (803) 255-8206
- By mail to SCDHHS, Attn.: Office of Appeals and Hearings, P.O. Box 8206, Columbia, SC 29202-8206
- By telephone to the Healthy Connections Medicaid Member Contact Center at (888) 549-0820 Monday through Friday from 8 a.m. to 6 p.m.
- Family Planning Limited Benefit Program
Family Planning is a limited benefit program, which provides coverage for preventive health care, family planning services and family planning-related services only. It does not provide full Medicaid benefits. Family Planning is available to individuals (men and women) whose annual family income is at or below 194% of the federal poverty level (FPL). View more information on the family planning limited benefit program.
- Frequently Asked Questions
Have questions about the Medicaid annual reviews process during the federal public health emergency? You’ll find answers to a few of the most common questions in our frequently asked questions (FAQ). If you don’t find an answer to your question, you can also call our Member Contact Center at (888) 549-0820 Monday through Friday from 8 a.m. to 6 p.m. or visit your local eligibility office.
If you don’t qualify for Medicaid coverage, you may be able to buy health insurance, and receive help paying for it, through the federal Health Insurance Marketplace (“the Marketplace”). Insurance plans in the Marketplace are offered by private companies. South Carolinians may use the Marketplace to compare options and apply for coverage. Depending on your income, you might qualify for a tax credit to lower premiums or a cost-sharing reduction, which lowers out-of-pocket costs like deductibles and copayments.
To be eligible for health coverage through the Marketplace, an applicant must live in the United States; must be a U.S. citizen or national or be lawfully present; and cannot be currently incarcerated.
Visit healthcare.gov or call (800) 318-2596 for more information.
- Healthy Connections Medicaid Communications Toolkit
SCDHHS is asking providers and community partners to help us spread the word about the unwinding of the federal PHE and the restart of annual reviews for Healthy Connections Medicaid members. Providers and partners can help in relaying consistent and simple messages to Medicaid members by sharing messages and materials from our communications toolkit in newsletters, social media posts and other available means of communication. Current messaging focuses on urging members to update their contact information.
- Change of Address Flyer (English) (Spanish)
- Social Media Graphics
- Provider Fact Sheet Medicaid Member Annual Reviews and the PHE (English)
- Member Fact Sheet: Medicaid Member Annual Eligibility Reviews Update (English) (Spanish)
- Provider Flyer - Online Annual Review Tool: (English) (Spanish)
- Stakeholder Annual Eligibility Reviews Presentation
- Annual Reviews and Standard Review Processes Webinar
- Medicaid Eligibility Categories Overview
Many groups of people can be covered by Healthy Connections Medicaid. Eligibility is determined by several factors, which may include your age, your income and assets, whether you are a U.S. citizen or a qualified alien or whether you are pregnant, have a disability or need long-term care. Please refer to our list of coverage groups for more information.