South Carolina Medicaid Long Term Care Eligibility for 2025

South Carolina Long Term Care

South Carolina is an income cap state, meaning that in order to be eligible for Medicaid long term care benefits there is a hard income limit. Non-income cap states allow applicants to spend down money for their care, whereas income cap states require the amount to be no higher than their limit at the time of application.

Programs in 2025:

Nursing home care
Assisted Living
Home waiver services
Medicaid health insurance card

Eligibility for 2025:

1. Residency and Citizenship – the applicant must be a resident of South Carolina and a U.S. citizen or have proper immigration status.

2. Age/Disability – the applicant must be age 65 or older, or blind, or disabled. The applicant must meet certain medical requirements consistent with the level of care requested. Persons must need care for thirty (30) consecutive days.

In South Carolina, an applicant must require assistance with at least five activities of daily living (ADLs): feeding, dressing, ambulation (movement), toileting, and incontinence.

3. Income Limitations – If single, the applicant’s monthly income must be no higher than $2,901 to become eligible for Medicaid. Income above this limit can be placed into a Qualified Income Trust (Miller Trust), which designates funds solely for costs accrued by Medicaid. There is a personal needs allowance of $30/month that is not factored into the total countable income.

4. Asset Limitations (Exempt vs. Available) – Medicaid divides assets into two categories: Exempt and Available. Exempt assets are specifically designated under the rules, and ownership of an exempt asset by the applicant will not result in a denial of benefits. If an asset is not listed as exempt, it needs to be liquidated and applied toward the costs of nursing home care before the applicant can receive Medicaid benefits. The state has a look-back period of 5 years with penalties for selling assets below fair market value, transferring assets, or giving money away. All money, property, or items that can be turned into cash are countable assets unless listed as exempt.

Exempt Assets in 2025 for an applicant in South Carolina include:

$2,000 or less in cash/non-exempt assets if single.
One home is exempt (equity limit $730,000) if the applicant plans to return, or a spouse, a child under 21, or a disabled person resides in it.
One automobile, no equity amount specified.
Irrevocable burial trust with a value of up to $1,500 per individual.
Non-saleable property, household furnishings, clothing, jewelry, and other personal effects.
Life insurance policies with a combined face value of $1,500 or less.
Retirement funds in “payout status” (Required Minimum Distribution).

Spousal Rules in 2025:

Amount of assets community spouse may retain: The community spouse can keep non-exempt resources with a maximum of $66,480. If the community spouse’s assets do not equal $66,480, they can retain assets from the institutionalized spouse until the maximum is reached.

Community spouse impoverishment protection: The community spouse can keep part of the institutionalized spouse’s income if their monthly income is less than $3,948. The maximum amount of income that can be retained is $3,948.

South Carolina Long Term Care Insurance Partnership

This program protects assets by matching dollar-for-dollar what policyholders pay into their policies. For instance, a Partnership Policy with a $155,000 maximum benefit payout allows the policyholder to exempt $155,000 in assets from Medicaid calculations. Married couples must purchase individual policies to benefit.