For additional background on the State’s policy decisions regarding the Medicaid Expansion option, see: Background.
Medicaid in South Carolina:
The South Carolina Department of Health and Human Services administers the Medicaid Program
Information about the state’s Medicaid program, including patient eligibility information, can be found at: https://www.scdhhs.gov/
Providers must enroll in the Medicaid fee-for-service program to receive payments for covered services.
Information about enrolling in the Medicaid fee-for-service program can be found at: https://www.scdhhs.gov/ProviderRequirements.
Medicaid website provides information about services covered by fee-for-service payments and payment amounts: https://www.scdhhs.gov/.
In order to retain access to all Medicaid patients in the state, providers must also connect to the managed care plans individually.
Medicaid Managed Care:
Some South Carolina Medicaid Program beneficiaries are enrolled in managed care plans, called the Healthy Connections Choices care coordination program.
South Carolina Healthy Connections Choices Beneficiaries Participating in Managed Care:
Managed care plans participating in Healthy Connections Choices offer detailed information about covered benefits for individuals enrolling in their plans. This information is available on the managed care websites shown below.
The state office of insurance is primarily responsible for examining and addressing issues with the plans offered within the state Exchange (Marketplace), and the companies that offer them. If you are experiencing problems as a medical provider with the plans or companies in the state exchange, or if your patients are experiencing problems with the plans or companies in the state exchange, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state office of insurance:
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
Managed Care Plans Participating in Healthy Connections Choices:
Absolute Total Care (Centene Corporation)
Advicare of South Carolina
Blue Choice Health Plan of SC
First Choice by Select Health
Molina Healthcare of South Carolina