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Medicaid Program - Payments for Services - South Carolina

Once an individual is determined eligible for Medicaid, a "Partners for Health" Medicaid card is issued. The individual is eligible to receive all services covered by Medicaid.

For an individual in a nursing facility, the Medicaid Program also makes a monthly payment to the facility for his care. Unless the individual has a spouse in the community, s/he must contribute most of his/her monthly income toward the cost of the care provided by the nursing facility. The Medicaid Program then pays the difference between the individual’s income and the Medicaid allowable charge.

For an individual receiving Home and Community-Based Services, the individual is allowed to keep his monthly income to cover the cost of his living expenses unless the income exceeds the Medicaid cap and s/he has established an income trust to become eligible for Medicaid. The Medicaid program pays for the Home and Community-Based Services the individual receives.

Payment for institutional services or Home and Community-Based Services is denied for individuals who dispose of assets for less than the fair market value within 36/60 months of requesting Medicaid sponsorship of those services, due to the transfer of assets penalty.

Also see:

Medicaid Program - Financial Eligibility

Medicaid Program - Non-Financial Eligibility

Medicaid Program - Services

Medicaid Program - Mandatory Group Coverage

Medicaid Program - Optional Group Coverage

Medicaid Program - Overview

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