Charleston Senior AdvisorWill Medicaid pay for a Charleston nursing home?
Yes, for residents who meet nursing facility level of care and Medicaid's financial rules, in homes that accept Medicaid; South Carolina Healthy Connections Medicaid, run by SCDHHS, pays the part of the bill the resident's own income does not cover.
Each month the resident's income, minus a small personal allowance and certain deductions such as health insurance premiums, goes to the nursing home, and Medicaid pays the remainder. Most certified homes in Charleston, Berkeley and Dorchester counties accept Medicaid, but a home may limit how many Medicaid beds it has, so ask how those beds are assigned and whether a private-pay resident can stay in the same room after converting.
What are the 2026 income and asset limits?
For long-term care Medicaid in 2026, South Carolina generally applies an income limit of $2,982 a month (300% of the $994 SSI federal benefit rate), a countable resource limit of $2,000 for an individual and a home equity limit of $752,000.
South Carolina is an income-cap state: someone whose income is over $2,982 can still qualify by sending the excess into a qualified income trust, often called a Miller trust, every month. The home, one vehicle, personal belongings and some burial funds are generally excluded from resources. When one spouse remains at home, federal spousal impoverishment rules protect part of the couple's assets and income for that spouse.
What is the look-back period?
Medicaid reviews the 60 months (five years) before the application for gifts or transfers made for less than fair value, and a transfer in that window can create a penalty period when Medicaid will not pay for nursing home care.
Paying for care, settling debts, home repairs and buying exempt items at fair value are generally fine. Giving money to children, adding a child to a deed or selling property to a relative below market are the moves that cause penalties. Keep receipts for large payments and see an elder law attorney before moving money.
How do we apply?
Through SCDHHS's Healthy Connections application at apply.scdhhs.gov or the Member Contact Center at (888) 549-0820, with the nursing home's business office helping on the level-of-care paperwork; SCDHHS may request up to 60 months of financial records.
A complete application moves fastest, so gather bank statements, income records, insurance policies and property documents before filing. If your parent is still at MUSC, Roper, Trident or East Cooper, ask the hospital social worker to start the level-of-care process before discharge.
What happens when Medicare's rehab coverage runs out?
Medicare pays for at most 100 days of skilled nursing care per benefit period after a qualifying inpatient stay of three days, and only while daily skilled care is needed; after that the resident pays privately or, if eligible, Medicaid takes over for a long-term stay.
Many families discover the gap the week rehab ends. If a parent is unlikely to go home, file the Medicaid application during the Medicare-covered stay so coverage can begin when Medicare stops. See short-term rehab vs. long-term nursing.
Side by side
| Nursing home Medicaid does | Nursing home Medicaid does not | |
|---|---|---|
| Payment | Pay what the resident's income does not cover | Let the resident keep all their income |
| Income | Allow a qualified income trust above $2,982 | Disqualify everyone over the cap |
| Gifts | Look back 60 months for transfers | Ignore gifts to family |
| Spouses | Protect part of the at-home spouse's income and assets | Require the at-home spouse to be impoverished |
Sources: S.C. Code Regs. 60-84, DPH Healthcare Quality, SCDHHS bulletins and charts, CareScout, CMS and VA rate tables, as cited in each answer. See our editorial standards.
