South Carolina Community Choices Medicaid Waiver

Page Reviewed / Updated - Feb. 2016

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers," which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services.

Waiver Description

 Under Community Choices, adult children can work as paid caregivers to their aging parents.

This Medicaid program is also referred to as the Elderly and Disabled Waiver. It allows individuals who require nursing home level care and assistance with their activities of daily living to receive care in their communities or homes instead of in nursing homes. The waiver states that the cost of care provided at home cannot exceed a certain percentage of the cost for the same care in a nursing home.

This waiver allows for consumer or participant direction of some services; meaning the individual receiving care can self-direct or choose the care providers from whom they receive assistance. Program participants are able to hire their own personal assistance providers, respite care providers, and companion services providers. Certain family members, such as the adult children of aged parents, are eligible to serve in these roles provided they pass the necessary background checks and are approved by the state. In addition to personal assistance, adult day care, medical equipment and supplies, home modifications, and a variety of other home supports are covered under this program.

To avoid confusion, it is also worth mentioning that South Carolina Medicaid is also referred to as Healthy Connections. This program is sometimes called South Carolina Community Long Term Care or CLTC, and is administered by the South Carolina Department of Health and Human Services (SCDHHS).


Eligibility Guidelines

In addition to requiring assistance and nursing home level care, South Carolina residents must be between the ages of 18 and 64 and disabled, or 65 years of age and older. Eligible applicants must also be willing and able to receive care at home or in the community instead of in a nursing home. In addition, the Community Choices Waiver requires participants to be eligible financially for South Carolina's HCBS Waivers.

It is important to note that while South Carolina HCBS Waivers are Medicaid funded, they have different financial limits from other Medicaid supports. For 2016, HCBS Waivers have a single applicant, monthly income limit of $2,199 (300% of the Federal Benefit Rate), while full Medicaid's monthly income limit is $981 for aged, blind or disabled persons.

The countable assets limit for this waiver is $2,000 for a single applicant. However, should one spouse of a couple not be applying for Medicaid, they are permitted countable assets up to $66,480. Certain assets are considered exempt, such as a single vehicle, burial plots, and the home in which an applicant resides, given it is valued under $552,000.

If a South Carolina resident's income or assets, or both, exceed the limits published here, they may consider working with a Medicaid planning expert to help them qualify. In brief, Medicaid planners help to restructure income into trusts, and assets into exempt assets, thereby allowing an applicant to meet the limits.  Learn more here.


Benefits and Services

Applicants are assessed and approved for services individually which can include any of the following.   Most of these services are available to be self-directed by the program participant.  

  • Adult Day Health Care (Adult Day Care) and Transportation
  • Community Residential Care Facility (Assisted Living Facility) - Personal care assistance and supervision, and skill training
  • Attendant Care – Nursing care and homemaking activities 
  • Companion Services
  • Case Management
  • Congregate and Home Respite Care
  • Disposable Medical Supplies – Supplies for incontinence, wipes, etc. 
  • Durable Medical Equipment – Hand held showerheads, shower chairs, transfer benches, etc. 
  • Home Delivered Meals
  • Home Modifications to Increase Accessibility – Ramps, grab bars, widening of doorways, etc. 
  • Nursing Home Transition Services
  • Nutritional Supplements
  • Personal Care – Assistance with daily living activities, such as bathing, eating, dressing, shopping & preparing meals, etc. 
  • Personal Emergency Response System (PERS) 
  • Telemonitoring – Daily monitoring of blood sugar, blood pressure, heart rate, etc.


How to Apply / Learn More

This program is available in all South Carolina counties. However, in recent years there have been waiting lists for services. As of last year, for every four persons receiving benefits, there was an additional person waiting for a slot to become available.

To apply or check wait list status, one should contact their DHHS County Office.


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