South Carolina Medicaid: Eligibility and application information

To complete the Medicaid application process:

How do I apply?

To apply for Healthy Connections, you will need to complete and submit an application. You can submit an application:

Online: https://www.scdhhs.gov/how-to-apply

By phone: 888-549-0820 (TTY: 888-842-3620)

SC Thrive is available to help you with the online application and can provide an assessment of your household’s most likely health coverage options. Call SC Thrive at 800-726-8774 or go to SCThrive.org

In person: Apply in person at your local county office  or at federally qualified rural health centers and most hospitals.

By email: Return your application and supporting documents electronically to 8888201204@fax.scdhhs.gov

By mail: Send your application and supporting documents to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101.

If you are a pregnant woman, you may be able to get medical care while you wait for Healthy Connections to process your application. Call Healthy Connections at 888-549-0820 for more information.

What you need when you apply

Before you apply, you will need to know the following for all the people in your household:

• Date of birth
• Social Security Number
• Income from jobs or training
• Benefits received now (or received in the past), such as Social Security, Supplemental Security Income (SSI), veteran's benefits, or child support
• Amount of money in your checking account, savings account(s), or other resources you own
• Monthly rent, mortgage payment, and utility bills
• Payments for adult or child care health coverage and/or medical benefits you currently have

You can find more information about the enrollment process and answers to frequently asked questions on the Healthy Connections website

Why Choose Humana Healthy Horizons

We designed Humana Healthy Horizons to provide you with the care and support you need – so you have more time to focus on what you love. Now more than ever, your health and healthcare coverage are important. Humana Healthy Horizons makes available to South Carolina Medicaid members access to the high-quality healthcare coverage you want and extras you need.

We have easy ways for you to find a doctor or a specialist. We can send your medicines to your home, so you don’t have to go to a pharmacy. And along with your medical care, you get:

• Access to doctors with no referrals needed
• Go365 for Humana Healthy Horizons^® a rewards program to help you stay healthy
• Behavioral and emotional health coverage
• Hearing, prescription, and vision coverage
• Digital tools to help you manage your health care

Here are some things you should know about Medicaid enrollment in South Carolina:

Mandatory enrollment

Mandatory enrollment means you qualify for South Carolina Medicaid and are required to enroll in a plan. You can choose the plan you want, or the state automatically will enroll you into a plan.

When you first enroll in a Medicaid Managed Care Plan, you have 90 days to try the plan. During this 90-day period, you can switch for any reason to a new plan. After this 90-day period ends, you cannot change health plans until the next open enrollment period, unless you have an event that allows a change.

Open Enrollment Period

The yearly Open Enrollment Period gives mandatory members another chance to change plans for any reason. You will get a letter from SCDHHS each year with information about your open enrollment period. This letter also will include information about how to change your health plan.

Disenrollment

Disenrollment is when you need to change your health plan outside of open enrollment or the first 90 days of enrollment. You need to have a reason approved by the state if you want to disenroll. For a list of approved reasons to disenroll, and how to ask for permission to disenroll, see your Member Handbook.

Humana is proud of our strong relationship with Healthy Connections (South Carolina Medicaid). We’re focused on helping you make the most of your plan so you can focus on what matters most.