How Medicaid works in SC

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Compare Health Plans


This chart shows the services that each plan offers. You can compare each plan and choose the one that meets your needs.

  • The top row shows the name of the Health Plan
  • The left-hand column shows a list of the types of benefits and services
    • A green checkmark shows that the plan offers that service
    • A red X in the column means the plan does not offer that service
  • To see details about each plan, click on the “Details” link under the health plan name
  • To compare each plan’s services, click on the “Details” link next to each category name

Available Programs:  
South Carolina Healthy Connections Choices 

  Schedule of Benefits for all Medicaid Members
Doctor Visits (per year) – Children * Unlimited visits in health plan (same as regular Medicaid) *$3.30 co-pay per visit for ages 19-20
Doctor Visits (per year) – Adults * Unlimited visits in health plan (Regular Medicaid limits visits to 12 per year) * $3.30 co-pay per visit
Pharmacy/Medications – Children * Unlimited prescriptions * $3.40 co-pay per medication for ages 19-20
Pharmacy/Medications – Adults * Pharmacy coverage is specific to the health plan * Check with the health plan to see if your medications are covered *$3.40 co-pay per medication, limit of 4 covered medications per month
Hospital Stay – Children * Check with the health plan for covered hospitals (same as regular Medicaid) *$3.40 non-emergency outpatient co-pay and $25 inpatient co-pay for ages 19 and above
Hospital Stay – Adults * Same benefit as for children
Home Health Care – Children * Unlimited visits (same as regular Medicaid) $3.30 co-pay per visit for ages 19-20
Home Health Care – Adults * Limit of 50 visits per year (same as regular Medicaid) $3.30 co-pay per visit
Durable Medical Equipment – Children * $3.40 co-pay per item for ages 19-20 (same as regular Medicaid)
Durable Medical Equipment – Adults * $3.40 co-pay per item (same as regular Medicaid)
Dental – Children * $3.40 co-pay per visit for ages 19-20 (same as regular Medicaid)
Dental – Adults * $3.40 co-pay per service (same as regular Medicaid); $750 max worth of preventive care services each year to include annual cleaning, oral exams, x-rays, pulling of teeth and fillings; limited coverage for services delivered in preparation for or during the course of treatment for organ transplants, radiation of the head or neck for cancer treatment, chemotherapy for cancer treatment, total joint replacement or heart valve replacement; or treatment of trauma related injuries administered in a hospital or outpatient facility
Oral Surgery – Children * Same as regular Medicaid
Oral Surgery – Adults * Emergency services only (same as regular Medicaid) $3.40 co-pay per visit
Vision – Children * Same as regular Medicaid – $3.30 co-pay for ophthalmologist or optometrist services for ages 19-20
Vision – Adults * No benefit available
  Additional Services Available for Medicaid
24-Hour Nurse Advice Line (not available in regular Medicaid) * Health plan offers unlimited access to a nurse for medical advice *Contact Health Plan Member Number on the back of this page
Disease Management (not available in regular Medicaid) * Programs are available for asthma, diabetes and pregnancy *Contact Health Plan Member Number on the back of this page
Care Coordination (managing care from different doctors or clinics) * Health plan will coordinate care; prior authorization may be required * Contact Health Plan Member Number on the back of this page

Absolute Total Care BlueChoice HealthPlan Medicaid First Choice by Select Health of South Carolina Molina Healthcare of SC WellCare
Details:

Details

Details

Details

Details

Details

Plan Type Details MCO MCO MCO MCO MCO
Phone Number Details
Website Details
Additional Services Details
How is your Health Plan Rated Details
Counties Served Details

For Health Plan contact information Click HereCancel, Go Back

If you have questions about the health plans, call the  member services office   of that health plan.

expand all »

What is a health plan?

What health plan choices do I have?

How do I choose a health plan and a doctor?

How do I use the Health Plan Comparison Chart?

Do I need to select a health plan and primary doctor for each member in my household?

Do I need to choose a health plan before I select my doctor?

Can I change my health plan?

I have health care coverage from another insurance company. Does this affect my South Carolina Healthy Connections membership?

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