South Carolina Medicaid for a Child Living With a Grandparent

Partners for Healthy Children: The Program That Covers Most Grandchildren

South Carolina runs its children's Medicaid and CHIP as a single integrated program called Partners for Healthy Children (PHC), administered by SCDHHS. It covers children from birth through age 18 with income up to 213% of the federal poverty level gross — $5,857.50 per month for a family of four in 2026.

For grandparents, the critical question is whether your income counts. In most cases, it does not.

When Your Income Is Excluded

Medicaid eligibility for children uses Modified Adjusted Gross Income (MAGI) rules. Under these rules, the child's household is determined by tax-filing relationships.

If you are raising your grandchild but do not claim them as a tax dependent on your federal return, the child's Medicaid household consists only of the child and any siblings living with you. Your income is completely excluded from the eligibility calculation. A grandparent earning $4,000 a month has no effect on a grandchild's PHC eligibility when they are not claiming the child.

If you do claim the child as a tax dependent, your income enters the picture. Even then, the 213% FPL threshold is generous enough that many grandparent households still qualify.

No asset or resource test applies to children's Medicaid in South Carolina. Savings accounts, property, and vehicles are irrelevant.

TEFRA Waiver for Children With Disabilities

The TEFRA option (named after the Tax Equity and Fiscal Responsibility Act) allows children with significant disabilities to qualify for Medicaid based on the child's own income and resources — regardless of parental or caregiver income. In South Carolina, the child's countable monthly income must be at or below $2,982.

If a grandchild has a documented physical or mental disability and would not otherwise qualify through the standard PHC pathway, TEFRA is worth exploring.

12-Month Continuous Eligibility

Children approved for Partners for Healthy Children receive 12 months of continuous coverage. Household income changes during those 12 months cannot strip the child's Medicaid. SCDHHS performs annual renewals using automated database matching. If the automated check fails, you receive a pre-populated renewal form in the mail with a 30-day response window.

How to Apply

Three channels:

1. Online at apply.scdhhs.gov
2. In person at your county SCDHHS or SCDSS office
3. By mail using the printed application

SCDHHS must process Medicaid applications within 45 calendar days (90 days if a disability evaluation is required). Healthy Connections Medicaid can provide up to three months of retroactive coverage before the application month if the child had medical bills and met income criteria during those months.

Medicaid for the Caregiver

Grandparents who want Medicaid for themselves face a much tighter threshold. The Parent/Caretaker Relative category caps eligibility at 62% FPL net — about $1,411 per month for a family of three. South Carolina has not expanded Medicaid under the ACA for childless adults, so caregivers earning between 62% and 100% FPL fall into the coverage gap.

How Medicaid Interacts With Other Benefits

Family Independence child-only cash payments are excluded from Medicaid income calculations. KinGAP guardianship payments preserve the child's automatic Medicaid eligibility. Foster care placements carry automatic full Medicaid.

The South Carolina Kinship Financial Help Guide covers PHC Medicaid alongside every other program available to kinship caregivers — TANF, SNAP, child care, and KinGAP — with document checklists for each application.

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