Further Navigation

Menu

Medicaid

Medicare Commercial

Browser Settings

You currently have JavaScript turned off. To utilize this portion of the website, please turn JavaScript on. To learn more about JavaScript, please visit our Help section.

South Carolina Medicaid Program-General Information

Program Description

  • Established by Title XIX of the Social Security Act
  • Provides quality health care to low income, disabled, and elderly individuals by utilizing state and federal funds to reimburse providers for approved medical services.
  • South Carolina Department of Health and Human Services (SCDHHS) is the single state agency designated to administer the SC Medicaid program.
  • SCDHHS administers the traditional fee-for-service Medicaid program and offers two (2) Medicaid Managed Care Programs.

**Click here to visit the SC Medicaid Program website

Medicaid Managed Care Organization (MCO) Program

  • Consists of contracted MCOs that provide approved medical services through a developed network of providers
  • SCDHHS pays a capitated rate per member per month, according to age, gender, and category of eligibility to MCOs.
  • Payments for core services provided to MCO members are the responsibility of MCOs, not the fee-for-service Medicaid program.
  • MCOs may elect to provide their members enhanced services beyond what is offered under traditional fee-for-service Medicaid.

SC Federal Qualified Health Centers participate in the traditional fee-for-service Medicaid program and the Medicaid Managed Care programs. Please contact the center in your area about the specific Medicaid Managed Care programs that are accepted.

Medicaid Bulletins

All Provider Bulletins
Bulletin Archives 
Dental Bulletins
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Bulletins
ICD-10 Bulletins
Pharmacy Bulletins 
Physicians Bulletins
Vision 
Waivers

 

 

 

 

Help us spread the word, GET SOCIAL!

Access to Quality Health Care for all of South Carolina