South Carolina Department of Health and Human Services
South Carolina Department of Health and Human Services (SCDHHS) administers the state's Healthy Connections Medicaid program and related health programs for eligible low-income residents across all 46 counties, delivering services through five managed care partners and specialized programs for children, pregnant women, elderly, and disabled populations.
- Company typePrivate
- Founded-
- HeadquartersColumbia, United States
- Headcount1,001–5,000
- GTM typeB2C
- OfferingServices
What South Carolina Department of Health and Human Services does
South Carolina Department of Health and Human Services (SCDHHS) is the state agency designated to administer South Carolina's Medicaid program, branded as Healthy Connections Medicaid. It serves eligible low-income residents across all 46 counties of the state, including children, pregnant women, parents and caretaker relatives, individuals aged 65 and older, blind and disabled individuals, former foster youth up to age 26, and dual Medicare-Medicaid eligibles. Programs include Partners for Healthy Children (CHIP), Katie Beckett/TEFRA, Breast and Cervical Cancer Program, Family Planning Limited Benefit, BabyNet early intervention, Program of All-Inclusive Care for the Elderly (PACE), and Dual Special Needs Plans (D-SNPs); the legacy Healthy Connections Prime Medicare-Medicaid Plan was discontinued January 1, 2026 in favor of D-SNP integration.
The agency's core technology stack centers on the apply.scdhhs.gov online portal with ID.me identity verification (introduced January 2024), the SC Choices managed-care comparison platform, the Medicaid Provider Web Portal, the Document Upload Tool, and the Community Connections social-services resource database built with Children's Trust of South Carolina. Service delivery is executed through five Managed Care Organization partners (Absolute Total Care, BlueChoice Healthy Blue, Humana Healthy Horizons, Molina, Select Health) for most members, with fee-for-service Medicaid and PACE organizations covering specific populations, and presumptive-eligibility authorized hospitals for immediate intake coverage. Member access is provided via 46 county eligibility offices, phone (888-549-0820), mail, online self-service, and partner-assisted application through SC Thrive.
The business model is a federally matched entitlement program rather than commercial revenue: SCDHHS receives federal matching funds through CMS and state appropriations, pays contracted MCOs and providers, and determines eligibility using Federal Poverty Level thresholds (e.g., parent/caretaker at 62% FPL, pregnant women at 194% FPL, children at 208% FPL, aged/blind/disabled at 100% FPL). Most eligible members pay no premiums; coverage is renewed annually. Strategic direction is shaped by federal CMS guidance and state policy, with recent moves including the D-SNP transition, the CMS/SCDHHS Rural Health Transformation Program with the SCRA-administered Tech Catalyst Fund, and a January 2024 platform modernization to ID.me.
South Carolina Department of Health and Human Services firmographics
Firmographics- Name
- South Carolina Department of Health and Human Services
- Legal name
- South Carolina Department of Health and Human Services
- Website
- https://scdhhs.gov
- Company type
- Private
- Operating status
- Operating
- Headcount range
- 1,001–5,000 employees
- Short description
- South Carolina Department of Health and Human Services (SCDHHS) administers the state's Healthy Connections Medicaid program and related health programs for eligible low-income residents across all 46 counties, delivering services through five managed care partners and specialized programs for children, pregnant women, elderly, and disabled populations.
- Ownership category
- akta.pro rank
South Carolina Department of Health and Human Services industry classification
Industry- Product category
- Government Healthcare Administration (Medicaid)
- NAICS
- Social Assistance (624), Services for the Elderly and Persons with Disabilities (624120), Other Individual and Family Services (624190), Services for the Elderly and Persons with Disabilities (62412)
- SIC
- Hospital & Medical Service Plans (6324), Services-Social Services (8300), Services-Health Services (8000), Services-Misc Health & Allied Services, Nec (8090)
- akta.pro primary industry
- Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)
- akta.pro secondary industries
- Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans (HLAEAEAI), Maternal, Child & Adolescent Health Administration (BPAIAJAJ), SNP Supplemental Benefits & SSBCI Design (HLAEAGAK), SNP Model of Care (MOC) & Care Management Programs (HLAEAGAE), MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI)
Keywords
Where South Carolina Department of Health and Human Services is headquartered
LocationHeadquarters
- HQ city
- Columbia
- HQ country
- United States
- HQ region
- North America
Offices16 records
Markets served
South Carolina Department of Health and Human Services business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Infrastructure, Others
Revenue model
- Medicaid Program Administration: SCDHHS administers South Carolina's Medicaid program (Healthy Connections) funded by state and federal tax money. The federal government provides matching funds for Medicaid expenditures under the state-federal partnership.
- Rural Health Transformation Program: Non-dilutive funding for rural healthcare tech startups through the Tech Catalyst Fund, part of a joint initiative between CMS and SCDHHS, administered by South Carolina Research Authority.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Monthly | Free Medicaid coverage for eligible low-income individuals and families |
Go-to-market motion2 records
Distribution channels7 records
Marketing channels9 records
South Carolina Department of Health and Human Services product offering
Product offeringCore offering
SCDHHS administers South Carolina's Medicaid program (Healthy Connections), providing health coverage for eligible low-income residents including children, pregnant women, parents/caretakers, aged, blind, and disabled individuals. The agency offers multiple coverage pathways including Managed Care Organizations, Fee-for-Service, Dual Special Needs Plans, PACE for the elderly, BabyNet early intervention, and specialized programs like Partners for Healthy Children (CHIP), Katie Beckett/TEFRA, Breast and Cervical Cancer Program, and Family Planning. Eligibility is determined within 45 days of application through online, phone, mail, county office, and authorized hospital channels.
Product overview
South Carolina Department of Health and Human Services (SCDHHS) administers the Healthy Connections Medicaid program, a unified public health insurance system for eligible low-income South Carolina residents. The core product is Healthy Connections Medicaid, which offers multiple coverage pathways including standard Medicaid, Managed Care Organizations (MCOs), Medicare-Medicaid Plans (now transitioning to D-SNPs), and specialized programs like BabyNet for early intervention and PACE for elderly care. The product portfolio includes the online apply.scdhhs.gov portal for applications and eligibility management, the Document Upload Tool for submitting paperwork, Community Connections for social services referrals, and managed care options through five partner MCOs (Absolute Total Care, BlueChoice/Healthy Blue, Humana Healthy Horizons, Molina, and Select Health). Specialized sub-brands include Partners for Healthy Children (CHIP), the Breast and Cervical Cancer Program, Family Planning, and Katie Beckett/TEFRA for children with disabilities. The architecture combines direct state administration with contracted managed care organizations and partner agencies like SC Thrive and Healthcare.gov for integrated service delivery.
Differentiator
Problem solved
Functional benefit
Products and services
- Healthy Connections Medicaid South Carolina's core Medicaid program administered by SCDHHS, providing health coverage for eligible low-income residents including children, pregnant women, parents, elderly, and disabled individuals. Covers doctor visits, medications, hospital visits, nursing home care, home health services, dental care, mental health services, and specialized programs.
- Managed Care Organizations (MCO) Program Partner health plans including Absolute Total Care, BlueChoice (Healthy Blue), Humana Healthy Horizons, Molina, and Select Health that manage Medicaid member healthcare under coordinated care arrangements. Members can compare and select health plans through SCChoices.com.
- Dual Special Needs Plans (D-SNP) Medicare Advantage plans for members eligible for both Medicare and Medicaid. Includes HIDE D-SNPs (Highly Integrated) and CO D-SNPs (Coordination Only). Partners include First Choice VIP Care, Humana Dual Integrated, Molina, Wellcare, Aetna Better Health, and United Healthcare. Replaced the Healthy Connections Prime Medicare-Medicaid Plan as of January 1, 2026.
- Program for All-Inclusive Care of the Elderly (PACE) State Plan program providing comprehensive community-based care for frail elderly participants meeting nursing home level of care. Available in select counties through providers including BoldAge PACE (Berkeley, Charleston, Dorchester), Prisma Health SeniorCare PACE-Midlands (Richland, Lexington), PACE-Upstate (Greenville, Pickens, Anderson), and Orangeburg Senior Helping Center (Orangeburg, Calhoun, Bamberg).
- BabyNet South Carolina's IDEA Part C early intervention system for infants and toddlers under three with developmental delays or conditions associated with delays. No Medicaid enrollment required for services.
- Partners for Healthy Children (CHIP) Health insurance plans for children in families meeting eligibility criteria, authorized under Title XXI of the Social Security Act. Provides Medicaid and CHIP coverage for children ages 0-19 from families at or below 208% FPL.
- Breast and Cervical Cancer Program Full Medicaid benefits for uninsured individuals needing treatment for breast or cervical cancer or pre-cancerous lesions, with income at or below 200% FPL.
- Family Planning Limited Benefit Program Limited-benefit program providing preventive health care and family planning services for individuals (men and women) at or below 194% FPL who are ineligible for full Medicaid.
- Katie Beckett/TEFRA Children Medicaid benefits for children with disabilities who would not ordinarily qualify based on parental income, allowing institutional-level care at home while retaining Medicaid coverage.
- apply.scdhhs.gov Online Portal Online Medicaid application platform allowing residents to apply for benefits, check eligibility status, submit annual reviews, update contact information, upload documents, and manage their Medicaid accounts. Uses ID.me for identity verification since January 2024.
- Community Connections Free 24/7 online database connecting South Carolinians with social and health services including medical care, employment, food assistance, education, transportation, and childcare resources. Developed in partnership with Children's Trust of South Carolina using FindHelp platform.
- Medicaid Provider Web Portal Provider-facing portal at portal.scmedicaid.com for Medicaid providers to access claims, eligibility verification, and administrative functions with ID.me authentication.
- SC Choices Managed Care Comparison and Enrollment Platform Online portal SCChoices.com allowing Medicaid members to compare and select from five managed care health plans (Absolute Total Care, BlueChoice Healthy Blue, Humana Healthy Horizons, Molina, and Select Health), search for doctors, and enroll in MCO coverage.
Quantifiable outcome
- Medicaid eligibility determined within 45 days of application
- +1 more outcomes
Companies that use South Carolina Department of Health and Human Services
Customer profileNamed customers7 records
Segments7 records
Ideal customer profiles6 records
South Carolina Department of Health and Human Services technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration8 records
Feature4 records
South Carolina Department of Health and Human Services partnerships and signals
Strategic signalPartnerships
18 partnerships are on record, tiered core and minor.
- South Carolina Research Authority (SCRA)coreSCRA selected to administer the Tech Catalyst Fund for rural healthcare tech startups due to its innovation and startup expertise. This is part of the Rural Health Transformation Program, a joint initiative of CMS and SCDHHS, with funding directed toward prevention and management of chronic diseases while increasing quality, affordability, and access to care in rural South Carolina. Prospective startups have until June 25 to apply.
- Centers for Medicare and Medicaid Services (CMS)coreFederal partner in the Rural Health Transformation Program and ongoing Medicaid program administration. CMS provides federal matching funds for Medicaid expenditures and regulatory oversight of the state Medicaid program.
- SC ThrivecoreSC Thrive assists individuals with Healthy Connections application and provides assessments of household health coverage options including Medicaid, CHIP, and Advanced Premium Tax Credit. Available to help fill out applications and answer questions via help line (800) 726-8774.
- Children's Trust of South CarolinacoreCollaborative partnership for Community Connections, a free 24/7 online resource database connecting South Carolinians with social and health care services across the state.
- Absolute Total CarecoreManaged Care Organization (MCO) partner providing Healthy Connections Medicaid coverage. Also offers Wellcare Prime (Medicare-Medicaid Plan) and Wellcare Absolute Total Care Dual Align (HIDE D-SNP).
- BlueChoice HealthPlan (Healthy Blue)coreManaged Care Organization (MCO) partner providing Healthy Connections Medicaid coverage.
- Humana Healthy HorizonscoreManaged Care Organization (MCO) partner providing Healthy Connections Medicaid coverage. Also offers Humana Dual Integrated (HIDE D-SNP) and HumanaChoice Special Needs Plan (CO D-SNP).
- Molina HealthcarecoreManaged Care Organization (MCO) partner providing Healthy Connections Medicaid coverage. Also offers Molina Dual Options (Medicare-Medicaid Plan) and Molina Medicare Complete Care Plus (HIDE D-SNP).
- Select Health (First Choice)coreManaged Care Organization (MCO) partner providing Healthy Connections Medicaid coverage. Also offers First Choice VIP Care PLUS (Medicare-Medicaid Plan) and First Choice VIP Care (HIDE D-SNP).
- BoldAge PACEminorPACE organization serving Berkeley, Charleston, and Dorchester counties. Provides all-inclusive care for elderly participants meeting nursing home level of care.
- Prisma Health SeniorCare PACEminorPACE organization with two locations: PACE-Midlands serving Richland and Lexington counties, and PACE-Upstate serving Greenville, Pickens, and Anderson counties.
- The Orangeburg Senior Helping CenterminorPACE organization serving Orangeburg, Calhoun, and Bamberg counties for all-inclusive elderly care.
- Aetna Better HealthminorCoordination-Only D-SNP partner offering Aetna Medicare Full Dual and Aetna Medicare Full Dual Care plans for dually eligible members.
- United HealthCare (UHC)minorCoordination-Only D-SNP partner offering UHC Dual Complete SC-S001 and UHC Dual Complete SC-S2 plans for dually eligible members.
- South Carolina Department on AgingcoreThe Healthy Connections Prime Advocate (ombudsman) role is filled by SC Department on Aging. The advocate assists members with billing, services, complaints, appeals, and understanding their rights as plan members.
- Family Connection of South CarolinaminorProvides information, support, and resources for families with children who have disabilities or special health care needs, particularly for Katie Beckett TEFRA program eligibility.
- ID.mecoreIdentity verification service used for the Citizen Portal at apply.scdhhs.gov since January 2024. Enables secure account access and allows use of additional online services.
- National Committee for Quality Assurance (NCQA)minorNCQA compares MCOs based on various aspects of care and service quality. Health plan report cards for South Carolina's MCOs are available on NCQA's website.
Scale indicators3 records
Recent moves7 records
Expansion highlights5 records
South Carolina Department of Health and Human Services competitors and assessment
Company assessmentDirect peers
- Georgia Department of Community Health (DCH): Administers Georgia Medicaid and PeachCare for Kids with similar managed care delivery (Peach State, CareSource, Amerigroup, Anthem), D-SNPs, and comparable non-expansion status.
- California Department of Health Care Services (DHCS): Single state agency administering California's Medi-Cal Medicaid program with a comparable structure of managed care plans, D-SNPs, county offices, and federal-state funding partnership. Closest peer in scale and program complexity.
- Alabama Medicaid Agency: Neighboring non-expansion state Medicaid agency with comparable regional office structure, fee-for-service/Regional Care Organization hybrid, and limited eligibility thresholds similar to SC.
- Virginia Department of Medical Assistance Services (DMAS): Virginia's state Medicaid agency with similar CardinalCare managed care program, D-SNPs, and CCC Plus/MLTSS structure for elderly and disabled populations.
- Tennessee Division of TennCare: Operates Tennessee's Medicaid program under a unique managed care waiver; comparable structure of MCO contracts, dual-eligible programs, and statewide eligibility operations.
- Florida Agency for Health Care Administration (AHCA): Florida's single state agency administering Medicaid through managed care plans, with comparable SMI and long-term care program structures and similar non-expansion posture.
- Texas Health and Human Services Commission (HHSC): Administers Texas Medicaid with comparable MCO-based managed care delivery, eligibility offices, and federal matching structure; serves a large non-expansion population similar to SC.
- North Carolina Department of Health and Human Services (NCDHHS): Neighboring Southeast state agency administering NC Medicaid with managed care launch, D-SNPs, and similar rural-health focus; operates Healthy Blue, AmeriHealth Caritas, UnitedHealthcare, and WellCare MCOs parallel to SC's roster.
- New York State Department of Health (NYSDOH) — Medicaid: Administers New York's Medicaid program with managed care, D-SNPs, and county-equivalent (LDSS) eligibility structures comparable to SCDHHS's 46-county office model.
Others
- Centers for Medicare & Medicaid Services (CMS): Federal regulator and funding partner for state Medicaid agencies; not a direct peer but the most important counterparty for SCDHHS, setting policy through FMAP, waivers, and the recent D-SNP transition mandate that ended Healthy Connections Prime.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
South Carolina Department of Health and Human Services social profiles
Digital presenceSouth Carolina Department of Health and Human Services compliance and trust
Trust signalCompliance3 records
South Carolina Department of Health and Human Services financial estimates
Financial estimateRevenue estimate
Valuation estimate
South Carolina Department of Health and Human Services leadership team
Management profileNumber of profiles
South Carolina Department of Health and Human Services funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
South Carolina Department of Health and Human Services M&A and investment
M&A and investmentM&A
Investments
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Frequently asked questions about South Carolina Department of Health and Human Services
What does South Carolina Department of Health and Human Services do?
SCDHHS administers South Carolina's Medicaid program (Healthy Connections), providing health coverage for eligible low-income residents including children, pregnant women, parents/caretakers, aged, blind, and disabled individuals. The agency offers multiple coverage pathways including Managed Care Organizations, Fee-for-Service, Dual Special Needs Plans, PACE for the elderly, BabyNet early intervention, and specialized programs like Partners for Healthy Children (CHIP), Katie Beckett/TEFRA, Breast and Cervical Cancer Program, and Family Planning. Eligibility is determined within 45 days of application through online, phone, mail, county office, and authorized hospital channels.
Is South Carolina Department of Health and Human Services a public or private company?
South Carolina Department of Health and Human Services is a private company. It is classified as state government owned and is currently operating.
When was South Carolina Department of Health and Human Services founded?
South Carolina Department of Health and Human Services was founded in -1. It employs 1,001 to 5,000 people.
Where is South Carolina Department of Health and Human Services based?
South Carolina Department of Health and Human Services is headquartered in Columbia, United States, in the North America region.
How does South Carolina Department of Health and Human Services make money?
Two revenue lines are on record. Medicaid Program Administration is the primary driver. The others are rural Health Transformation Program.
Who are South Carolina Department of Health and Human Services's main competitors?
Direct peers on record are Georgia Department of Community Health (DCH), California Department of Health Care Services (DHCS), Alabama Medicaid Agency, Virginia Department of Medical Assistance Services (DMAS), Tennessee Division of TennCare, Florida Agency for Health Care Administration (AHCA), Texas Health and Human Services Commission (HHSC), North Carolina Department of Health and Human Services (NCDHHS) and New York State Department of Health (NYSDOH) — Medicaid. Centers for Medicare & Medicaid Services (CMS) is listed as an others.
Does South Carolina Department of Health and Human Services have an API?
No public API is recorded for South Carolina Department of Health and Human Services.
What industry is South Carolina Department of Health and Human Services in?
South Carolina Department of Health and Human Services's product category is Government Healthcare Administration (Medicaid). Its primary akta.pro industry code is BPAIAKAH, Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage), with a secondary code of HLAEAEAI, Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans. Its NAICS code is 624 and its SIC code is 6324.