South Carolina pays for home care through two waiver programs, both contained within the Healthy Connections Medicaid program. The individual waivers available to seniors are called Community Choices and Community Supports. 

Healthy Connections

Seniors in South Carolina who participate in the Healthy Connections Medicaid program can get short-term home health services directly from their health plan, which is required to cover all medically necessary services for enrollees. Typically, a Medicaid-authorized physician assesses the senior’s needs and determines that home health services are needed for a few days or weeks, usually less than 60 days, and approves a care plan.

Home health aides from an enrolled private agency can then deliver paramedical services for seniors, who may also qualify for home delivery of needed medical equipment and supplies through Medicaid’s managed care model. Medicaid coverage extends to all necessary services, equipment and supplies, though seniors with long-term needs may eventually transition over to one of two nursing home waivers.

The Community Choices Waiver

Community Choice is the basic Medicaid waiver for South Carolina seniors who need home health care. Seniors who have exhausted their short-term home health benefits through Healthy Connections may be required to transition over to the waiver program for ongoing home health aide visits and durable medical equipment they can use at home. After getting a Medicaid-authorized physician’s recommendation for home health, a program worker performs a needs assessment for the senior and approves the waiver application. Home health aides are employed by a state-approved agency, which is paid directly by the Community Choices program on behalf of the beneficiary.

Community Supports

The Community Supports waiver is similar to the Community Choices program, but its services are tailored more toward the needs of beneficiaries with mental and behavioral disabilities, including those caused by Alzheimer’s disease and other forms of dementia. Seniors with early-stage dementia who can still remain safely at home with caregiver support can move onto the Community Supports waiver as an alternative to Community Choices and receive memory care-specific home health services until they are no longer able to remain at home.