South Carolina Fine Print: Medicaid, Waivers and Katie Beckett

South Carolina Has a Katie Beckett (TEFRA) Option

Families often hear 'you make too much' and stop there. South Carolina Medicaid has a program for children with disabilities that counts only the child's income, not the family's. The TEFRA / Katie Beckett page explains the federal rule. Here's how SCDHHS describes it.

SCDHHS says: “Healthy Connections provides benefits to certain children with disabilities who would not ordinarily be eligible because their parents' income and/or resources exceed the limit.” (scdhhs.gov, program eligibility)

SCDHHS lists the conditions. A child must be 18 or under, a U.S. citizen or lawful permanent resident, a South Carolina resident, living at home, meeting the SSI definition of disability, and meeting an institutional level of care. The page shows these limits as of 2026 (which change every year):

SCDHHS says: “Have gross monthly income below $2,982 and countable resources at or below $2,000 (only the child's income and resources are counted)” (scdhhs.gov, program eligibility)

A level of care sounds like the child has to live in an institution. SCDHHS says that's not true.

SCDHHS says: “Meeting a level of care does not mean a child must be institutionalized.” (scdhhs.gov, program eligibility)

What you get and what you don't get is spelled out too.

SCDHHS says: “A child who meets these requirements is eligible for the full range of Medicaid covered services. If the child needs special services, which are available only under the home and community based waiver, they must apply for and be accepted into one of the waiver programs to receive these special services.” (scdhhs.gov, program eligibility)

Say: “My child has a disability and our income is over the Medicaid limit. Is my child eligible for the TEFRA (Katie Beckett) program, and what is the application and level-of-care process?”

The page has a TEFRA application form and fact sheet, and points families to Family Connection of South Carolina for help.

The Waivers by Name, and the Ones That Are Closed

The waivers are where the home and community services are, and a family needs the program's name before anyone will talk to you. SCDHHS lists the active ones and tells you where to read who is eligible and how to apply.

SCDHHS says: “Currently Approved Waivers Community Choices (CC) Waiver (SC.0405) Community Supports (CS) Waiver (SC.0676) Head and Spinal Cord Injury (HASCI) Waiver (SC.0284) HIV/AIDS Waiver (SC.0186) Mechanical Ventilator Dependent (Vent) Waiver (SC.40181) Medically Complex Children (MCC) Waiver (SC.0675) Intellectual Disability and Related Disabilities (ID/RD) Waiver (SC.0237)” (scdhhs.gov, waivers)

SCDHHS says: “Descriptions of these waiver programs, who is eligible and how you can apply are available on the waiver overview chart” (scdhhs.gov, waivers)

For families of a child with autism, one line matters. A waiver many families have heard of is closed.

SCDHHS says: “The following waivers are currently inactive: Pervasive Development Disorder (PDD), Psychiatric Residential Treatment Facility (PRTF), Community Engagement and Children's Health Access In Community Environments (CHANCE).” (scdhhs.gov, waivers)

When someone says to look into the autism waiver, ask which one. Two of the active waivers are proposed for renewal, which can change who qualifies.

SCDHHS says: “The proposed effective date for these waivers is Jan. 1, 2027: Medically Complex Children (MCC) Waiver (SC.0675) Intellectual Disability and Related Disabilities (ID/RD) Waiver (SC.0237)” (scdhhs.gov, waivers)

Say: “Which South Carolina waivers could my child qualify for, which are open, and how do I get on the waiting list today even if we do not need services yet?”

My Paying for It page explains why getting on a list early matters.

If Medicaid Says No: Where the Hearing Goes

A denial is not the last word. SCDHHS has an office for appeals, and an appeal gets you an in-person hearing.

SCDHHS says: “The SCDHHS Office of Appeals and Hearings oversees appeals filed by either an applicant, member, or provider from an adverse agency decision.” (scdhhs.gov, appeals)

SCDHHS says: “When you file an appeal, you are requesting an in-person hearing before a hearing officer.” (scdhhs.gov, appeals)

Your deadline is printed on the notice you got, so find it first. Federal law gives you 90 days from when the notice was mailed (see the Medicaid fine print). The SCDHHS appeals page also mentions 30 days, but that's for providers fighting a payment, not for members. A short, written request is enough to start. The letters page has a template.

A Way to Ask That Works

Ask in writing and keep a copy. Name the program you're asking about. The people on the phone are working through a long queue, so a clear question gets a clear answer. Family Connection of South Carolina is free and can help you figure out which of these fits your child. Programs and limits change every year, so check the SCDHHS pages linked below before you rely on any number here.