South Carolina Medicaid Asset Limits for Long-Term Care in 2026

The $2,000 Asset Threshold

To qualify for Medicaid long-term care in South Carolina — whether nursing home coverage or the Community Choices waiver — a single applicant's countable assets must fall below $2,000. If both spouses are applying, the combined limit is $4,000.

This is one of the lowest asset thresholds in the country, and it applies to the applicant's resources at the time of application. SCDHHS evaluates assets on an individual basis but counts the assets of both spouses jointly when determining eligibility for institutional or waiver services.

What Counts as a Countable Asset

Any asset not explicitly exempted by federal or state law is countable and must be reduced below the threshold. The most common countable assets:

• Cash, checking, and savings accounts — all balances, across all institutions
• Certificates of deposit and money market accounts
• Stocks, bonds, and mutual funds
• Individual retirement accounts (IRAs) and 401(k) plans — for both spouses
• Cash surrender value of life insurance — if the combined face value of all policies exceeds $10,000
• Non-home real estate — vacation homes, rental properties, undeveloped land
• Any other liquid or semi-liquid asset not specifically exempted

The inclusion of both spouses' retirement accounts catches many families off guard. A community spouse's IRA or 401(k) is fully countable in the eligibility assessment, even though the community spouse isn't applying for Medicaid.

What's Exempt

South Carolina law exempts several categories of property from the asset count:

The Primary Residence

The family home is exempt if the applicant lives in it, intends to return to it, or if a qualifying relative resides there. For 2026, the home equity limit is $752,000 — meaning the home remains exempt as long as the applicant's equity interest doesn't exceed that amount.

The equity limit is waived entirely if the applicant's spouse, a child under age 21, or a blind or permanently disabled child of any age lives in the home. In practice, the surviving spouse's continued residence in the home keeps it exempt regardless of the home's value.

An "intent to return" declaration protects the home even when a parent moves permanently to a nursing facility. SCDHHS generally accepts this intent at face value.

One Vehicle

One motor vehicle of any value is completely exempt if it's used for transporting the applicant or the community spouse. There is no cap on the vehicle's value — a $50,000 car receives the same exemption as a $5,000 one.

Additional vehicles are countable at their fair market value.

Household Goods and Personal Effects

All furniture, appliances, clothing, and personal jewelry are exempt. There's no dollar cap on these items.

Prepaid Burial Arrangements

Irrevocable prepaid funeral and burial contracts are fully exempt. South Carolina does not impose a rigid dollar cap on these contracts, provided they're funded through an irrevocable trust or life insurance assignment and cover actual, itemized goods and services.

Separately, up to $1,500 per spouse can be set aside in a designated burial fund account. This is in addition to the prepaid funeral contract.

Life Insurance (Under the Face Value Threshold)

If the combined face value of all life insurance policies is $10,000 or less, the entire cash surrender value is exempt. If the combined face value exceeds $10,000, the cash surrender value of all policies becomes countable.

This creates a planning point: if your parent has a $15,000 whole life policy with $8,000 in cash value, that $8,000 counts against the $2,000 limit. Reducing face value below $10,000, cashing out the policy and spending the proceeds on legitimate expenses, or converting the policy to an irrevocable funeral trust are all options.

The Married Couple Calculation

When one spouse needs long-term care and the other remains at home, the calculation involves the Community Spouse Resource Allowance (CSRA). South Carolina uses a flat CSRA of $66,480 — not the sliding scale that some states employ.

The calculation:

1. Add all countable assets of both spouses on the date of the applicant's institutionalization (the "snapshot date")
2. The community spouse retains up to $66,480
3. The applicant's remaining share must be reduced to $2,000

For a couple with $150,000 in countable assets: the community spouse keeps $66,480, and the remaining $83,520 must be spent down to $2,000 — meaning $81,520 in spending before the applicant qualifies.

South Carolina's flat $66,480 CSRA is notably restrictive. Other states allow up to the federal maximum of $162,660 or use a sliding scale. This forces South Carolina families to deplete substantially more of their joint savings than families in more generous states.

Making the Numbers Work

Reducing countable assets below $2,000 requires strategic spending — paying off debts, making home modifications, purchasing irrevocable funeral plans, and properly timing the conversion of retirement accounts. Every dollar must be documented, because SCDHHS will audit five years of financial history during the application process.

The South Carolina Medicaid Long-Term Care & Asset Protection Guide includes an asset classification worksheet that helps you categorize each of your parent's assets as countable or exempt, calculate the spend-down target, and plan compliant asset reduction strategies.

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