Medicaid Coverage for COVID-19 Testing for South Carolinians Without Healthcare Coverage

 

The South Carolina Department of Health and Human Services (SCDHHS) announced it will immediately begin accepting applications for a new limited-benefit Medicaid coverage group to provide reimbursement for coronavirus disease 2019 (COVID-19) testing for those without healthcare coverage. SCDHHS’ COVID-19 Limited Benefit Program was authorized by the Families First Coronavirus Response Act (FFCRA) and will provide additional financial support to increase access to testing, a critical component of the state’s response to addressing the pandemic, for South Carolinians without other sources of healthcare coverage.

In order to qualify for this new SCDHHS-administered program, an individual must:

  • Be uninsured;
  • Be a resident of South Carolina;
  • Provide a Social Security number; and,
  • Have a qualifying citizenship or immigration status.

For testing to be covered by the new COVID-19 Limited Benefit Program, the test must be conducted by a healthcare provider who accepts Healthy Connections Medicaid. Coverage for this group is limited to COVID-19 testing. Testing provided by a healthcare provider who is enrolled in Healthy Connections Medicaid is covered if the test was performed on or after March 18, 2020. A list of in-network Healthy Connections Medicaid providers is available on SCDHHS’ website.

To apply for this new limited-benefit coverage, visit www.scdhhs.gov/COVID19, click on “Apply for COVID-19 Limited Benefit Coverage” to download an application, then follow the instructions on the application for how to return it; or, call (888) 549-0820 from 8 a.m.-6 p.m. Monday-Friday or 9 a.m.-2 p.m. on Saturday. COVID-19 testing is a covered benefit for current Healthy Connections Medicaid members, including those enrolled in Family Planning, so they do not need to apply for the new program.

SCDHHS has also made a number of temporary policy changes to ensure ongoing access to care during the COVID-19 pandemic, including creating additional ways to submit documents electronically to the agency. For more information regarding those changes, visit www.scdhhs.gov/COVID19.

Guidance for healthcare providers, including COVID-19 testing fee schedules and billing codes, is also available on SCDHHS’ COVID-19 website. Providers who are not enrolled in Healthy Connections Medicaid can find information on how to enroll as a Healthy Connections Medicaid provider on the provider section of SCDHHS’ website.

SCDHHS’ COVID-19 Limited Benefit Program is being offered in addition to the South Carolina Department of Health and Environmental Control’s (DHEC) statewide testing strategy, which includes a variety of free COVID-19 testing resources. A list of DHEC mobile and popup testing clinics and telehealth virtual providers is available on DHEC’s COVID-19 website.

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