Networks change. We verify your specific South Carolina Medicaid (Healthy Connections) plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: Healthy Connections, Healthy Connections Choices, SC Medicaid, SCDHHS Medicaid. Offered in South Carolina.
Healthy Connections is the name of South Carolina's Medicaid program, administered by the Department of Health and Human Services. Most members are enrolled in one of the managed care organizations under Healthy Connections Choices: Absolute Total Care, BlueChoice HealthPlan Medicaid, Humana Healthy Horizons, Molina Healthcare of South Carolina or Select Health of South Carolina (First Choice). Some members, such as those in certain waiver programs, remain in fee-for-service Medicaid. South Carolina has not expanded Medicaid, so eligibility is centered on children, pregnant women, low-income parents, seniors and people with disabilities. Outpatient psychiatry, medication management and psychotherapy are covered with no copay for most members, and no referral is required for behavioral health. Telehealth psychiatry is covered for members located in South Carolina.
For interventional treatments, Healthy Connections plans apply prior authorization and medical necessity review. South Carolina Medicaid coverage of transcranial magnetic stimulation for adults is limited and plan-specific, while coverage for members under 21 can be broader under EPSDT. Spravato is covered with prior authorization for treatment-resistant depression when you are taking an oral antidepressant and receive treatment at a REMS-certified site. Because Stedfast Psychiatry's TMS and Spravato programs are located in Florida, South Carolina Medicaid members should talk with us about coverage and travel before any authorization is submitted.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
Does Stedfast Psychiatry accept South Carolina Medicaid?
Stedfast Psychiatry accepts several Healthy Connections managed care plans at our Goose Creek, Lexington, Bluffton and Hilton Head Island offices where contracted. Which plans are in network can vary by office. Call the member number on your plan card or ask our front desk to verify your eligibility before your first appointment.
Is there a copay for psychiatry on Healthy Connections?
Most South Carolina Medicaid members pay nothing for covered outpatient mental health services, including psychiatric evaluation, medication management and therapy, when seeing an in-network provider. A small number of adult members may have nominal copays for some services, and children, pregnant women and members in certain categories are exempt from all copays.
Does South Carolina Medicaid cover telehealth psychiatry?
Yes. Healthy Connections covers video psychiatry visits with in-network providers for members located in South Carolina during the appointment, at no cost to the member. Telehealth is convenient for medication follow-ups and for families in rural parts of the Lowcountry and Midlands. TMS and Spravato must be delivered in person.
Will South Carolina Medicaid pay for Deep TMS?
Adult TMS coverage under Healthy Connections is limited and reviewed under prior authorization by your managed care plan. Coverage for members under 21 can be broader under EPSDT when medically necessary. Because our TMS program is at Palm Beach Gardens, Florida, we would discuss logistics and likely coverage with you before submitting any request.
Does Healthy Connections cover Spravato?
South Carolina Medicaid plans cover Spravato with prior authorization for treatment-resistant depression when you are taking an oral antidepressant and receive treatment at a REMS-certified clinic. Our Spravato offices are in Palm Beach County, Florida, so coverage of out-of-state treatment and travel should be confirmed with your plan before an authorization is submitted.