South Carolina Medicaid waiver guide
Learn how South Carolina Medicaid waiver services work, which state agency to start with, how the application process usually begins, and where to search for home and community-based services.
Last reviewed July 2026. See something out of date? Use the “Suggest an edit” button to let us know.
South Carolina's developmental disability services now sit within the Department of Behavioral Health & Developmental Disabilities (BHDD), through its Office of Intellectual and Developmental Disabilities — the former DDSN. Older materials, phone trees, and web links still say DDSN, and the intake number is unchanged. Three waivers serve different populations: ID/RD for intellectual disability and related disabilities, Community Supports, and HASCI for head and spinal cord injury. Both ID/RD and Community Supports have waiting lists, and South Carolina does something useful — it tells you your position number in writing.
Search by state, city, or ZIP code to compare provider profiles, services, contact details, and verified status.
People with an intellectual disability or related disability meeting ICF/IID level of care
People needing a different package of community supports — a separate waiver with its own manual and waiting list
People with a head or spinal cord injury
For the ID/RD Waiver you must have a diagnosis of intellectual disability or a related disability, qualify for Medicaid, meet ICF/IID level of care criteria, choose community-based services over institutional care, and receive a waiver slot allocation. That last requirement is what the waiting list governs — meeting the clinical and financial criteria does not by itself produce services.
You must have a diagnosis of intellectual disability or a related disability. Related disabilities are a distinct qualifying category — ask about them if an intellectual disability diagnosis does not fit.
You must meet the level of care criteria an intermediate care facility for individuals with intellectual disabilities would provide.
You must qualify for Medicaid or already have it. Waiver services are Medicaid-funded.
You must actually receive a waiver slot. This is the piece the waiting list controls — clinical and financial eligibility alone do not start services.
The ID/RD and Community Supports waivers each maintain a waiting list. If you are determined eligible for services, you are added to the appropriate waiver waiting list if you were not already on it. South Carolina then sends a letter to everyone added to the priority list, and that letter includes your position number on the list — a level of transparency many states do not offer.
Let your Case Manager or Early Interventionist know you want to apply, or call the intake line directly. They help gather the information needed to complete the application.
Open linkYou need a diagnosis of intellectual disability or a related disability, and a finding that you meet ICF/IID level of care criteria.
You must qualify for or already have Medicaid. Sorting this out early prevents a stall later when a slot becomes available.
Once found eligible you are added to the appropriate waiver waiting list, and South Carolina mails you a letter stating your position number. Keep it. Comparing letters over time is how you see whether the list is moving.
ID/RD carries specific caps: respite is limited to 68 hours per month, environmental modifications to $15,000 lifetime, and private vehicle modifications to $7,500 per vehicle for up to two vehicles in a lifetime. Knowing these before planning avoids unpleasant surprises.
Open linkExact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.
South Carolina offers participant-directed options within its waivers, letting people take a role in selecting and managing their own supports. Ask your Case Manager which services can be self-directed under the specific waiver you are enrolled in — the three waivers differ.
Approved waiver services are paid by South Carolina Medicaid. Once enrolled, there is generally little or no direct cost for covered services.
ID/RD limits respite to 68 hours a month, environmental modifications to $15,000 over a lifetime, and private vehicle modifications to $7,500 per vehicle for at most two vehicles in a lifetime. These are lifetime limits, not annual ones — spend them deliberately.
Service plans must be completed within 364 days, so the renewal cycle comes around slightly faster than a calendar year. Missing it can interrupt services.
Early Interventionists work with young children and can start the waiver application — you do not need to wait for school age to ask.
Because slot allocation is a separate step from eligibility and both ID/RD and Community Supports have waiting lists, being added early matters. Ask to be placed on every list you may qualify for.
School districts provide special education under an IEP. Waiver services are separate and additional.
Attendant care, day health services, nursing, and specialized medical equipment are adult ID/RD services. Talk with your Case Manager about what changes at adulthood well before it arrives.
If eligibility or a waiver service is denied, reduced, or ended, you have the right to appeal and to request a Medicaid fair hearing within the deadline printed on your notice. Disability Rights South Carolina is the state's federally authorized protection and advocacy system; all services are free and confidential, and if an intake specialist is unavailable you receive a call back within two working days.
Protection & Advocacy system for South Carolina
1-866-275-7273Visit siteApply for services — formerly DDSN, same intake number
1-800-289-7012Visit siteEligibility criteria, covered services, and the specific service caps
Visit siteFree confidential advocacy — voice and TTY, callback within two working days
1-866-275-7273Visit siteMedicaid eligibility and waiver policy
Visit siteLocal help & referrals — dial 211
Visit siteBoth names refer to the same system. South Carolina's developmental disability services now sit in the Department of Behavioral Health & Developmental Disabilities, through its Office of Intellectual and Developmental Disabilities. Plenty of documents and links still say DDSN, and the intake number 1-800-289-7012 is unchanged.
South Carolina mails a letter to everyone added to a priority list, and that letter includes your position number. Keep every letter — comparing them over time is the clearest way to see whether the list is actually moving. You can also ask your Case Manager or call 1-800-289-7012.
Because slot allocation is a separate requirement from eligibility. You must have a diagnosis, meet ICF/IID level of care, qualify for Medicaid, choose community services — and receive a waiver slot. The waiting list controls that last piece.
On ID/RD, respite is limited to 68 hours per month, environmental modifications to $15,000 across a lifetime, and private vehicle modifications to $7,500 per vehicle for at most two vehicles in a lifetime. Because the modification caps are lifetime rather than annual, use them deliberately.
They are separate waivers with their own manuals and their own waiting lists. ID/RD is the intellectual disability and related disabilities waiver with the service set described here. Ask your Case Manager which fits your needs, and about being placed on both lists if you may qualify for both.
For the ID/RD Waiver you must have a diagnosis of intellectual disability or a related disability, qualify for Medicaid, meet ICF/IID level of care criteria, choose community-based services over institutional care, and receive a waiver slot allocation. That last requirement is what the waiting list governs — meeting the clinical and financial criteria does not by itself produce services.
call 1-800-289-7012 or tell your case manager, establish the diagnosis and level of care, get medicaid in place, get on the right waiting list — and keep the letter, then enroll and choose providers. Start with South Carolina Department of Behavioral Health & Developmental Disabilities.
Covered services vary by waiver and assessed need, and commonly include in-home supports, respite, supported employment, day services, behavior support, residential supports. Confirm specifics with the state and provider.
The ID/RD and Community Supports waivers each maintain a waiting list. If you are determined eligible for services, you are added to the appropriate waiver waiting list if you were not already on it. South Carolina then sends a letter to everyone added to the priority list, and that letter includes your position number on the list — a level of transparency many states do not offer.
Approved waiver services are generally covered by Medicaid at little or no direct cost once enrolled, though some enrollees may owe a monthly patient responsibility based on income.
Eligibility criteria, covered services, and the respite, environmental, and vehicle modification caps.
South CarolinaSouth Carolina's I/DD services, formerly DDSN.
South CarolinaThe Medicaid agency's page on the ID/RD waiver.
South CarolinaFree confidential protection and advocacy services, including appeals help.
South CarolinaFind waiver providers and services in South Carolina on Waiverly.
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