Effective Jan. 1, 2026: Medicaid members 18+ who are dual Medicare/Medicaid, in the HIV/AIDS, Vent or Community Choices waiver, or in a nursing facility receive medical services through managed care.
| Claim type | Routes to |
|---|---|
| Medical claims | MCO |
| Incontinence supplies | MCO |
| Waiver services | FFS |
| X1939 nutritional supplements | FFS |
| T2028 hand-held showers | FFS |
| X1917 and X1918 specialized equipment and supplies | FFS |
Continuity of care: 180 days, honoring prior authorizations at 100 percent of the FFS rate unless a negotiated rate exists, regardless of network status.
Plans and provider numbers:
| Plan | Provider number |
|---|---|
| Select Health | HM1000 |
| Absolute Total Care | HM2200 |
| Healthy Blue | HM3200 |
| Molina | HM3600 |
| Humana | HM4200 |
Verification: Phoenix (case managers) or the SC Medicaid Web Tool (providers).
General information, not legal advice. Requirements change; confirm against the official source before you act, or ask us how this applies to your organization.