Medicaid & Assisted Living in South Carolina: Yes

Updated September 4, 2026. Quick answer: yes, through Community Choices (CC) Waiver, SC.0405 / Draft SC.016.05.00 renewal. Medicaid does not pay the facility’s room and board either way; only the care and service component.

What South Carolina covers

Waiver / state plan option	Community Choices (CC) Waiver, SC.0405 / Draft SC.016.05.00 renewal
Covers an assisted living setting?	Yes: “This service is available only to waiver participants residing in Community Residential Care Facilities (CRCFs) with an assessed intermediate nursing facility level of care. It is designed to enable such participants to complete tasks that they would normally complete themselves if they did not have a disability.”
Room and board	Never covered by Medicaid, in South Carolina or any state; see below.

The room-and-board split

Federal law is the floor every state builds on: “The Secretary may by waiver provide that a State plan approved under this subchapter may include as “medical assistance” under such plan payment for part or all of the cost of home or community-based services (other than room and board) approved by the Secretary” (42 U.S.C. §1396n(c)(1), Social Security Act §1915(c)). The words in parentheses do the work: whatever a state’s waiver pays for inside an assisted living community, it is not the rent, the meals, or the room itself. That portion stays the resident’s own to fund, out of income, savings, or a family contribution; the waiver only ever reaches the care and service layer on top of it. South Carolina’s own materials say the same thing directly: “Payments are made only for authorized waiver services. No payments are made directly to CRCF providers. Participants must find alternative means for making room and board payments, primarily through the use of personal recurring income. Fee-for-service payments do not include an allowance for room and board. The only services available to participants residing in Community Residential Care Facilities are Case Management and Specialized Medical Equipment – Nutritional Supplements.” (SC Community Choices Waiver renewal application (Draft SC.016.05.00), Appendix I-5).

The waitlist

Open: state does not limit the number of participants served at any point in time : “The state does not limit the number of participants that it serves at any point in time during a waiver year.” (as of 02/27/2026 (Draft SC.016.05.00 renewal application, effective Jul 01, 2026))

What you get to keep: the personal needs allowance

Not published in the materials reviewed this session. This is the amount of a waiver participant’s own income the state lets them keep for personal spending after the rest goes toward the cost of their care; it varies by state because each state sets its own figure inside the federal floor.

What this doesn’t answer

Coverage is real but narrow: the CC waiver’s own service definitions name Community Residential Care Facilities (CRCFs, SC’s licensure term functionally equivalent to assisted living) as a covered provider setting, but only for two services: Residential Personal Care II and short-term (28 days/year) CRCF Respite, not an ongoing room-and-board-inclusive AL benefit. The waiver explicitly excludes room and board; the actual room-and-board subsidy mechanism for CRCF/assisted-living residents in South Carolina is Optional State Supplementation (OSS), which SCDHHS’s own OSS page states ‘is not a Medicaid program.’ Personal needs allowance is unverified: the waiver application’s PNA question is a fillable form field left blank/unreadable in the version reviewed. Waitlist verdict comes from a Draft renewal application dated 02/27/2026, not yet a fully executed CMS approval.

Sources

Read September 4, 2026.

Same question, other states: South Dakota · Tennessee.

General information drawn from each state’s own Medicaid agency and federal statute, not legal, tax or financial advice. Medicaid is administered state by state; waiver names, coverage decisions, waitlists and allowance amounts change by state budget and legislative action. This page cannot see your own state’s current caseload. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.

Related: South Carolina’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.

Does Medicaid Pay for Assisted Living in South Carolina?