| Doctor Visits (per year) | * Unlimited visits in health plan * No co-pays |
| Pharmacy/Medications | * Pharmacy coverage is specific to the health plan * Check with the health plan to see if your medications are covered * Co-pays vary by plan |
| Hospital Stay | * Same benefit as Medicare |
| Home Health Care | * Limit of 50 visits per year (same as Healthy Connections Medicaid) |
| Durable Medical Equipment | * Same as Healthy Connections Medicaid |
| Dental and Oral surgery | * $3.40 co-pay per service (same as Healthy Connections Medicaid) * Emergency services only for oral surgery (same as Original Medicaid) Limited coverage for services delivered in preparation for or during the course of treatment for one or more of the following conditions: organ transplants; chemotherapy for cancer treatments; radiation of the head and/or neck for cancer treatments; total joint replacement; heart valve replacement; or treatment of trauma related injuries administered in a hospital or outpatient facility. Coverage provided by South Carolina Medicaid, not the individual plans. |
| Long-term Care Services and Supports | * Available for eligible waiver participants * Some co-pays apply * Includes hospice, assisted living and nursing facilities |
| Transportation Services | * Non-emergent medical transportation available |
| Behavioral Health Services | * Same as Healthy Connections Medicaid |
| 24-Hour Nurse Advice Line (not available in Original Medicaid) | * Health plan offers unlimited access to a nurse for medical advice * Contact Health Plan Member Number listed below |
| Disease Management (not available in Original Medicaid) | * Programs are available for diabetes * Contact Health Plan Member Number listed below |
| Care Coordination (managing care from different doctors or clinics) | * Coordinates care, through care manager * Contact Health Plan Member Number listed below |
| No extra costs for coverage | * No premiums or deductibles |