What is Healthy Connections Prime?
Healthy Connections Prime is a new program that combines all of the benefits of Medicare and
Healthy Connections Medicaid under a single Medicare-Medicaid plan to make it easier to get the
health services you need. Your Medicare Part D prescription plan is also covered under this plan.
- Better care by making it easier for you to get all of your Medicare,
Medicaid and Part D services from a single health plan.
- Better value through a care team and a care manager that works directly
with you and your loved one and providers to make sure you or your loved one get needed health services.
- Better health through flexible benefits that will help you stay at home
with family as long as possible.
How is this different?
This program combines all of the benefits of Medicare (Parts A/B), Medicare
Part D (prescription drugs) and Healthy Connections Medicaid under a single Medicare-Medicaid Plan to make
it easier to get the care you need. As a member, you will have:
| Current Services |
New Benefits |
| Doctor visits | One plan |
| Hospital care | One card |
| Prescription and over-the-counter drugs | One number to call |
| Adult preventive dental* |
No insurance premiums, no costs for doctor visits and hospital stays |
| Durable Medical Equipment (DME) | $0 drug copays |
| Medical transportation* | A care team |
| Nursing Home and Community Long-Term Care (CLTC) |
A personalized care plan that fits your needs |
| Behavioral health services | Help transitioning home from the hospital or nursing home |
*These services are still covered and available for you under Healthy Connections Medicaid.
Who qualifies for the program?
Healthy Connections Prime provides coverage to seniors age 65 or older, who live in South Carolina,
have both Medicare and Healthy Connections Medicaid, and are living at home. Some exclusions may apply.
To learn more, call South Carolina Healthy Connections Choices Customer Service Center at (877) 552-4642
Monday-Friday, 8:30 a.m. – 5:00 p.m. TTY users call (877) 552-4670. This call is free.
When do I sign up for Healthy Connections Prime?
Individuals who are eligible for the program will be automatically enrolled into one of our
three participating health plans.
You may also apply over the telephone. Contact the South Carolina Healthy Connections Choices
Customer Service Center at (877) 552-4642 to speak with an enrollment
counselor. TTY users call (877) 552-4670. This call is free.
What is covered?
When you enroll in Healthy Connections Prime, you will continue to receive all of your Medicare (Parts A/B),
Medicare Part D (prescription drugs), and Healthy Connections Medicaid services. As a member, you will have:
Current services, such as:
- Doctor visits
- Hospital care
- Prescription and over-the-counter-drugs
- Adult preventive dental*
- Durable Medical Equipment (DME)
- Medical transportation*
- Nursing Home and Community Long Term Care(CLTC)
- Behavioral health services
*Adult dental and Medicaid transportation services are still covered and available for you under
Healthy Connections Medicaid.
Click here to see a complete list of
Healthy Connections Covered services on the Healthy Connections Prime website.
Are prescription drugs covered?
Yes, under Healthy Connections Prime you will also receive prescription drug coverage. You will not need to sign up
for a separate Medicare Part D plan. Medicare Part D is included under Healthy Connections Prime.
If I sign up for Healthy Connections Prime, will I lose my Medicare/Medicaid coverage?
No, signing up for Healthy Connections Prime allows you to continue to receive your current Medicare, Medicare Part D
and Healthy Connections Medicaid benefits without interruption. You will also receive a number of extra benefits.
Will I lose my doctors if I sign up for this new plan?
Even if the doctor or pharmacy is not in network, they can continue to be seen for 6 months while the plan reaches out
to build a connection with them or help you transition to a doctor or pharmacy that is satisfactory. Ask the provider if
they participate in Healthy Connections Prime. An enrollment counselor can also help you find out if a provider is a part
of this program.