Eligibility Requirements

If all of the following apply to you, you may be able to sign up for Absolute Total Care. If they do not, you are not eligible to participate.

Absolute Total Care is available to individuals who:

  • live in our service area; and
  • are age 65 or older at thetime of enrollment; and
  • have Medicare Parts A, B, and D; and
  • are eligible for full Healthy Connections Medicaid benefits; and
  • are a United States citizen or are lawfully present in the United States.

You are not eligible to participate if you are:

  • are part of the Healthy Connections Medicaid spend-down population; or
  • have Comprehensive Third Party Insurance; or
  • live in an Intermediate Care Facility for people with Intellectual Disabilities (ICF/IID) or Nursing Facility at the time of eligibility determination; or
  • are in a hospice program or are getting End-Stage Renal Disease (ESRD) services at the time of eligibility determination; or
  • are participating in a community long-term care waiver program other than the Community Choices Waiver, HIV/AIDS Waiver, or Mechanical Ventilation Waiver.

You may choose to either enroll or remain in Absolute Total Care if you:

  • are currently enrolled in a Medicare Advantage plan or in Program of All-inclusive Care for the Elderly (PACE). Enrolling in Healthy Connections Prime will automatically disenroll you from your existing program and any Medicare Part D plan; or
  • transition from a Nursing Facility or ICF/IID into the community; or
  • are already enrolled in this plan but later enter a Nursing Facility; or
  • are enrolled in this plan but enter a hospice program or become eligible for ESRD services.

If you have any questions, call South Carolina Healthy Connections Choices Customer Service Center at 1-877-552-4642, from 8 a.m. to 6 p.m. Monday through Friday. TTY users should call 1-877-552-4670.

Or you may call Member Services at 1-855-735-4398. Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. TTY users call 711.

Last Updated: 11/30/2017
H1723_18_Website_Pending

 
 
 
 
 

2018 Eligibility Requirements

 
 
 

Section for 2018 Components

 

If all of the following apply to you, you may be able to sign up for Absolute Total Care. If they do not, you are not eligible to participate.

Absolute Total Care is available to individuals who:

  • live in our service area; and
  • are age 65 or older at thetime of enrollment; and
  • have Medicare Parts A, B, and D; and
  • are eligible for full Healthy Connections Medicaid benefits; and
  • are a United States citizen or are lawfully present in the United States.

You are not eligible to participate if you are:

  • are part of the Healthy Connections Medicaid spend-down population; or
  • have Comprehensive Third Party Insurance; or
  • live in an Intermediate Care Facility for people with Intellectual Disabilities (ICF/IID) or Nursing Facility at the time of eligibility determination; or
  • are in a hospice program or are getting End-Stage Renal Disease (ESRD) services at the time of eligibility determination; or
  • are participating in a community long-term care waiver program other than the Community Choices Waiver, HIV/AIDS Waiver, or Mechanical Ventilation Waiver.

You may choose to either enroll or remain in Absolute Total Care if you:

  • are currently enrolled in a Medicare Advantage plan or in Program of All-inclusive Care for the Elderly (PACE). Enrolling in Healthy Connections Prime will automatically disenroll you from your existing program and any Medicare Part D plan; or
  • transition from a Nursing Facility or ICF/IID into the community; or
  • are already enrolled in this plan but later enter a Nursing Facility; or
  • are enrolled in this plan but enter a hospice program or become eligible for ESRD services.

If you have any questions, call South Carolina Healthy Connections Choices Customer Service Center at 1-877-552-4642, from 8 a.m. to 6 p.m. Monday through Friday. TTY users should call 1-877-552-4670.

Or you may call Member Services at 1-855-735-4398. Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. TTY users call 711.

 
 
 

Section for 2017 Components

 

If all of the following apply to you, you may be able to sign up for Absolute Total Care. If they do not, you are not eligible to participate.

Absolute Total Care is available to individuals who are:

  • A U.S. Citizen 
  • Lawfully present in the U.S. 
  • Age 65 and older at the time of enrollment;
  • Entitled to benefits under Medicare Part A, enrolled in Medicare Parts B and D, and receiving full Medicaid benefits.  (This includes individuals enrolled in the Community Choices Waiver, HIV/AIDS Waiver and Mechanical Ventilator Dependent Waiver.)

You are not eligible to participate if you are:

  • Under the age of 65;
  • Part of the Medicaid spend-down population;
  • Enrolled in both Medicare and Medicaid who have full Third Party Insurance;
  • Residing in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) or Nursing Facility at the time of eligibility determination;
  • Residing in a Long Term Care or Nursing Facility at the time of  eligibility determination;
  • In a hospice program or are receiving End-Stage Renal Disease (ESRD) services at the time of eligibility determination; and
  • Participating in federal waiver programs or home and community based Medicaid coverage other than the Community Choices Waiver, HIV/AIDS Waiver and Mechanical Ventilator Dependent Waiver (e.g., Intellectual Disabilities and Related Disabilities Waiver, Head and Spinal Cord Injury Waiver, Community Supports Waiver, Medically Complex Children’s Waiver, Pervasive Developmental Disorder Waiver and Psychiatric Residential Treatment Facility Alternative CHANCE Waiver.)

For Questions:
Contact South Carolina Healthy Connections Choices Customer Service Center at 1-877-552-4642, from 8 a.m. to 6 p.m. Monday through Friday. TTY users should call 1-877-552-4670.

OR

Call Member Services at 1-855-735-4398. Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. TTY users call 711.

 
 
 
 
 
 
 
 

Last Updated: 09/30/2017
H1723_18_Website_Pending