HealthChoice Enrollment

A health plan is a group of doctors (or clinics) that may also include hospitals and other medical staff. Health plans offer the same benefits as regular Medicaid, but also offer extra services that may help you and your family get better care. Some plans offer vision and dental care, and all plans help with managing diseases, like diabetes and high blood pressure. They also have a nurse help line you can call any time with health care questions.

Look at the Health Plan Comparison Chart. This chart shows you which plans you can choose from and what benefits and services they provide.

You can also view the chart that came in your Welcome Packet.

If you have questions or need help, call our Customer Service Center at 1-877-552-4642.

Choosing a health plan and a doctor for each member of your family in the program is as easy as 1-2-3. Here’s how:

Step 1: Think about your family’s health needs.
To start, think about and write down:

• The doctors you want to see.
• Do you have a doctor you and your family already like? Or is having a doctor close to where you live or work more important?
• You can search for a doctor by name, distance, or specialty (such as pediatrics) by clicking here.
• Which hospitals, clinics, and pharmacies you want to use.
• Do you want them to be close to your home, your job, or your kids’ school?
• Other services or benefits that you need.
• Do you or your family members have special health conditions? If so, choose a health plan that lets you keep getting treatment. Special health conditions include asthma, diabetes, pregnancy care, mental health services, and physical therapy.

• Click here to compare the services each health plan offers and to find out which plans work with the doctors, hospitals, clinics, and pharmacies you want to use.
• Choose a plan that lets you go to the doctors and clinics you want, and gives you the services you need.
• Each person in your family can have a different health plan, but it’s easier to have the same plan for everyone.

• The fastest and easiest way to choose the health plan and doctor you want is online.
• At the top of the page, click “Enroll Now.”
• Enter your Member ID and PIN (you can find both numbers on the first page of the letter that came in your Welcome Packet).
• Click on “Continue.” Follow the easy instructions to choose your health plan and doctor.
• You can also call our Customer Service Center at 1-877-552-4642. We can help you in the language you speak.
• Or fill out the Health Plan and Doctor Selection form. Mail it back in the envelope provided or fax it to 1-877-552-4672.

The Health Plan Comparison Chart shows the services that each plan offers. Use it to compare the plans in your area. Then choose the one that best meets you and your family’s needs.

• The top row shows the name of each health plan.
• The left-hand column shows a list of the types of benefits and services.
• A shows that the plan offers that service.
• A means the plan does not offer that service.
• To see details about each plan, click on the “See Details” link under the health plan name.
• To compare each plan's services, click on the “See Details” link next to the name of each service. Since each plan may offer slightly different options for the same service, it’s a good idea to compare the details of the services that are important to you.
• To see details for all of the plans and all of the services, click on the “See All” button.

Yes. You must select a health plan and primary care physician (PCP) for each member of your family who is in the program. Use the “How to Choose a Health Plan and Doctor” guide to help you find the health plans and PCPs that meet you and your family’s needs. Click here to see the guide.

No. You can choose a plan first or a doctor first. It’s up to you. If you pick a doctor first, we’ll tell you which health plans work with that doctor. Then you can choose one of those plans. If you pick a plan first, you can then select a doctor who works with that plan.

Yes. You can change your health plan once within the first 90 days of when you enrolled. To change health plans, click here. To log in, use your Member ID and PIN. Click “Continue,” and follow the easy instructions to change your health plan and doctor. Or call our Customer Service Center at 1-877-552-4642.

If you don’t change plans in 90 days, then you must stay in the health plan for at least 1 year, unless you can show a good reason to change.

You may have health care coverage from another insurance company and still be eligible for South Carolina Healthy Connections. It is important to tell your local Medicaid eligibility worker if your other insurance coverage changes.