South Carolina's income-cap rule is the single most important planning lever for the nursing-home and HCBS pathways. The cap sits at 300% of the SSI federal benefit rate, which CMS lists as $2,982 per month for 2026. SCDHHS's policy is clear that once gross income crosses that line, an applicant who's otherwise eligible may establish an Income Trust — making this a central planning issue in South Carolina rather than an optional technique reserved for edge cases.
The specific mechanics of that trust are governed by Section 44-6-720. The statute limits what can go into the trust to the applicant's monthly unearned income, names both the applicant and the state Medicaid agency as beneficiaries, requires that distributions go toward nursing-home expenses, and directs whatever remains at the applicant's death back to the state. Because of these built-in requirements, the trust has to be treated and administered as a purpose-built Medicaid device — not as a standard family trust with different goals.