If you had Healthy Connections Prime — South Carolina's plan for people who have both Medicare and Medicaid — you may have gotten a letter, or heard from a neighbor, that "the plan is ending." It's true: as of January 1, 2026, Healthy Connections Prime has ended. It wasn't just a South Carolina decision — the federal government (CMS) retired this type of Medicare-Medicaid plan nationwide.

First, the reassuring part: this does not mean you were left with nothing. In almost every case, your coverage was automatically moved to a new plan built to do the same job. But you should take a few minutes to make sure your new plan actually fits your doctors and your prescriptions — and that's what this guide is for.

What actually happened

Healthy Connections Prime was a Medicare-Medicaid Plan (MMP) — a single plan that coordinated your Medicare and your Medicaid benefits together. CMS decided to retire all MMPs across the country and replace them with a newer, similar model called a Dual-Eligible Special Needs Plan, or D-SNP.

So on January 1, 2026, South Carolina transitioned everyone in Healthy Connections Prime to an aligned D-SNP. A D-SNP does the same core thing Prime did: it's built specifically for people who have both Medicare and Medicaid, and it coordinates both sets of benefits under one plan. The South Carolina Department of Health and Human Services (SCDHHS) managed this transition, with aligned D-SNP plans available from carriers like Humana, WellCare, Aetna, Molina, and UnitedHealthcare.

Did I lose my coverage? (Almost certainly not)

Here's the most important reassurance: most Prime members were automatically enrolled into a new D-SNP so their coverage would continue without a gap. If your Prime plan's company offered an aligned D-SNP, you were generally moved into it automatically on January 1, 2026.

You did not have to do anything to keep coverage in most cases. But "you have a plan" and "you have the right plan" are two different things — and that's where a few minutes of checking pays off.

Your 3-step move

Step 1 — Confirm which plan you're in now. Look for the letters and the new member ID card you should have received around the end of 2025 or start of 2026. They'll tell you the name of your new D-SNP. If you can't find them or you're not sure, don't guess — call SCDHHS or 1-800-MEDICARE, or let me look it up with you.

Step 2 — Make sure your new plan covers what you need. This is the step that actually matters. Check that your new D-SNP includes:

• Your doctors and specialists
• Your hospital and pharmacy
• Your prescriptions (on the plan's drug list, at a cost you can manage)
• Any extra benefits you relied on (transportation, dental, over-the-counter, etc.)

If everything lines up, you're set. If your doctor or a key prescription isn't covered by the plan you were auto-assigned, that's your signal to look at other options.

Step 3 — Switch plans if the fit is wrong. Here's good news that most people don't know: because you have both Medicare and Medicaid, you have far more flexibility to change plans than most people do. You generally don't have to wait for the once-a-year window everyone else uses. If your auto-assigned D-SNP doesn't fit, you can usually move to a different aligned D-SNP that does. An agent or SCDHHS can tell you exactly what options are open to you right now.

What to Do Don't ignore the mail, and don't assume the plan you were placed in is automatically the best one for your doctors and medications. Take ten minutes to check Steps 1 and 2. If anything looks off, get free help before you make a change — that's what Step 3 is for.

One more thing: keep your Medicaid active

A D-SNP only works if you stay eligible for both Medicare and Medicaid. Make sure you respond to any Medicaid renewal or redetermination notices from SCDHHS on time — if your Medicaid lapses, it can affect your D-SNP. Keeping your address and contact information current with SCDHHS is one of the simplest, most important things you can do.

Where to get free help

You do not have to figure this out alone, and you should never pay someone to help you choose a Medicare plan — that help is free. Good places to turn:

• SCDHHS (South Carolina Healthy Connections / Medicaid) for questions about your Medicaid and the Prime transition.
• 1-800-MEDICARE for Medicare questions.
• South Carolina SHIP (State Health Insurance Assistance Program) for free, unbiased counseling.
• A local licensed agent like me — I can review your new D-SNP against your doctors and prescriptions at no cost to you and, if a different plan fits better, help you make the change correctly.

If you want to understand how these plans compare more broadly, our South Carolina Medicare Advantage Plans: 2026 Guide and Medicare Advantage vs. Medigap in South Carolina are good next reads — and if you'd rather just talk to a person, here's local Medicare help in the Columbia area.

Had Healthy Connections Prime? Let's Make Sure Your New Plan Fits — for Free.

No-cost, no-pressure review. I'll confirm which D-SNP you're now in, check it against your doctors and prescriptions, and if it's not the right fit, help you switch to one that is.

📞 Call or Text Ben: 803-920-8827 🌐 MauldinInsuranceGroup.com 📍 100 Old Cherokee Rd STE F #167, Lexington, SC · Serving all of South Carolina

This article is general information, not medical or enrollment advice. Always confirm your specific coverage with SCDHHS, your plan, or 1-800-MEDICARE.

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Frequently Asked Questions

What happened to Healthy Connections Prime in South Carolina? Healthy Connections Prime, South Carolina's Medicare-Medicaid Plan (MMP), ended January 1, 2026, as part of a nationwide federal decision to retire MMPs. Members were transitioned to aligned Dual-Eligible Special Needs Plans (D-SNPs) that coordinate Medicare and Medicaid the same way.

Did I lose my health coverage when Prime ended? In almost all cases, no. Most Prime members were automatically enrolled into a new D-SNP so coverage continued without a gap. You should still confirm which plan you're now in and that it covers your doctors and prescriptions.

What is a D-SNP? A Dual-Eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage plan built specifically for people who have both Medicare and Medicaid. It coordinates both sets of benefits under a single plan, similar to what Healthy Connections Prime did.

Do I need to do anything now that Prime ended? Confirm which D-SNP you were moved into, check that it includes your doctors, hospital, pharmacy, and medications, and switch to a different aligned D-SNP if the fit is wrong. Also keep your Medicaid active by responding to any renewal notices from SCDHHS.

Can I switch to a different D-SNP if I don't like the one I was assigned? Usually, yes. Because you have both Medicare and Medicaid, you generally have more flexibility to change plans than other people and don't have to wait for the annual enrollment period. SCDHHS or a licensed agent can tell you your current options.

Where can I get free help choosing a plan? You can contact SCDHHS, call 1-800-MEDICARE, use South Carolina's SHIP for free counseling, or work with a local licensed agent. Help choosing a Medicare plan is free — you should never pay for it.