How Much Does Assisted Living Cost in South Carolina in 2026?

Assisted living in South Carolina costs a median of $5,350 a month in 2026, or about $64,200 a year.

That’s roughly $850 below the national median of $6,200 a month, which makes South Carolina one of the more affordable states for the level of care between living alone and a nursing home.

But that’s only a statewide average.

A studio in a coastal retirement town runs a different bill than a shared room outside Spartanburg.

And the base rate rarely covers everything a resident needs.

Note: This is general information, not financial or legal advice. Costs, program rules, and dollar amounts are subject to change.

What Assisted Living Costs in South Carolina in 2026

South Carolina’s statewide median for assisted living sits at $5,350 a month, according to the CareScout Cost of Care Survey, the industry’s longest-running annual price check on long-term care.

That works out to about $176 a day.

The same survey puts South Carolina 41st out of 50 states by cost, which sounds low until you flip it around.

Only nine states charge less.

Hawaii tops the national list above $12,000 a month, while Mississippi anchors the bottom near $4,400.

South Carolina lands comfortably in the cheaper half, closer to Mississippi’s end than Hawaii’s.

Why Prices Swing Across the State

A statewide median smooths over some real differences between a Lowcountry beach town and an Upstate mill town.

Coastal and tourist-heavy markets, think Charleston, Hilton Head Island, and Myrtle Beach, tend to price above the state median.

Land costs more there, staff wages run higher to compete with tourism jobs, and demand from retirees who moved south for the beach keeps waitlists tight.

Inland cities and rural counties tell a different story.

Upstate communities around Spartanburg and Greenville, along with rural Midlands and Pee Dee counties, often run below the statewide median.

Room type moves the number too.

A private one-bedroom apartment costs more than a shared room.

A community with a memory care wing for residents with Alzheimer’s disease or another dementia typically charges more across the board for the added staffing and locked-door security that comes with it.

What's Included in the Monthly Price

Most South Carolina communities build the monthly rate around a base package.

That typically covers a private or shared room, three daily meals, housekeeping, laundry, transportation to appointments, and staff on hand around the clock to help with bathing, dressing, and other daily tasks, the services a trade group lists as standard across most communities.

What it usually doesn't cover costs extra.

Communities typically bill higher tiers of hands-on care, medication management beyond a basic level, and incontinence supplies as add-ons.

They arrange outside services like physical therapy, podiatry, or hospice through a separate provider.

Ask every community for a full price sheet before signing anything.

A quote that looks cheap on the tour can rise fast once a resident needs more help than the base tier assumes.

Does Medicaid Cover Assisted Living in South Carolina?

Not directly, and that surprises many families.

Standard South Carolina Medicaid, called Healthy Connections, doesn't pay the room and board portion of an assisted living bill.

The workaround runs through the Community Choices Waiver, a home and community-based services (HCBS) program that the South Carolina Department of Health and Human Services (SCDHHS) administers.

It pays for the care side, like personal care assistance and case management, for people who need a nursing-facility level of care but choose to receive it at home, with a relative, or in a licensed community residential care facility (CRCF), the state's term for an assisted living residence.

Room and board still falls on the resident.

To qualify in 2026, a single applicant's income can't top $2,982 a month, and countable assets are capped at $2,000.

The waiver also isn't an entitlement.

Slots are limited, so a waitlist can form once they fill.

Optional State Supplementation and Other Help

South Carolina runs a second program built for CRCF residents, and it isn't Medicaid at all.

Optional State Supplementation (OSS) is a state-funded cash supplement that tops up a low-income resident's Supplemental Security Income (SSI) so they can afford to live in a licensed CRCF.

To qualify, a resident has to be 65 or older, blind, or disabled, a U.S. citizen or otherwise eligible, and living in a facility with an authorized OSS slot.

The net income limit rose to $1,804 a month effective January 1, 2026, tied to that year's Social Security cost-of-living adjustment, according to the SCDHHS OSS manual, which notes the limit is set annually by the state legislature.

Approved residents keep a small personal needs allowance, $85 a month as of 2026, for things like haircuts and snacks.

Between the waiver's waitlist and OSS's narrow income limit, most South Carolina families still end up paying privately, at least at first.

Nationally, the majority of assisted living residents use some form of private pay, while fewer than one in five rely on Medicaid for their care costs.

Long-term care insurance, a Department of Veterans Affairs (VA) benefit called Aid and Attendance, and a home sale are the usual ways people bridge the gap.

None of these programs move fast, so the best time to ask about the Community Choices Waiver or Optional State Supplementation is before a crisis forces the decision.

A call to the local Area Agency on Aging or an SCDHHS Community Long Term Care office can confirm whether a given South Carolina community even has an open OSS slot.

How South Carolina Compares to Nearby States

South Carolina undercuts both of its bigger neighbors.

North Carolina runs about $6,500 a month, more than a thousand dollars above South Carolina's median.

Florida lands closer, around $5,600 a month.

But South Carolina still comes in a few hundred dollars cheaper.

Georgia edges South Carolina on price by only a small margin, at roughly $5,300 a month.

For a family weighing a move to be closer to a South Carolina retiree, that gap matters over a multi-year stay.

A nursing home costs far more than any of these numbers.

A semi-private nursing home room in South Carolina runs about $9,034 a month.

A private room runs closer to $9,612, roughly double an assisted living rate for a much higher level of medical care.

How to Budget for the Cost

Start with a real price sheet, not a brochure estimate.

Ask each community for its base rate, its level-of-care tiers, and a written list of what triggers a rate increase.

Compare that against in-home care, since a full-time non-medical caregiver in South Carolina runs about $31 an hour, per the same CareScout survey cited above.

At 44 hours a week, that adds up to roughly $5,982 a month, close to the assisted living median once meals, housekeeping, and social activity are added back in.

The math often favors assisted living once a person needs more than part-time help.

FAQ

Is South Carolina cheap for assisted living compared to the rest of the country?

Yes. Its $5,350 monthly median ranks 41st out of 50 states, meaning only nine states charge less.

Does South Carolina Medicaid pay for assisted living?

It pays for care services through the Community Choices Waiver, not room and board, and only for applicants under strict income and asset limits.

What is Optional State Supplementation in South Carolina?

It's a state cash supplement, separate from Medicaid, that helps low-income residents in a licensed community residential care facility cover their costs.

Is assisted living cheaper in Charleston or Spartanburg?

Coastal markets like Charleston generally price above the state median, while Upstate cities like Spartanburg and Greenville tend to run below it.

How much does memory care add to the price in South Carolina?

Communities with a dedicated memory care wing typically charge more across the board for the extra staffing and security dementia care requires, though the exact amount varies by facility.