Qualifications for Medicaid in South Dakota

South Dakota Medicaid benefits eligibility is made available to qualifying applicants who need affordable health insurance coverage. South Dakota’s Department of Social Services is accountable for administering local Medicaid and CHIP programs. To meet Medicaid eligibility requirements, qualifying applicants must be low-income families, children, pregnant women or disabled adults. Candidates who meet Medicaid eligibility requirements will receive financial assistance for medical expenses such as doctor visits, prescription drugs, hospital stays, nursing home care and home health care needs. Other covered services are health services deemed medically necessary.

Below, Medicaid applicants can find information on Medicaid in South Dakota:

  • Who is eligible for Medicaid in South Dakota?

  • What are the requirements for Medicaid in South Dakota?

  • What are the requirements for Medicaid disabled services in South Dakota?

  • What are the requirements for Medicaid foster care youth in South Dakota?

  • What are the income requirements for Medicaid in South Dakota?

  • What are the Medicaid application guidelines in South Dakota?

Who is Eligible for Medicaid in South Dakota?

In South Dakota, several medical assistance programs are available to low-income residents who need medical assistance. Medicaid eligibility requirements are made available to uninsured children under age 19, low-income families, pregnant women, newborns, disabled children and women with cervical or breast cancer.

Additionally, SD Medicaid benefits eligibility is also available to disabled and elderly candidates. Eligible applicants include workers with disabilities, South Dakotans with developmental disabilities, applicants in adult foster care facilities, certain adults in assisted living facilities or nursing homes, South Dakotans with chronic renal disease who meet Medicaid benefits eligibility, quadriplegics, certain elderly adults, refugees and youth between the ages of 18 and 26 who are from former foster homes.

What Are the Requirements for Medicaid in South Dakota?

South Dakota Medicaid eligibility requirements include income and age restrictions. To apply for the Children’s Health Insurance Program (CHIP), children must be 19 or under and reside in the state of South Dakota. Low-income families who meet Medicaid benefits eligibility may be qualified to receive free or low-cost Medicaid coverage if the household consists of a parent or other adult caretaker relative and at least one dependent child.

Additionally, Medicaid benefits eligibility SD automatically applies to refugees in need under the Refugee South Dakota Medicaid program. This program provides Medicaid benefits eligibility to refugees who are not eligible to receive any other health care program. The program is available to refugees for eight months after they enter the U.S.

SD Medicaid benefits eligibility also applies to pregnant women and their newborn babies. Pregnant women who meet income, resource and general eligibility requirements may qualify to receive full or limited Medicaid coverage. Newborns meet Medicaid benefits eligibility until turning one year of age. Additionally, uninsured women may be eligible to receive Medicaid benefits from the Breast and Cervical Cancer Program if they are being treated for breast or cervical cancer. Medicaid benefits eligibility ends after treatment is completed or when the state determines that a woman is no longer eligible to receive Medicaid benefits under this category.

What Are the Requirements for Medicaid Disabled Services in South Dakota?

Other South Dakota Medicaid eligibility requirements apply to disabled beneficiaries. Available programs include the Disabled Children’s Program, South Dakota Medicaid program for Workers with Disabilities, Family Support Services, Home and Community Based Services for the Developmentally Disabled, South Dakota Medicaid for Individuals in Adult Foster Care Facilities and South Dakota Medicaid for Individuals with Chronic Renal Disease.

Several other SD Medicaid eligibility requirements apply to elderly adults who would require nursing home care or quadriplegics who would require nursing home care.

What Are the Requirements for Medicaid Foster Care Youth in South Dakota?

South Dakota Medicaid benefits eligibility also applies to former foster children if they leave foster care after their 18th birthday. Medicaid coverage will be available to the beneficiary until the candidate turns 26. There are no income or financial Medicaid eligibility requirements for former foster care youth.

What Are the Income Requirements for Medicaid in South Dakota?

Income requirements for South Dakota Medicaid benefits eligibility vary depending on the type of Medicaid program applying for. Rates may vary and are available in more detail through the South Dakota Department of Social Services.

However, South Dakota Medicaid eligibility requirements are as follows for low-income families: households of one may not earn more than $613 monthly; households of two who meet Medicaid benefits eligibility may not earn more than $770 monthly; households of three may not earn more than $880 monthly; households of four who meet Medicaid benefits eligibility may not earn more than $986 monthly; households of five may not earn more than $1,096 monthly; households of six who meet SD Medicaid eligibility requirements may not earn more than $1,206 monthly; households of seven may not earn more than $1,313 monthly and households of eight may not earn more than $1,419 monthly.

South Dakota Medicaid eligibility requirements for pregnant women who are applying for full coverage Medicaid benefits must meet the following income restrictions: households of one may not earn more than $408 monthly; households of two who meet Medicaid benefits eligibility may not earn more than $515 monthly; households of three may not earn more than $591 monthly; households of four who meet Medicaid benefits eligibility may not earn more than $664 monthly; households of five may not earn more than $741 monthly; households of six who meet SD Medicaid eligibility requirements may not earn more than $816 monthly; households of seven may not earn more than $891 monthly and households of eight may not earn more than $965 monthly.

What Are the Medicaid Application Guidelines in South Dakota?

For applicants who wish to learn about how to qualify for Medicaid in South Dakota, a Medicaid application should be completed and submitted to the South Dakota Department of Social Services.

Candidates who meet SD Medicaid eligibility requirements may apply for Medicaid online, by mail, fax, or by delivering the completed application to a local Department of Social Services office. Interviews are not required to apply for South Dakota Medicaid; however, applicants may request an interview if they prefer.



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