Apply For Medicaid South Dakota


How To Apply For Medicaid By Mail In South Dakota

The Push For, And Push Back, Against Medicaid Expansion In South Dakota

You can download and print a South Dakota Medicaid application online. You can also choose to have the Department of Social Services mail you a paper application. Try to complete the Medicaid application form to the best of your ability. If you are living with family members, or are considered a dependent, youll need the identifying information for your family members, as well as income information for the head of household.

To ensure your application does not need further review, make sure you provide all of the information asked of you on the application. Individuals who are currently holding a job will need to provide income information. Those who are considered a dependent of another member of the household will need to provide the head of households information and income data.

Once you have completed your application you will need to mail your application to the Department of Human Services. It may take a few weeks to process your Medicaid application form, but you will receive a response within 30 days of your application being processed.

If you are applying for Medicaid on the basis of disability, it can take up to 90 days to get a decision from the Medicaid office. If you have not received a response within a month, you may need to follow up. You can visit your local DSS office, or call the office to check on the status of your application.

What Is South Dakota Medicaid Number

South Dakota Medicaid number where you can call and speak to South Dakota state health care agent regarding Apply for Medicaid South Dakota is .

South Dakota Medicaid hours of operation regarding Apply for Medicaid South Dakota are Monday through Friday, from 8:00 am to 5:30pm, but the best calling hours for South Dakota Medicaid to call regarding Apply for Medicaid South Dakota are 9:30 am to 2:00 pm.

What Is The Income Level To Qualify For Medicaid

Eligibility is also based on annual household income before taxes. The maximum allowable income in South Dakota varies by household size, as displayed in the table below:

Household Size


However, there are some exceptions to these income limits. Disabled children who receive Supplemental Security Income are automatically eligible for Medicaid in South Dakota. Pregnant women and families may qualify for low-cost health coverage, such as the Children’s Health Insurance Program , even if they have a higher income. For example, a family of 4 can earn up to $95,400 per year and qualify for some benefits. South Dakota residents who are unsure of their eligibility can fill out an application or contact a local DSS office for more information.

Read Also: Obgyn In Houston That Accept Medicaid

How To Contact Your State Medicaid Department About Medicaid Or Chip

Learn about how to contact your state Medicaid department to see if you and your family qualify for Medicaid or CHIP.

TIP: This page helps you understand how you can contact your State Medicaid Agency for questions about Medicaid or CHIP. It is meant as a secondary resource for people using our site. The official resource for this information is

What Does South Dakota Medicaid Cover

South Dakota South Dakota Medicaid Hospice Notification Download ...

South Dakota Medicaid covers a variety of medically necessary care. Covered care and services may include:

  • Annual physicals
  • Emergency care
  • Mental health care

There are some limits on covered services. For example, although regular physicals are covered, each enrollee is typically limited to one exam per year. Specialist and out-of-state care usually require pre-authorization, and emergency room coverage is only available for serious medical emergencies.

Don’t Miss: Social Security Medicaid Card Replacement

How Many People Are On Medicaid

According to the Centers for Medicare & Medicaid Services, as of November 2020, here are the number of people enrolled in Medicaid and Chip in the entire United States:

  • 78,521,263 individuals were enrolled in Medicaid and CHIP
  • 72,204,587 individuals were enrolled in Medicaid
  • 6,695,834 individuals were enrolled in CHIP

South Dakota Telepsychiatry Laws & Regulations

Understanding state laws and regulations is essential when starting a telepsychiatry program. No two states are alike and in the current climate, laws are changing rapidly. A resource we recommend for staying up to date is the Center for Connected Health Policys website.

South Dakota Medicaid

South Dakota Medicaid will reimburse for certain telemedicine services as long as they are conducted via live video. The maximum reimbursement for telehealth services is the amount that would be reimbursed if the service was conducted in-person. In order to be eligible for reimbursement, providers must comply with any prior authorization requirements. Additionally, services provided via telehealth are subject to the same requirements and limitations as in-person services. Psychotherapy is included in the reimbursable services, for complete details on eligible mental health clinicians and services see the South Dakota Medicaid Billing and Policy Manual for independent mental health practitioners.

Private Payer & Parity Laws

Many states have parity laws that prevent private payers from excluding certain services from their coverage. In South Dakota, health insurers are prohibited from excluding coverage just because a service was provided via telehealth. As long as accepted services provided via telehealth are in accordance with applicable law and healthcare guidelines, insurers cannot exclude coverage.

Don’t Miss: Iowa Medicaid Customer Service Number

What Is South Carolina Medicaid Number

South Carolina Medicaid number where you can call and speak to South Carolina state health care agent regarding South Carolina Medicaid Application is .

South Carolina Medicaid hours of operation regarding South Carolina Medicaid Application are Monday through Friday, from 8:30 am to 4:30pm, but the best calling hours for South Carolina Medicaid to call regarding South Carolina Medicaid Application are 10:00 am to 3:30 pm.

Penalty Information In South Dakota For Medicaid

Medicaid Expansion in South Dakota with Mitch Richter

If a gift of any amount is given in South Dakota during a period of 5 years before applying to Medicaid, a penalty period will be initiated. This penalty period in South Dakota is called a look-back period and it can make an individual not eligible for Medicaid. Medicaid will not pay for care until the penalty period is over. The penalty is calculated by taking the total amount of any gifts given, and dividing it by $ 6,215, which creates a number of months before Medicaid kicks in.

The average cost of Nursing home care in South Dakota is $6,509, so penalties can become very costly for a family that has not planned appropriately for Medicaid.

Read Also: Dcbs Ky Medicaid Phone Number

Expansion Under The Affordable Care Act

The Affordable Care Act provided for the expansion of Medicaid to cover childless adults whose income is 138 percent of the federal poverty level or below. The provision for expanding Medicaid went into effect nationwide in 2014. As of November 2018, a total of 36 states and Washington, D.C., had expanded or voted to expand Medicaid.

South Dakota had not expanded Medicaid under the Affordable Care Act as of June 2017. South Dakota GovernorDennis Daugaard expressed opposition to Medicaid expansion in 2015 when he stated, “I just don’t know if the money works.” Daugaard did support a proposal that would have expanded Medicaid to those with incomes at 100 percent of the federal poverty level, but it was rejected by the federal government. Governor Daugaard reconfirmed his opposition to Medicaid expansion in November 2016, stating, “On Monday, I met with Vice President-elect Mike Pence. … Based on that discussion, I will not recommend that South Dakota pursue Medicaid expansion in 2017.”


Arguing in support of the expansion of Medicaid eligibility in an April 2013 article, the Center for American Progress states that the expansion helps increase the number of people with health insurance and benefits states economically. The organization argues that by providing health insurance to those who would otherwise be uninsured, Medicaid expansion allows low-income families to spend more money on food and housing:


Rapid City Sd Medicaid Food Stamp And Welfare Office

RAPID CITY SD Medicaid Food Stamp and Welfare Office administrates your local program under South Dakota State guidelines. Medicaid provides health care for low income people. Supplemental Nutrition Assistance Program or Food Stamps helps low-income families buy food. While Welfare program give assistance to those who have little or no income.


You May Like: What Is A Medicaid Provider Number

How To Apply To Medicaid

Watch this video to learn about Medicaid application process and how to apply to Medicaid to get your state health insurance, Medicaid eligibility and more.

Are you looking for additional information for Medicaid or any state health insurance? Do you need any assistance with Medicaid application? Please contact us and we will be happy to help you with any Medicaid application related matter.

Good & Healthy South Dakota

Form DSS

The South Dakota Office of Chronic Disease Prevention and Health Promotion created Good & Healthy South Dakota to provide educational resources and assistance for South Dakotans in need.

Coupled with Good & Healthy South Dakota are several programs throughout the state for tobacco cessation, cancer screenings, newborn health, opioid addiction, and more.

Also Check: Free Car Seat Through Medicaid Texas

How To Apply For Medicaid In Person South Dakota

Medicaid application forms in South Dakota can also be submitted in person at your local Department of Social Services office. Local office information can be found directly on the states DSS website. South Dakotas DSS is dedicated to building strong families and there are several office locations dedicated to serving the community. Find an office close to your home by using the DSS website.

Before you head down to a local office, please ensure you have all of the necessary identifying information with you. You may print an application beforehand to ensure all of your information is correct, and you have accompanying documentation.

Discover all of the steps you must take when applying for Medicaid by .

Medicaid Eligibility Program Overview

Medicaid pays for the cost of Nursing Home care in South Dakota that meet certain financial and health criteria. The average cost of Skilled Nursing Care in South Dakota is $74,820, so securing Medicaid coverage is essential. In South Dakota there are 112 Nursing Homes, of which 99% accept Medicaid insurance as a form of payment. The most expensive Nursing Home in South Dakota is The Neighborhoods At Brookview which costs $331 per day and the least expensive Nursing Home is Oakview Terrace which costs $119 per day. Nursing Homes in South Dakota are currenlty 90.29% full with 6,112 patients currently using the 6,769 beds available.

To learn about the entire Medicaid eligibilty process, we have put together a comprehensive medicaid nursing home guide which you can read here.

Recommended Reading: Dentist That Take Medicaid In Michigan

South Dakota Medicaid Income Limit Charts

The South Dakota Medicaid eligibility income limit charts are divided by groups.

For example, the first chart is focused on income limits for children who qualify for Medicaid.

Similarly, the second chart below focuses on the Medicaid income limits for adults in South Dakota who qualify for Medicaid.

South Dakota Medicaid Income Limit for Children

Below is the income limit for children by age category. Find the age category your child falls into and you will see the income limit by household size.

South Dakota Medicaid Income Limit Children
Children Medicaid Ages 0-1

How to Read the South Dakota Medicaid Income Limits Charts Above

You cannot have an income higher than the Federal Poverty Level percentage described for your group to be eligible for Medicaid.

Similarly, when you identify the income group that applies to you, the income limit you see refers to the maximum level of income you can earn to qualify for benefits.

For example, if you are pregnant, to qualify for Medicaid, you cannot have an income higher than 133% of the Federal Poverty Level which for a family of two is $23,169 as shown in the chart above.

How To Apply For Medicaid By Phone In South Dakota

South Dakota and Sanford Health settle Medicaid case

While most people apply for Medicaid online, there is a phone option for those who do not feel comfortable completing their application online. The staff is available Monday through Friday from 9:00 a.m. to 5:00 p.m. to help individuals fill out their applications.

There will be several types of Medicaid insurance to discuss, so before you call, it is important that you have all of your verifying information available. You will need the social security number of all members of your family who will be applying, in addition to a W-2 for income verification, if you work.

In the event you do not have all of the required information on hand, you can still apply. Once youve applied on the phone, you may be contacted for further identity verifying information, if you were unable to provide all the information needed at the time.

Once your application is processed, a decision on your Medicaid benefits eligibility will be made within 30 days of the application. If you are approved you will receive your Medicaid card, and accompanying benefits information within 7 business days of approval.

Don’t Miss: Does Medicaid Pay For Prescription Glasses

Children’s Health Insurance Program

The Children’s Health Insurance Program is a public healthcare program for low-income children who are ineligible for Medicaid. CHIP and Medicaid are related programs, and the former builds on Medicaid’s coverage of children. States may run CHIP as an extension of Medicaid, as a separate program, or as a combination of both. Like Medicaid, CHIP is financed by both the states and the federal government, and states retain general flexibility in the administration of its benefits.

CHIP is available specifically for children whose families make too much to qualify for Medicaid, meaning they must earn incomes above 138 percent of the federal poverty level, or $33,948 for a family of four in 2017. Upper income limits for eligibility for CHIP vary by state, from 175 percent of the federal poverty level in North Dakota to 405 percent of the FPL in New York. States have greater flexibility in designing their CHIP programs than with Medicaid. For instance, fewer benefits are required to be covered under CHIP. States can also charge a monthly premium and require cost sharing, such as copayments, for some services the total cost of premiums and cost sharing may be no more than 5 percent of a family’s annual income. As of January 2017, 14 states charged only premiums to CHIP enrollees, while nine states required only cost sharing. Sixteen states required both premiums and cost sharing. Eleven states did not require either premiums or cost sharing.

South Dakota Long Term Care

South Dakota is an income cap state, meaning that in order to be eligible for Medicaid long term care benefits there is a hard income limit. Non income cap states allow applicants to spend down money for their care, whereas income cap states require the amount to be no higher than their limit at time of application.

You May Like: What Is The Household Income Limit For Medicaid

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.

Primary Care Management Reform Presentations

North Dakota Medicaid Application Form Form : Resume Examples

North Dakota Medicaid is hosting informational presentations on primary care management reform. The state is considering a new primary care management model as an alternative to it Primary Care Case Management program. Several presentations are planned this year to learn from other state Medicaid programs that have implemented care management models.

  • Alabama Medicaids Coordinated Health Networks

Dont Miss: How Much Money Disqualifies You For Medicaid

Also Check: Dentist Waco Tx Accept Medicaid

What Is South Carolina Medicaid Fax Number

South Carolina Medicaid fax number where you can send fax messages including application forms for South Carolina state health insurance is 803-285-7628.

Are you looking for additional information for South Carolina Medicaid and South Carolina state health insurance? Do you need any assistance with South Carolina Medicaid? Please contact us and we will be happy to help you with any Medicaid application related matter.

Does South Dakota Help With My Medicare Premiums

Many Medicare beneficiaries who struggle to afford the cost of Medicare coverage are eligible for help through a Medicare Savings Program . In South Dakota, these programs pay for Medicare Part B premiums, Medicare Part A and B cost-sharing, and in some cases Part A premiums.

  • Qualified Medicare Beneficiary : The income limit is $1,063 a month if single and $1,437 a month if married. QMB pays for Part A and B cost sharing, Part B premiums, and if a beneficiary owes them it also pays their Part A premiums.
  • Specified Low-Income Medicare Beneficiary : The income limit is from QMB levels up to $1,276 a month if single and $1,724 a month if married. SLMB pays for Part B premiums.
  • Qualified Individuals : The income limit is from SLMB levels up to $1,436 a month if single and $1,940 a month if married. QI pays for Part B premiums.

MSP asset limits: The asset limits for QMB, SLMB and QI are $7,860 if single and $11,800 if married.

You May Like: Eye Doctors That Accept Alabama Medicaid

Also Check: How Much Money Disqualifies You For Medicaid

What Are The Requirements For Medicaid In South Dakota

South Dakota Medicaid benefits eligibility is made available to qualifying applicants who need affordable health insurance coverage. South Dakotas 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.


More like this

How Do I Sign Up For Pregnancy Medicaid

Can Uninsured...

Can Medicaid Take My Settlement Money

What Are...

What Is Family Planning Medicaid Nc

There Are...

Is Everyone Eligible For Medicaid

What If...