South Dakota Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in South Dakota.
7.6 million Medicaid long-term care recipients nationwide
South Dakota Department of Social Services - Division of Medical Services
Processing Time
30-45 days for standard Medicaid; Choices Waiver applications take 45-60 days. South Dakota generally has adequate capacity with minimal waiting lists.
South Dakota Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in South Dakota, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). South Dakota follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$3,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
South Dakota Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $8,022/month average (semi-private), $8,800/month (private) (the average monthly nursing home cost in South Dakota).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in South Dakota
Nursing Home Care
Medicaid pays 100% of nursing home costs in South Dakota once eligibility is established. The average monthly cost is $8,022/month average (semi-private), $8,800/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Choices Waiver - Assisted Living Center Services: South Dakota's Choices Waiver includes services for individuals residing in licensed assisted living centers. Medicaid covers personal care, medication administration, and care coordination through the waiver. Room and board costs are not covered by Medicaid—residents must pay housing costs from their monthly income or other resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
South Dakota offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Choices Waiver
Serves individuals age 65+ or adults with physical disabilities who meet nursing facility level of care. Provides adult day services, assistive technology, case management, home-delivered meals, home modifications, homemaker services, personal care, personal emergency response systems, respite care, specialized supplies and equipment, and transportation. Approximately 3,200 participants.
Program Details →Community Support Provider (CSP) Program
State plan service (not a waiver) providing personal care and homemaker services to Medicaid beneficiaries who meet certain criteria but not necessarily nursing facility level of care.
Program Details →How to Apply for Medicaid in South Dakota
South Dakota Medicaid applications typically take 30-45 days for standard Medicaid; Choices Waiver applications take 45-60 days. South Dakota generally has adequate capacity with minimal waiting lists.. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in South Dakota through:
- Online at sss.sd.gov (South Dakota Benefits Portal)
- Phone: 1-877-999-5612 (SD Medicaid)
- Download application and mail to: SD Dept of Social Services, 700 Governors Drive, Pierre, SD 57501
- In-person at local Department of Social Services office
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in South Dakota from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
South Dakota-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Part B premiums. QI pays Part B premiums (limited funding).
Learn MoreWorking Disabled Medicaid (WDM)
Medicaid buy-in program for working individuals with disabilities. Allows income up to 250% FPL while maintaining Medicaid coverage.
Learn MoreNeed Help with South Dakota Medicaid?
Contact South Dakota Department of Social Services - Division of Medical Services for specific questions about eligibility, application status, or covered services.