Are you eligible for Medicaid? See if you might qualify by using our Medicaid eligibility calculator
South Dakota Medicaid Eligibility Information - 2022
There are many paths to Medicaid eligibility. Medicaid eligibility can depend on factors such as
your household size, household income, household assets, you age, and whether you have a disability. If you're
under 65 and don't have a disability, you're eligibility will likely be based on your income only (no asset test).
If you're over
65 or have a disability, you're likely eligible for Medicare. If eligible for Medicare,
there are alternate pathways to Medicaid eligibility which typically include asset tests. Additionally,
the way that your income is calculated for these programs is more complicated, meaning that your
income could be above the income limits and you'd still be eligible.
For a more personalized estimate, you can
use our Medicaid eligibility calculator.
Please note that there may be other
health insurance assistance programs offered by your state not listed here,
and there may be other eligibility
requirements for these programs that are not listed here. Additionally, the way that household income
and household size are calculated can differ from a household's
total pre-tax income and the number of people on the tax return.
- Medicaid for Children 0 to 18
-
FPL
187%1$2,117/mo2$2,853/mo3$3,588/mo4$4,324/mo5$5,059/mo6$5,795/mo7$6,530/mo - CHIP for Children 0-18
-
FPL
209%1$2,366/mo2$3,188/mo3$4,011/mo4$4,833/mo5$5,655/mo6$6,477/mo7$7,299/mo - Medicaid for Pregnant Women
-
FPL
138%1$1,562/mo2$2,105/mo3$2,648/mo4$3,191/mo5$3,734/mo6$4,276/mo7$4,819/mo - Medicaid for Parents of Children 18 or Younger
-
FPL
57%1$645/mo2$869/mo3$1,093/mo4$1,318/mo5$1,542/mo6$1,766/mo7$1,990/mo - ABD Income Limits
-
FPL
74%1$838/mo2$1,129/mo - ABD Asset Limits
-
1$2,000 in assets2$3,000 in assets
- Working People with Disabilities Income Limits
-
FPL
250%1$2,831/mo2$3,814/mo - Working People with Disabilities Asset Limits
-
1$8,000 in assets2$8,000 in assets, exluding spouse's assets
- QMD Income Limits
-
FPL
100%1$1,132/mo2$1,525/mo - QMD Asset Limits
-
1$8,400 in assets2$12,600 in assets
- SLMB Income Limits
-
FPL
120%1$1,359/mo2$1,830/mo - SLMB Asset Limits
-
1$8,400 in assets2$12,600 in assets
- QI Income Limits
-
FPL
135%1$1,528/mo2$2,059/mo - QI Asset Limits
-
1$8,400 in assets2$12,600 in assets
Medicaid for Children
Medicaid eligibility for children without disabilities is based on total household income. The income limit depends on your household size. There is no asset test.
CHIP for Children
CHIP eligibility for most children without disabilities is based on total household income. The income limit depends on your household size. There is no asset test.
Medicaid for Children with Disabilities
Children with disabilities are often eligible for additional programs. These programs vary state to state. For more information visit kidswaivers.org
Medicaid & CHIP for Parents
If you are a parent or are pregnant, you may also be eligible for Medicaid. Expected children can be counted as part of your household size. The pregnancy Medicaid programs are available until 60 days after the end of the pregnancy.
Medicaid for Adults 19-64
Medicaid eligibility for adults that are not eligible for Medicare is based on total household income. The income limit depends on your household size. There is no asset test.
There is no Medicaid program for most non-parent adults in South Dakota
Aged, Blind, Disabled (ABD) Medicaid Pathway
The aged, blind, and disabled pathway to Medicaid eligibility is the most common pathway to eligibility
for those with a disability or over 65 years old. In general, states count your household size
as one or two, depending on whether you are married.
While there is an income limit and asset limit
for ABD Medicaid, there are significant deductions to your income that may apply, including
ignoring half of your earned (from a job) income. For a more accurate estimate use our Medicaid eligibility calculator.
Working People with Disabilities Medicaid Pathway
The working people with disabilities pathway to Medicaid eligibility is for people with disabilities that have at least $1 in earned income. Like ABD Medicaid, there are significant deductions to your income that may apply, including ignoring half of your earned (from a job) income. However, income and asset limits are often much higher than ABD Medicaid. For a more accurate estimate use our Medicaid eligibility calculator.
Medically Needy Medicaid Pathway
The medically needy pathway to Medicaid eligibility allows people who spend a significant
amount of their income on medical expenses to "spend down" their income to recieve Medicaid.
Like ABD Medicaid, there are significant deductions
to your income that may apply, including
ignoring half of your earned (from a job) income. Additionally, your monthly medical expenses
are subtracted from your income to get the final income that's used in the eligibility calculation.
For a more accurate estimate use our Medicaid eligibility calculator.
The Medically Needy pathway to Medicaid eligibility is not availble in South Dakota
Medicare Savings Programs
Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries
pay their Medicare premiums and in some case other Medicare-related expenses.
If an individual is eligible for Medicare Part A, they may qualify for one of the MSPs below.
The calculated income used for MSP eligibility is the same as that for the Aged,
Blind, and Disabled Medicaid pathway.
There are three common levels of MSPs. The Qualified Medicare Beneficiary program covers Part A & B premiums,
as well as some other out-of-pocket expenses, while the Specified Low-Income and Qualifying Individuals programs
cover Part B premiums only.
For a more accurate eligibility estimate use our Medicaid eligibility calculator.