Guide for 2022 Medicaid Eligibility in South Dakota
There are many paths to Medicaid eligibility. Medicaid eligibility can depend on factors such as your household size, household income, household assets, your age, and whether you have a disability. If you're under 65, your 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. Medicare recipients can be "dually eligible"—eligible for both Medicare and Medicaid—in which case Medicaid will help cover Medicare expenses. These programs typically include an asset test. Additionally, the way 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.
This page contains basic summary information for each major Medicaid pathway in South Dakota. For more detailed information, visit a group-specific guide below:
Children's Medicaid Income Limits
Medicaid eligibility for children is based on total household income. The income limit depends on your household size. There is no asset test.
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1 person household$2,117 / month
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2 person household$2,853 / month
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3 person household$3,588 / month
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4 person household$4,324 / month
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5 person household$5,059 / month
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6 person household$5,795 / month
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7 person household$6,530 / month
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Each additional person+$735 / month
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1 person household$2,366 / month
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2 person household$3,188 / month
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3 person household$4,011 / month
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4 person household$4,833 / month
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5 person household$5,655 / month
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6 person household$6,477 / month
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7 person household$7,299 / month
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Each additional person+$822 / month
Most states offer additional pathways for Medicaid eligibility to children with disabilities. These programs vary by state, but typically have higher income limits than the standard eligibility criteria. For more information, visit KidsWaivers.org.
Medicaid Income Limits for Adults 19-64
Standard Medicaid Income Limits
South Dakota is one of the states that did not roll out the Medicaid expansion, so Medicaid for most adults aged 19 - 64 with no dependents is not available in South Dakota
If you are a parent to a child under 18 or are pregnant, there are additional pathways to Medicaid eligibility. Expected children can be counted as part of your household size. The pregnancy Medicaid pathways are available until 60 days after the end of the pregnancy.
Medicaid for Parents
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1 person household$645 / month
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2 person household$869 / month
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3 person household$1,093 / month
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4 person household$1,318 / month
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5 person household$1,542 / month
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6 person household$1,766 / month
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7 person household$1,990 / month
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Each additional person+$224 / month
Medicaid for Pregnant Women
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1 person household$1,562 / month
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2 person household$2,105 / month
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3 person household$2,648 / month
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4 person household$3,191 / month
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5 person household$3,734 / month
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6 person household$4,276 / month
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7 person household$4,819 / month
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Each additional person+$542 / month
CHIP for Pregnant Women
South Dakota does not offer a CHIP program for pregnant women separately from Medicaid.
Medicaid Income Limits for Seniors and People with Disabilities
Medicare recipients can be "dually eligible"—eligible for both Medicare and Medicaid—in
which case Medicaid will help cover Medicare premiums and some other out-of-pocket medical expenses.
The eligibility criteria for these specific Medicaid pathways can be complicated,
both in terms of how income is counted and what income needs to be under in order to be eligible.
For all pathways below, there are significant deductions to your income that may apply, including
ignoring half of your earned (job) income. For a more accurate estimate use our Medicaid eligibility calculator.
For more information, view our Medicaid for Seniors guide.
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.
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1 person household$838 / month
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2 person household$1,129 / month
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1 person household$2,000
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2 person household$3,000
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.
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1 person household$2,831 / month
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2 person household$3,814 / month
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1 person household$8,000
Do not count your spouse's assets for eligibility for this program, always use household size of 1.
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.
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.
Qualified Medicare Beneficiary (QMB)
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1 person household$1,132 / month
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2 person household$1,525 / month
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1 person household$8,400
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2 person household$12,600
Specified Low-Income Medicare Beneficiaries (SLMB)
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1 person household$1,359 / month
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2 person household$1,830 / month
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1 person household$8,400
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2 person household$12,600
Qualifying Individuals (QI)
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1 person household$1,528 / month
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2 person household$2,059 / month
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1 person household$8,400
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2 person household$12,600
Medicaid for Long Term Care
Medicaid for Long Term Care provides support to those
with long-lasting health problems or disabilities and
includes services such as home health aides,
nursing home care, and
community based care that are not covered by regular Medicaid.
Most people would benefit from speaking to an expert before applying for
Medicaid for long term care.
If applying, consider contacting a Medicaid Navigator or a legal aid nonprofit in your state.
This website does not currently have any information about Medicaid for Long Term Care.