Topics on this page:
Medicaid in South Dakota*
"The Department of Social Services’ Division of Economic Assistance is responsible for administering the Medicaid and Children’s Health Insurance (CHIP) Programs to help low income individuals, families and children.
Medical Assistance Programs are available to help pay for the necessary medical expenses individuals need to stay healthy.
These expenses may include: hospital stays, doctor visits, prescriptions, nursing home care and other health care needs..."
*source: South Dakota Department of Social Services , Pierre, SD 57501
Definitions of Medicaid in South Dakota
Children's Medicaid in South Dakota
See the section on this page Health Programs for Children: CHIP: South DakotaNote: You will need the Adobe® Reader® software to open and read some of these publications. Get it from Adobe®
Medicaid in South Dakota: How It Works; An Introduction to South Dakota Medicaid; What is South Dakota Medicaid?
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- web page:
A Consumer's Guide to Getting and Keeping Health Insurance in South Dakota: MEDICAID
source:healthinsuranceinfo.net - Georgetown University's Health Policy Institute
languages: English
from the webpage:
"...Medicaid is a program that provides health coverage to some low-income South Dakota residents... Legal residents who are not U.S. citizens may be eligible for Medicaid However, questions concerning immigration status and eligibility should be directed to the South Dakota Department of Social Services...
"
- web page:
Key Medicaid Information for South Dakota for 2010
source:Elder Law Answers
languages: English
Explains important basics about South Dakota Medicaid. Topics include protections for the community spouse, transfers, income, and estate recovery..."
- brochure:
The Medicaid Program at a Glance
source:The Kaiser Commission on Medicaid and the Uninsured
file size: 2 pg. languages: English
This fact sheet provides an overview of the Medicaid program, the populations that it serves, the services that it covers and the expanded role it will play under the health reform law...- also from The Kaiser Commission on Medicaid and the Uninsured:
brochure:
Medicaid: A Primer
languages: English
from the brochure:
"This primer provides an overview of the basic components of Medicaid, the nation's largest health coverage program, which covers nearly 60 million low-income individuals, including children and families, people with disabilities and seniors who are also covered by Medicare...
"
- also from The Kaiser Commission on Medicaid and the Uninsured:
- web page:
South Dakota & United States State Medicaid Fact Sheets
source:Kaiser Family Foundation
languages: English - web page:
South Dakota Medical Assistance for Low Income Families (LIF) Program
source:GovBenefits.gov - Your Benefits Connection
languages: English
from the web page:
"The Medical Assistance for Low-Income Families (LIF) program is designed to help low-income South Dakota families (with or without private health insurance) receive full medical assistance coverage. LIF is funded through the Medicaid program and covered services include...
"
South Dakota Medicaid Eligibility, How to get Medicaid in South Dakota, Requirements
- web page:
Low-Income Families
source:South Dakota Department of Social Services
languages: English
"Low income families in South Dakota (with or without private health insurance) may be eligible for FREE or low cost medical assistance including regular checkups, Well-Child Care exams, dental care, and vision care..."
- also from South Dakota Department of Social Services:
web page:
Medical Assistance for Low-Income Families - Income Guidelines
languages: English
from the web page:
"Eligibility for Low Income Families (LIF) requires that a dependent child and a caretaker relative be present in the home. When determining family size, include the parent(s), stepparent, or caretaker relative living in the home with the dependent child and any blood related brothers and sisters living in the home ...
"
- also from South Dakota Department of Social Services:
- web page:
South Dakota: Medicaid/CHIP Eligibility
source:Kaiser Family Foundation
languages: English
from the web page:
"Medicaid and State Funded Coverage Income Eligibility Limits for Low-Income Adults, 2009..."
- web page:
2011 HHS Poverty Guidelines
source: Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services
languages: English
from the web page:
"...The poverty thresholds are the original version of the federal poverty measure... The poverty guidelines are the other version of the federal poverty measure.
- web page:
Medicaid Eligibility
source: Centers for Medicare & Medicaid Services
languages: English
Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.
South Dakota Medicaid Citizenship Requirements
- brochure:
Citizenship Documentation Requirements in Medicaid
source:Kaiser Family Foundation
3 pages; languages: English
from the publication:
"Medicaid citizenship requirements Under federal law, all U.S. citizens and certain legal immigrants who meet Medicaid’s financial and non-financial eligibility criteria are entitled to Medicaid. The Medicaid program has long required states to establish that individuals applying for Medicaid are U.S. citizens or satisfy the immigration restrictions.... "
- brochure:
Medicaid Citizenship Verification Requirement
source:American Public Human Services Association
5 pages; languages: English
from the publication:
"What has changed? In the Deficit Reduction Act of 2005, a new requirement was established with respect to citizenship verification of current and new Medicaid applicants. Citizen applicants were previously able to self-attest their citizenship and identity under penalty of perjury to qualify for Medicaid..... "
Applying for South Dakota Medicaid
- web page:
How do I apply for Medical Assistance for Low-Income Families?
source:South Dakota Department of Social Services
languages: English
from the web site:
"It's easy to apply! You may apply by printing the application below and mailing, faxing, or delivering your application to a Department of Social Services local office. You may also contact your nearest Department of Social Services office or call 1-800-305-3064 to request an application be sent to you...
"- also from South Dakota Department of Social Services:
web page:
Download and print application for Medical Assistance for Low-Income Families
languages: English
- also from South Dakota Department of Social Services:
South Dakota Medicaid Offices
- web page:
LOCAL OFFICES
source:South Dakota Department of Social Services
languages: English
from the web page:
"The Department of Social Services has full time and itinerant offices located in 64 communities throughout South Dakota...
" - hotline:
South Dakota Medicaid Helpline
South Dakota Medicaid Health Plans, HMO, South Dakota Managed Care
- web page:
Managed Care Program
source:South Dakota Department of Social Services
languages: English
from the web page:
"The Managed Care Program is designed to improve access to medical care for Medicaid/CHIP recipients as well as improve the quality of care they receive by giving them a medical home....
" - web page:
South Dakota: Medicaid Managed Care
source:Kaiser Family Foundation / statehealthfacts.orgn
languages: English
from the web page:
"Medicaid Managed Care Enrollees... Medicaid Enrollment in Comprehensive Managed Care Plans... Medicaid Managed Care Enrollees as a Percent of State Medicaid Enrollees
"
Find South Dakota Medicaid Physicians, Doctors
- web page:
South Dakota Managed Care Program Primary Care Provider List
source:South Dakota Department of Social Services
languages: English, Spanish
from the web page:"Click on a county to select that county or Ctrl+Click to select multiple counties that you would like to have displayed on the Provider List, then Click on the Submit Button to display the Provider List for the counties that you have selected...."
Disclaimers: Call the Provider first to see if they are accepting new patients.
Children's Medicaid: Health Programs for Children: South Dakota CHIP:
What is Medicaid for children in South Dakota?
Children's Medicaid in South Dakota; Children's Health Care: CHIP
-
"The South Dakota Children's Health Insurance Program (CHIP) provides quality health care (including regular check-ups, Well-Child Care exams, dental care, and vision care) for children and teenagers
To be eligible for CHIP, children must be under the age of 19 and be residents of South Dakota. Children who are uninsured or already have health insurance may be eligible for CHIP based on family size and income."
*source: South Dakota Department of Social Services , Pierre, SD 57501 What is CHIP?
- "
Originally created in 1997, the Children's Health Insurance Program (CHIP) is a state and federal partnership that provides low-cost health insurance coverage for children in families who earn too much income to qualify for Medicaid but cannot afford to purchase private health insurance coverage. States have considerable flexibility to establish income eligibility rules for CHIP, but children enrolling in the program must be otherwise uninsured.
"
source: InsureKidsNow.gov - Sponsored by the U.S. Department of Health and Human Services. , Washington, DC
- web page:
CHIP - Frequently Asked Questions
source:South Dakota Children's Health Insurance Program (CHIP)
languages: English,Español
from the webpage:
"PeachCare for Kids™ began covering children in 1999, providing comprehensive health care to children through the age of 18 who do not qualify for Medicaid and live in households with incomes at or below 235% of the federal poverty level...
"- also from South Dakota Children's Health Insurance Program (CHIP) :
brochure:
CHIP brochure
2 pages; languages: English
from the brochure:
"The CHIP program is provided at no cost to reduce the number of uninsured children in South Dakota and to improve the quality of medical care for a healthier tomorrow...
"
- web page:
How do I apply for CHIP?
languages: English,Español
from the web page:
"It's easy to apply for CHIP! You may apply by printing the CHIP application below and mailing, faxing, or delivering your application to a Department of Social Services local office...
"
- web page:
Income Guidelines for Children with Private Health Insurance
languages: English,Español
from the web page:
"To determine if a child with private health insurance may be eligible for medical assistance, follow the steps outlined below:...
"
- also from South Dakota Children's Health Insurance Program (CHIP) :
- web page:
South Dakota Children’s Health Insurance Program (CHIP)
source:healthinsuranceinfo.net - Georgetown University's Health Policy Institute
languages: English
from the webpage:
"...The (South Dakota) Children’s Health Insurance Program (CHIP) is a state program that provides health insurance to low-income families with children under the age of 19 who are not eligible for Medicaid and are uninsured...
"
- bublication / brochure:
Children’s Health Coverage South Dakota
source:Children's Defense Fund
languages: English
from the web page:"South Dakota has programs that provide free and low-cost health care to children. If you are a family of four with income of $... or less, your children may be eligible for CHIP. If you are a family of four with income of $... or less, your children may be eligible for additional benefits under Medicaid. There is one application for both programs. The state will determine which is right for you...."
- also from Children's Defense Fund:
brochure:
Health Coverage for All Children: South Dakota
2 pages; languages: English
from the brochure:
"How simple are enrollment procedures in CHIP and Medicaid for South Dakota’s children? Simplification procedures: No face-to-face interview No asset test Joint application...
"
- also from Children's Defense Fund:
- brochure or publication:
South Dakota MEDICAID FACTS
source:AMERICAN ACADEMY OF PEDIATRICS
languages: English
from the web page:
"The Medicaid program provides health insurance for over 70,000 low-income children in South Dakota. Medicaid is an indispensable health program providing health insurance coverage for part or all of the year to one in three children.
" - Medicaid brochure:
South Dakota Public Health Insurance for Children
source:National Center for Children in Poverty (NCCP)
languages: English, Spanish
from the brochure:
"...The two major federal funding sources for low-income children’s public health insurance are Medicaid and the State Children’s Health Insurance Program (SCHIP). States enjoy some flexibility in their Medicaid programs for children,...
"- also from National Center for Children in Poverty (NCCP):
web page:
South Dakota Public Health Insurance for Parents
languages: English
from the web page:
"Most family plans are funded through Medicaid, but a handful of states have waivers to use State Children’s Health Insurance Program (SCHIP) funds to cover parents. ...
"
- web page:
South Dakota Demographics of Low-Income Children
languages: English
from the brochure:
"In South Dakota, there are 106,924 families, with 194,414 children.
Low-Income Children: 37% (70,965) of children live in low-income families (National: 41%), defined as income below 200% of the federal poverty level..."
- also from National Center for Children in Poverty (NCCP):
- web page:
South Dakota: CHIP Program Name and Type
source:Kaiser Family Foundation statehealthfacts.org
languages: English, Spanish
from the web page:
"Individual state profiles...
" - web page:
South Dakota CHIP
source:GovBenefits.gov - Your Benefits Connection
languages: English
from the webpage:
"...In order to qualify for this benefit program, you must be a resident of the State of South Dakota, under 19 years of age, not covered by health insurance (including Medicaid), a US national, citizen, legal alien, or permanent resident, and you must have an annual household income before taxes of less than...
"
- web page:
South Dakota Medicaid, SCHIP, & Federal Authority
source:State Coverage Initiatives
languages: English
South Dakota Medicaid Benefits and Coverage: Medicaid Services
- web page:
Covered Services
source:South Dakota Department of Social Services
languages: English
from the web page:
"It is your responsibility to ask your medical provider (your doctor, pharmacist, etc.) if Medical Assistance covers particular services. Do NOT assume that all medical services are covered and paid for by Medical Assistance...
" - brochure or publication:
Women and Medicaid in South Dakota
source:National Women's Law Center
3 pages; languages: English, Spanish
from the brochure or publication:
"Tens of thousands of women in South Dakota receive health care coverage through Medicaid... Medicaid is the most important source of coverage for low-income women. In 2006-07, 19 percent of all low-income women in South Dakota were enrolled in the program. 7
"
- web page:
Benefits by State: South Dakota (October 2008)
source:Kaiser Family Foundation
languages: English, Spanish
from the web page:
"Medicaid benefits: Online database
"
- web page:
South Dakota: CHIP Program Name and Type
source:Kaiser Family Foundation statehealthfacts.org
languages: English, Spanish
from the web page:
"Individual state profiles...
" - brochure or publication:
Mental Health and Substance Abuse Services in Medicaid and SCHIP in South Dakota (2003)
source: US Dep't of Health and Human Services, Substance Abuse and Mental Health Services Administration
file size: 4 pg.; languages: English
from the brochure:
"In South Dakota, low-income children may be enrolled into the Medicaid program, a SCHIP Medicaid expansion program, or a separate SCHIP program based on the child’s age and their family’s income.....
"
Medicaid Prescription Drugs; Preferred Drug List
South Dakota Medicaid Dental Services; Dentist
- brochure or publication:
SD Medical Assistance Dental FAQs
source:South Dakota Department of Social Services
1 page; languages: English
from the brochure or publication:
"Why is it hard to find a dentist who will accept South Dakota Medicaid?... May I continue to see my current dentist? ...I don’t know where to go to find a dentist who will accept me as a Medicaid recipient. Can anyone help me? ...What do I need to know or do when I find a dentist?
" - web page:
Find an Oral Health Provider: South Dakota Dental Providers
source:InsureKidsNow.gov
languages: English
- also from InsureKidsNow.gov:
web page:
South Dakota (Dental) Benefits Description
languages: English
from the web page:
"Under the Medicaid State Plan dental benefits are provided to eligible individuals under the age of 21 in compliance with the requirements of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services...
"
- also from InsureKidsNow.gov:
- brochure or publication:
Guide to Children's Dental Care in Medicaid
source:Centers for Medicare & Medicaid Services
52 pages; languages: English
from the brochure:"The Guide is intended to serve as a resource of current information on clinical practice, evolving technologies and recommendations in dental care. The guide is not intended to change current Medicaid policies, nor is it intended to impose any new requirements on states..."
- also from Centers for Medicare & Medicaid Services:
web page:
Medicaid Dental Coverage - Overview
languages: English
from the web page:
"Dental services under Title XIX of the Social Security Act, the Medicaid program, are an optional service for the adult population, individuals age 21 and older. However, dental services are a required service for most Medicaid-eligible individuals under the age of 21, as a required component of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit...
"
- also from Centers for Medicare & Medicaid Services:
Other Health Coverage Options in South Dakota
- web page:
HRSA - Find a Health Center - Search Page
source:U.S. Department of Health & Human Services
languages: English
from the brochure:"Federally-funded health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income. Health centers provide •checkups when you're well •treatment when you're sick •complete care when you're pregnant •immunizations and checkups for your children •dental care and prescription drugs for your family •mental health and substance abuse care if you need it..."
- brochure:
South Dakota Health Center Fact Sheet
source: National Association of Community Health Centers (NACHC)
languages: English
from the brochure:"...South Dakota Federally-Supported Health Centers, 2008"
- also from National Association of Community Health Centers (NACHC):
web page:
Find a Health Center
languages: English
from the web page:
"If you need affordable health care, a Community Health Center may be what you're looking for... Click here to find the health center closest to your address or to see a list of health centers in your state or county/parish...
"
- also from National Association of Community Health Centers (NACHC):
- brochure:
South Dakota Health Care Options Matrix™ Guide
source:Foundation for Health Coverage Education
2 pages; languages: English, Spanish
from the brochure:"...hand-held guide available that outlines your state’s (South Dakota) public and private health care choices for individuals and groups in almost every demographic profile, as well as offers a reference list of phone numbers and Web sites...
" - brochure:
Consumer Guide for Getting and Keeping Health Insurance in South Dakota
source:Georgetown University Health Policy Institute
file size: 42 pg.; languages: English
from the brochure:
"...As a South Dakota resident, you have rights under federal and state law that will protect you when you seek to buy, keep, or switch your health insurance, even if you have a serious health condition. This guide describes your protections as a South Dakota resident......
"
South Dakota Medicaid and Nursing Homes, Assisted Living, Home Health Care
- web page:
Long-Term Care - Medical Assistance for Long-Term Care
source:South Dakota Department of Social Services
languages: English
from the web page:
"The following medical assistance programs are available for people who need long-term care...
"- also from South Dakota Department of Social Services:
web page:
Medical Assistance for Individuals in Nursing Facilities or Homes
languages: English
from the web page:
"Individuals in nursing facilities or homes who meet eligibility criteria may qualify for Medical Assistance. Eligibility Requirements... Covered Services... Basic Budget...
" - web page:
Medical Assistance for Individuals in Assisted Living Facilities
languages: English
from the web page::
"Individuals in assisted living centers who meet all eligibility criteria may qualify for Medical Assistance. Eligibility Requirements... Covered Services... Application ...
" - brochure:
Medicaid Spousal Care Handbook
16 pages; languages: English
from the brochure:
"Medicaid can help couples pay the cost of a spouse's care in a medical facility...
"
- also from South Dakota Department of Social Services:
-
web site:The South Dakota Long Term Care Care Project
South Dakota Medicare Medicaid Nursing Homes Directory
languages: English
from the web page:
"These are South Dakota Nursing Homes in cities A - Z.
" In addition to the state directory described above, there are nursing home directories for principal South Dakota cities. A few examples:
South Dakota Assisted Living
languages: English
from the web page:
"A consumer's guide to information and help about assisted living in South Dakota, with a directory of assisted living facilities...
"
South Dakota Home Health Care Agencies
languages: English
from the web page:
"Directory of South Dakota Home Care Providers and Home Health Agencies, sorted by South Dakota cities. ...
"
South Dakota Medicare / Medicaid Dual Eligibles - South Dakota Medicare Savings Program
- web page:
Medicare Recipients
source:South Dakota Department of Social Services
languages: English
from the web page:
"The Medicare Savings Program assists individuals with payment on their Medicare expenses. This program can save people up to $1,156 each year...
"- also from South Dakota Department of Social Services:
web page:
South Dakota Application for Medicare Savings Program
languages: English
from the web page:
"This application CAN be used for a single person or a couple (self and spouse). This is NOT an application for full Medicaid, cash assistance, or the Supplemental Nutrition Assistance Program. If you want more information...
"
- also from South Dakota Department of Social Services:
- brochure:
Medicaid Coverage of Medicare Beneficiaries (Dual Eligibles) At A Glance
source:Centers for Medicare & Medicaid Services
4 pages; languages: English
from the brochure:
"Individuals who are entitled to Medicare Part A and/or Part B and are eligible for some form of Medicaid benefit are often referred to as “dual eligibles.” These benefits are sometimes referred to as Medicare Savings Programs (MSPs). Dual eligibles are eligible for some form of Medicaid benefit, whether that Medicaid coverage is limited to certain costs, such as Medicare premiums, or the full benefits covered under the State Medicaid plan...
" - brochure:
Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries
source:Kaiser Family Foundation: Medicaid/CHIP
languages: English
2 pages; from the brochure:
"Nearly 8.8 million Medicaid beneficiaries are “dual eligibles” – low-income seniors and younger persons with disabilities who are enrolled in both the Medicare and Medicaid programs. Dual eligibles are among the sickest and poorest individuals covered by either the Medicaid or Medicare programs...
"
South Dakota Medicaid Waiver Programs
- web page:
Contact Info and Descriptions for all South Dakota Medicaid 1915(c) HCBS Waivers, 2006
source:Center for Personal Assistance Services
languages: English
from the web page:"TThe following is a list of all South Dakota 1915(c) Waivers by name - complete with a description, contact information and web link..."
- web page:
(South Dakota) Medicaid Waivers and Demonstrations List
source:Centers for Medicare & Medicaid Services
languages: English
from the web page:
"...This list contains information about state-specific Medicaid waiver and demonstration programs. Users can access fact sheets, copies of proposals, approval letters, and other documents related to specific programs...
"
Report Medicaid Fraud in South Dakota
- web page:
Medicaid Fraud Control Unit
source:South Dakota Attorney General
languages: English
from the web page:"The South Dakota Medicaid Fraud Control Unit consists of an Assistant Attorney General, two investigators, one auditor, and an administrative assistant, all of whom work under the direction of the Attorney General..."
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