The Medicaid Income Limit is the most important criteria for deciding whether you qualify for Medicaid in your state. In this post, we are going to explain in detail the South Dakota Medicaid Income Limits for 2021.
Based on this information, you will be able to determine whether your income qualifies you for South Dakota Medicaid or not.
However, before we get into details about the income limit, we will first explain the Medicaid program in South Dakota and how it works.
Next, we will discuss who is eligible for Medicaid, including how eligibility works for various categories, including Children, Pregnant Women, and Adults.
What is Medicaid?
Medicaid is a federal and state health insurance program for people with a low income.
It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.
The Children’s Health Insurance Program (CHIP) offers health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage.
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 Medicaid
The South Dakota Medicaid program provides medical coverage to low-income individuals and families.
As of 2020, the program, along with the Children’s Health Insurance Program (CHIP) covered 121,622 people.
This includes about 86,000 children as shown by the image below.
Medicaid in South Dakota is administered by the South Dakota Department of Social Services (DSS) agency.
Who Can Get Medicaid in South Dakota?
You should apply for Medicaid if your income is low and you match one of the descriptions below:
- You think you are pregnant
- The parent or caretaker of a child and/or teenager under the age of 19.
- You are a child or teenager age 18 or under.
- An adult age 65 or older.
- You are legally blind.
- Living with a disability or disabled.
- You are in need of nursing home care.
South Dakota Medicaid Income Limit
The South Dakota Medicaid Income Limit is calculated as a percentage of the Federal Poverty Line.
To qualify, you must meet the South Dakota Medicaid Income limits listed below.
Here is the Federal Poverty Level (FPL) for 2021.
| 2021 Federal Poverty Levels for the 48 Contiguous States & D.C. | |||
| Household Size | Poverty Guideline for 48 states & DC | Alaska | Hawaii |
| 1 | $12,880 | $16,090 | $14,820 |
| 2 | $17,420 | $21,770 | $20,040 |
| 3 | $21,960 | $27,450 | $25,260 |
| 4 | $26,500 | $33,130 | $30,480 |
| 5 | $31,040 | $38,810 | $35,700 |
| 6 | $35,580 | $44,490 | $40,920 |
| 7 | $40,120 | $50,170 | $46,140 |
| 8 | $44,660 | $55,850 | $51,360 |
| Over 8 people | add $4,540 for each additional person | $5,680 | $5,220 |
Additionally, to be eligible for Medicaid, you cannot make more than the income guidelines outlined below:
- Children up to age 1 with family income up to 182 percent of FPL
- Any child age 1-5 with a family income up to 182 percent of FPL
- Children ages 6- 18 with family income up to 182 percent of FPL
- CHIP for children with family income up to 204 percent of FPL
- Pregnant women with family income up to 133 percent of FPL
- Parents of minor children with family income up to 53 percent of FPL
- Individuals who are elderly, blind, and disabled with family income up to 74% of the FPL
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 | Children Medicaid Ages 1-5 | Children Medicaid Ages 6-18 | Children Separate CHIP | |||
| % FPL | 100% | 182% | 182% | 182% | 204% | |
|
Household Size
|
1 | $12,880 | $23,442 | $23,442 | $23,442 | $26,275 |
| 2 | $17,420 | $31,704 | $31,704 | $31,704 | $35,537 | |
| 3 | $21,960 | $39,967 | $39,967 | $39,967 | $44,798 | |
| 4 | $26,500 | $48,230 | $48,230 | $48,230 | $54,060 | |
| 5 | $31,040 | $56,493 | $56,493 | $56,493 | $63,322 | |
| 6 | $35,580 | $64,756 | $64,756 | $64,756 | $72,583 | |
| 7 | $40,120 | $73,018 | $73,018 | $73,018 | $81,845 | |
| 8 | $44,660 | $81,281 | $81,281 | $81,281 | $91,106 | |
Next is the income limit for adults by category. Find the category you fall into and you will see the income limit by household size.
South Dakota has not expanded Medicaid to include adults without dependents.
Therefore, adults without dependents do not qualify for Medicaid in South Dakota.
For an update on the Medicaid expansion debate and timeline in South Dakota, see our South Dakota Medicaid Expansion update below.
South Dakota Medicaid Income Limit for Adults
| South Dakota Medicaid Income Limit – Adults | ||||||
| Pregnant Women Medicaid | Adults (Medicaid) Parent/ Caretaker | Seniors & People w/ Disabilities (Medicaid) | Adults (Medicaid) Expansion to Adults | |||
| % FPL | 100% | 133% | 53% | 74% | NO | |
|
Household Size
|
1 | $12,880 | $17,130 | $6,826 | $9,531 | N/A |
| 2 | $17,420 | $23,169 | $9,233 | $12,891 | N/A | |
| 3 | $21,960 | $29,207 | $11,639 | $16,250 | N/A | |
| 4 | $26,500 | $35,245 | $14,045 | $19,610 | N/A | |
| 5 | $31,040 | $41,283 | $16,451 | $22,970 | N/A | |
| 6 | $35,580 | $47,321 | $18,857 | $26,329 | N/A | |
| 7 | $40,120 | $53,360 | $21,264 | $29,689 | N/A | |
| 8 | $44,660 | $59,398 | $23,670 | $33,048 | N/A | |
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 South Dakota Medicaid
There are 2 ways you can apply for Medicaid in South Dakota.
Option 1 – Apply at DSS Office Near You
You can apply in person at the South Dakota Department of Social Services (DSS) office near you. Click here to locate a DSS office.
Option 2 – Download South Dakota Food Stamps Application
You can download an application, complete it, and mail it to your county DSS office or submit it in person.
If you need assistance completing an application contact the Department of Social Services office nearest you or call 800.305.3064.
South Dakota Medicaid Phone Number
Here’s how to contact the South Dakota Medicaid Agency:
You can contact South Dakota Medicaid at 1.800.597.1603.
Medicaid Eligibility
Phone: 605.773.4678
Fax: 605.773.7183
South Dakota Medicaid Expansion Update
South Dakota has not yet accepted federal funding to expand its Medicaid program under the Affordable Care Act (ACA).
Former Governor Dennis Daugaard supported Medicaid expansion by 2015 but the issue did not have lawmakers’ support.
However, current Governor Kristi Noem is opposed to Medicaid expansion.
Furthermore, instead of expanding Medicaid, South Dakota is seeking federal approval for a work requirement for low-income parents in the existing Medicaid program.
That waiver application is pending CMS approval.
Medicaid expansion advocates have until November 2021 to gather enough signatures to get Medicaid expansion on the 2022 ballot.
South Dakota Medicaid Income Limits Summary
We hope this post on South Dakota Medicaid Income Limits was helpful to you.
If you have any questions about Medicaid in the state of South Dakota, you can ask us in the comments section below.
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Be sure to check out our other articles about Medicaid.
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