South Dakota Medical Application Information

South Dakota Medical Assistance for Low-Income Families (LIF) program is meant to help low-income South Dakota families (with or without private health insurance) access full medical assistance coverage. LIF is funded through the Medicaid program.

Medical Assistance Programs are available to assist in paying for the necessary medical expenses families need to stay healthy.

Eligibility for SD Medical Assistance for Low Income Families (LIF) requires that a dependent child and a caregiver relative be present in the home. When determining family size, the parties are put into consideration - parent(s), stepparent, or caregiver relative living in the home with the dependent child and any blood related siblings living in the home who also meet the definition of a dependent child. Step siblings of the dependent child are excluded from this requirement. However, the caregiver relative may opt to include them. If a step sibling is included, all the other siblings living in the home who are eligible for LIF must also be included.

The Department of Social Services processes takes 45 days to process an application; although it normally does not take that long. Submitting the requested documentation together with the application or soon after submitting the application helps in speeding up the application process.

Documents required include:

  • Proof of identity or alien status
  • Social Security numbers for all family members
  • Proof of income (Pay stubs or earning statements for the past 30 days if employed or income tax return or self-employment ledgers if self employed)
  • Proof of any other income (Social Security, SSI, workmen's compensation, unemployment benefits, BIA general assistance, child support, rental income, VA benefits, interest income for last year, etc.)
  • Current bank statements for checking accounts, savings accounts, certificates of deposit, credit union accounts, retirement accounts, stocks, bonds, dividends, etc.
  • Utility Bills (Rent or mortgage payment, lot rent, household, real estate taxes, utility bills - heat, electricity, water/sewage/garbage, telephone, etc.)
  • Proof of dependent care expenses (e.g. Statement from provider, signed receipts, etc.)
  • Proof of medical expenses not paid by another source (e.g. health insurance, doctor bills, hospital bills, drug receipts, pharmacy statement, etc for anyone aged 60 or older, or permanently disabled)
  • Proof of obligation and payment, if paying child support payments (divorce decree/administrative order, cancelled checks, clerk of courts receipt, etc.)

The start of medical coverage is based on the date the application is received in the local DSS office.

Services offered by South Dakota Medical Assistance Programs include:

  • Inpatient and outpatient hospital services
  • Clinic and emergency room care
  • Laboratory and x-rays services
  • Prescription drugs
  • Dental care
  • Home care
  • Emergency transportation (Ambulance)
  • Mental health center services
  • Drug abuse
  • Nursing care
  • Hospice care
  • Organ transplant services

In South Dakota, children eligible for Medical Assistance are also entitled to Healthy Kids Klub checkups. Unregistered aliens can only get emergency care.

Eligibility Requirements

Income Requirements

  • Pregnant Women whose income limit is below 133% FPL
  • Children Aged 0 to 5yrs with an income limit below 133% FPL
  • Children aged 6yrs to 18 yrs with an income limit below 100% FPL
  • Parents/guardians living with children under 19 years of age with an income below 52% FPL
  • Aged, blind, and disabled with an income below 75% FPL and asset limit of $2,000 for singles; 83% FPL and asset limit of $3,000 for couples
  • Income limits and requirements for refugees should be below 62% FPL. Refugees must be living in South Dakota

People with Disabilities

An adult with disability is eligible for Medical assistance. However, documentation showing proof of disability from a doctor must be produced. The documents can either be medical records or a letter from the physician. Other criteria that the applicant with disability must meet are income and asset criteria. Income may not exceed 100% of the set FDL.

Adult Supplemental Security Income Recipients

In South Dakota, an adult who has been approved for supplemental security income through the Social Security Administration automatically qualifies to receive Medical benefits. Enrollment in Medical does not require a separate application. The SSA requires a proven disability expected to last at least 12 months or one which will result in death. Income must not exceed the designated state limits; the total value of available resources must be less than $2,000 for an individual or $3,000 for a couple.

Children Who Receive SSI

A child under the age of 18 years old who is suffering from severe functional limitations as a result of mental or physical illness may qualify for supplemental security income and automatic enrollment in Medical. The disability must be expected to last not less than 12 months or lead to death. The child's income and assets combined with that of any family members in the family must not exceed limits as determined by the SSA. Learn more at:
www.dss.sd.gov/medicaid/generalinfo/verifyeligibility/

Children with Disabilities

Disabled children who do not qualify for supplemental security income due to the parent's income and assets may still qualify for Medical benefits. The provision allows children with severe disabilities receive Medical without regard to the income or assets of the parents. Eligibility for the waiver is determined by the South Dakota Department of Human Services and is based on the degree of the disability and the amount of care required.

More details on children eligibility can be downloaded or read at DSS official website:
www.dss.sd.gov/medicaid/generalinfo/verifyeligibility/

Medical Application Instructions

Apply Online or by Mail

To apply for this program, download and print an application from this website: www.apps.sd.gov/SS36SNAP/Web/Portal

Call your local DHS office during the normal working hours on (401) 462-5300 to set up an appointment. A list of all DHS offices that serves your county can be gotten on this website:
www.dss.sd.gov/findyourlocaloffice/

Remember to attach the necessary documentation with your application form

Telephone Application

You can request an application by calling 1 (800) 452-7691, during regular business hours and an agent is always there to assist you with the application process.

Make sure you follow all of the application instructions, sign your application, and submit all requested additional documentation.

Mailing address:

Department of Social Services of South Dakota
700 Governors Drive
Richard F Kneip Bldg
Pierre, SD 57501

Medicaid Office Phone: 1 (800) 452-7691

Medicaid State Website: www.dss.sd.gov/medicaid/generalinfo/verifyeligibility/