Health Insurance Basics > Medicaid
South Dakota Medicaid
Medicaid is health insurance available to people who qualify.
You do not have to pay premiums or enrollment fees. You do not have to pay out-of-pocket costs like copayments, coinsurance, and deductibles for services. You can apply for Medicaid anytime.
Eligibility is determined in part by:
- Income;
- If you’re pregnant;
- Presence of a disability; or,
- Medicare ineligibility.
You can enroll with free help from a Navigator or you can apply online yourself. Applications can be done online or on paper and sent to Department of Social Services (DSS).
If you have applied for Medicaid before and were denied coverage, we encourage you to apply again. Eligibility requirements may have changed.
2025 Household Income Guidelines
| Household Size* | Maximum Gross Monthly Income |
| 1 | $1,800 |
| 2 | $2,433 |
| 3 | $3,065 |
| 4 | $3,698 |
| 5 | $4,331 |
| 6 | $4,963 |
| 7 | $5,595 |
| 8 | $6,228 |
*A “household” includes earners and dependents.
Ready to Enroll?
When working with a Navigator be prepared! You’ll need to bring information and documents when applying for health insurance.
Enroll Now
You can apply yourself through the Department Social Services (DSS) via their online portal, paper application, in person at their office, or via HealthCare.gov.
Update Your Information
to stay enrolled in Medicaid
Log into your account to view recent communications, check the status of your enrollment, or update your personal information. This helps you stay covered and avoid losing your Medicaid because of missing or outdated information. It’s quick, private, and works on computers and mobile phones.
What You Can Do on the Portal
- Check if you’re still covered;
- View notices and messages about your benefits;
- Report changes (job, move, new baby, income amount);
- Update contact information; and,
- Upload or view documents.
Helpful Tip
Make sure your contact information is always up to date so you don’t miss important notices or risk losing coverage.
When you enroll in Medicaid
You’ll have
Access to Free
Health Care
- Doctor visits;
- Hospital stays;
- Immunizations;
- Pregnancy and newborn care;
- Emergency services;
- Mental health therapy;
- STD testing and treatment;
- Substance use treatment;
- Prescriptions;
- Vision exams and glasses;
- Dental cleanings;
- Manual chiropractic care;
Curious what else?
Medicaid can change everything. See how Medicaid impacts real people in South Dakota by reading their stories.
Medicaid Frequently Asked Questions
I applied for South Dakota Medicaid in the past and did not qualify. Can I apply again?
Yes, you can re-apply. Your eligibility may have changed based on new or updated eligibility requirements or if your income or household circumstances have changed.
Can I still qualify if I don’t have a home address?
You do not need a home address to apply. But you must give a mailing address where you can get mail. Examples of a mailing address that is not your home are: Sioux Falls Banquet or Bishop Dudley Hospitality House.
How long will it take to find out if I’m approved?
Most people get a letter in the mail within 45 days. The letter will say if you can get access to Medicaid or if you need to provide additional information. If approved, you will get a South Dakota Medicaid card in the mail.
What happens if I am not eligible for South Dakota Medicaid?
If you don’t qualify for Medicaid, your information will be sent to the Marketplace. The Marketplace will mail you a letter. You can also go to HealthCare.gov and make an account. Need help with the Marketplace? Our trained Navigators can guide you and help you find the best health plan for you.
I’m eligible for South Dakota Medicaid, but I have a Marketplace plan. Will my Marketplace plan automatically stop?
No. If you enroll in Medicaid, you will need to stop your Marketplace plan. Do not stop your Marketplace plan until you know you are approved for Medicaid.
If I get insurance through my employer, can my spouse or children have access to South Dakota Medicaid?
Possibly, yes. Medicaid coverage is available to your family members based, in part, on household income and household size.
Can I qualify for South Dakota Medicaid if I have Medicare?
Having Medicare does not mean you can’t get Medicaid. But it can make things more complicated. Some people have both Medicaid and Medicare. This is called “dual eligibility.” If you qualify for both, you can get help from both programs. To get both, you must meet your state’s income and asset rules for Medicaid. You also must qualify for Medicare based on your age or a disability. To apply, start with Medicare through Social Security.
More Questions?
For More Info
Penny Kelley
Outreach & Enrollment Services Program Manager
penny@communityhealthcare.net
605.277.8405
Sioux Falls
196 E 6th Street, Suite 200
Sioux Falls, SD 57104
605.275.2423
This page is supported by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,600,000 with 100 percent funded by CMS/HHS. The content are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.