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Learn About Requirements for Medicaid in South Dakota

Medicaid benefits eligibility in South Dakota ensures that low-income families get vital assistance with health care coverage. South Dakota Medicaid follows the guidelines set by the federal program and administers benefits on the state level. The program covers many medical expenses, including hospital stays, doctor visits, prescriptions, nursing home care and other health care needs. However, there is a process to qualify for Medicaid that determines who receives assistance from the program. The path to satisfy Medicaid eligibility requirements begins with understanding eligibility and then completing an application form. Learn how to qualify for Medicaid and more on the page below.



Who qualifies for Medicaid in South Dakota?

To determine who qualifies for Medicaid in South Dakota, officials use categories to quickly sort through ineligible individuals, allowing more time to focus on qualifying petitioners. Medicaid benefits eligibility hinges on whether or not potential beneficiaries fit in to one of the acceptable categories. For instance, pregnant women and children struggling with income are eligible for Medicaid, in most cases. Additionally, individuals who receive Supplemental Security Income (SSI) are automatically eligible for aid. Medicaid eligibility guidelines further extended to low-income families, disabled residents and children younger than a certain age.

Medicaid eligibility requirements were further expanded in with the passing of the Affordable Care Act (ACA). Now, states are free to extend Medicaid coverage to more potential beneficiaries. However, South Dakota did not choose to do so.

What are the requirements for Medicaid in South Dakota?

The requirements for Medicaid in South Dakota include various guidelines to determine if an applicant is viable. While meeting one of the categories for Medicaid eligibility is a necessary first step, next, petitioners will have to meet more requirements.

Applicants who qualify for Medicaid in South Dakota will have to provide two vital pieces of information regarding residency and legal status within the country. U.S. citizens will automatically meet Medicaid eligibility requirements regarding legal residency, but they will also have to provide officials with Social Security Numbers. Additionally, citizens will need to provide proof of residency in South Dakota by using any number of documents. For noncitizens, certain statuses of legal immigrants may be eligible for Medicaid assistance, and they must also show state residency status. Medicaid benefits eligibility is also possible for refugees and other particular types of immigrants. To learn about the documents required to support the above claims, download our free guide.

What are the income requirements for Medicaid in South Dakota?

South Dakota income requirements for Medicaid use the Modified Adjusted Gross Income, or MAGI, to calculate the income of potential beneficiaries. Introduced by the Affordable Care Act, MAGI determines gross annual income by using detailed financial data provided by petitioners. Gross income requirements for Medicaid eligibility are compared with household size to determine if a family will qualify for Medicaid and how much Medicaid coverage can be received. Items such as homes, vehicles, bank assets, insurance policies, bonds and more are involved in determining gross annual income. The procedure for how to qualify for Medicaid regarding income will also exclude certain items. To meet Medicaid eligibility requirements, gross annual income must fall within limits established by the state and, in part, the Federal Poverty Level (FPL). Download our guide to review further details about income requirements for Medicaid.

What are the Medicaid application guidelines in South Dakota?

Meeting Medicaid eligibility requirements makes it likelier for low-income families to receive much-needed assistance from the program. However, qualifying for Medicaid further includes an application process where information is provided to officials reviewing such cases. Medicaid applications guidelines may disqualify potential beneficiaries for a range of reasons. Additionally, there are several ways to learn how to apply for Medicaid, which require the same information, but have caveats unique to each particular process. For instance, completing a paper form and mailing it in to officials for reviews is subject to the speed of the postal service. A hand-written application to qualify for Medicaid is also at the mercy of clear, legible writing.

What are common Medicaid disqualifications in South Dakota?

Understanding Medicaid eligibility requirements in South Dakota helps potential beneficiaries avoid many of the common mistakes that cause disqualification. For instance, one of the most common reasons applicants do not qualify for Medicaid is related to money. Income levels are vital for Medicaid assistance, and many families do not review the income requirements before attempting to get Medicaid. Another reason an applicant may not qualify for Medicaid benefits is due to failing to provide proof of established residency. Out-of-state applicants cannot benefit from the Medicaid program in South Dakota. Lastly, petitioners will not satisfy Medicaid benefits eligibility in South Dakota if any information provided to officials throughout the process cannot be verified.