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.
Program Name | South Dakota Medicaid |
Expanded Medicaid | No |
Website | https://dss.sd.gov/medicaid/ |
Phone | 877-999-5612 |
Apply Online | https://apps.sd.gov/ss36snap/web/Portal/Default.aspx |
Appeal a Denial | Request a Fair Hearing |
Find a Local Office | https://dss.sd.gov/findyourlocaloffice/ |
Eligibility Requirements
To be eligible for South Dakota Medicaid, you must be a resident of the state of South Dakota, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.
You must also be one of the following:
- Pregnant
- Be responsible for a child 18 years of age or younger
- Have a disability or a family member in your household with a disability
Annual Household Income Limits (before taxes)
Household Size* | Maximum Income Level (Per Year) |
1 | $17,131 |
2 | $23,169 |
3 | $29,207 |
4 | $35,245 |
5 | $41,284 |
6 | $47,322 |
7 | $53,360 |
8 | $59,398 |
*For households with more than eight people, add $6,038 per additional person.
Available Services Include:
Chiropractic | Medical equipment and supplies |
Dental | Mental health |
Diabetes education | Nursing home |
Dietician and nutritionist | Personal care |
Family planning | Podiatry |
Home health | Prescription drugs |
Hospice | Substance use disorder |
Hospital | Transportation coverage |
Medical and surgical services | Vision |
Copayments
Ambulatory Surgical Centers | 5% up to $50.00 |
Chiropractic Services | $1.00 |
Dental Services | $3.00 |
Dentures | $3.00 |
Diabetes Education | $3.00 |
Dieticians and Nutritionist Services | $3.00 |
Durable Medical Equipment | 5% of allowable reimbursement |
Rural Health Clinics | $3.00 |
Independent Mental Health Practitioners | $3.00 |
Inpatient Hospital Services | $50.00 |
Mental Health Clinics | 5% of allowable reimbursement |
Nutrition Services | $2.00 – $5.00 |
Optometric Services | $2.00 |
Optical Supply | $2.00 |
Outpatient Hospital Services | 5% of allowable reimbursement ($50.00) |
Physician Services | $3.00 |
Podiatry Services | $2.00 |
Prescription Drugs | $1.00 – $3.30 |
Individuals exempt from cost sharing include:
- Children under age 21
- Individuals receiving hospice care
- Individuals residing in a long-term care facility
- Some Native American Indians
- Individuals eligible for Medicaid through the Breast and Cervical Cancer program
Services exempt from cost sharing include:
- True emergency services
- Family planning services and supplies
- Services relating to a pregnancy
- Provider-preventable services
- Laboratory services
- Psychiatric inpatient and rehabilitation services;
- Radiological services
- Substance use disorder treatment
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