South Dakota program
Health coverage for an uninsured child (CHIP)
Children’s health coverage with a higher income limit for a child who has no insurance.
What it is
Children’s health coverage with a higher income limit for a child who has no insurance.
The higher CHIP income line can help a child who has no health insurance. South Dakota uses the same application to check both children’s coverage routes. A parent’s access to the state employee plan can affect this route.
Eligibility rules
- Your child must be under 19 and live in South Dakota. Income uses the child’s tax household.
- Published monthly limits are $3,768 for two people, $4,759 for three, $5,748 for four and $6,736 for five.
- This route is for a child with no other insurance. A child whose parent could join the state employee plan is usually excluded too, unless that plan gives no real access to care.
- ARSD 67:46:14:03 includes exceptions, including coverage that gives no access to care.
- The amounts already include the state's income allowance. Your child also needs an eligible citizenship or immigration status.
What you get
- Health coverage for hospital care, treatment, medicines and clinic visits.
- Twelve months of continuous eligibility once your child qualifies.
What the help includes
- Bills from up to three months before you apply can be covered (two months from 2027). Ask the counselor for the coverage start date in writing before you drop any other insurance.
If you decide to apply
- Your hospital social worker can compare the two child coverage routes and help with BEES if appropriate.
- Have current income records and birth dates ready. Explain all insurance available through each parent’s work.
South Dakota Department of Social Services, Economic Assistance: 877-999-5612 · Official page ↗
After you ask
- The usual decision standard is 45 days. South Dakota decides which children’s coverage group fits.
Good to know
A child with work insurance usually belongs under the lower Medicaid income line. The higher line is not a reason by itself to end coverage during treatment.
Other details
- The public-employee exception needs an individual review. A school, city, county or state job alone does not settle the answer.
Federal background: Children’s Health Insurance Program (CHIP).
Official sources
“Would the uninsured-child coverage route fit our child? What would it cost, what are the drawbacks, and could you help us with the application if you recommend it?”
Why I’m asking: I want to understand the higher income line and avoid a gap in treatment coverage.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Say on the form that your child has no insurance, and say where each parent works.
Your social worker
The hospital financial counsellor can file with you the same week.
The care team
Records and letters when the application asks for them.
- Who decides
- South Dakota Department of Social Services decides which of the two children's lines applies.
- Ask the agency
- “My child has no health insurance. Please check us against the higher children's income table, not the one for children with private cover.”
How to apply
First step: File at eaportal.sd.gov and state that your child has no insurance.
- File the one children's application; the office decides which line you are on.
- Say plainly on the form that your child has no insurance.
- If a parent works for a school, a city, a county or the state, ask whether the state employee plan rule applies to you.
Official application / program page ↗
Where it starts: The same application as the ordinary children's line: eaportal.sd.gov or 877-999-5612.
What to gather
- Proof your child's old plan has ended, if it has
- This month's pay for each parent
- Where each parent works
How long: 45 days, and no waiting period before your child can start.
What a yes looks like
A card and a notice saying the cover runs twelve months.
What a no looks like, and the next move
If the no is about a parent's public-agency job, ask which exception in the rule was considered, and appeal by the date on the notice.
Watch out
- A child enrolled in a work plan is measured against the lower line instead.
- A parent who works for a public agency and can join the state employee plan is a bar, with exceptions written into the rule.
- Whether a premium is charged on this band was not published.
Dates that change this
2026-09-11: Whether South Dakota charges a premium or an enrolment fee on this children's band was not published. Medicaid copays were removed on July 1, 2024, which is not the same thing. Ask when you apply. (not yet confirmed against the final rule)
2024-11-11: South Dakota's rule bars a child whose parent works for a public agency and can join the state employee health plan, with exceptions in the rule. If you work for a school, a city, a county or the state, ask about this before you assume the answer.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
The same cover on a higher line: $5,748 a month for four, $4,759 for three.
- $5,748/month — Household of 4, published monthly line for a child with no private insurance (209% of poverty)
- $4,759/month — Household of 3, published monthly line
- $3,768/month — Household of 2, published monthly line
- $6,736/month — Household of 5, published monthly line
Covers: Check-ups, hospital and clinic care, dental and vision · Chemotherapy and prescriptions
Legal protection: Twelve months of continuous cover for a child · No waiting period before enrolling a child who has just lost a work plan
What it costs the family: Whether South Dakota charges a premium or enrolment fee on this band was not published. Ask when you apply.
The eligibility facts, as published
- Age
- under 19
- Age max exclusive
- 19
- Income
- MAGI budget group; the rule sets a ceiling of 209% of the federal poverty guidelines (ARSD 67:46:14:02(2))
- Insurance status condition
- the child must not be covered under health insurance or a group health plan, and must not be in a unit where a parent works for a public agency and can join the state employee plan; ARSD 67:46:14:03 lists exceptions, including cover that gives no access to care
- Residency
- South Dakota
- Continuous eligibility
- 12 months
- Processing standard
- 45 days
Decisions this site cannot make: Department of Social Services MAGI decision
Expect friction on: The public page calls both children's tables CHIP, so a family cannot tell from the page which one it is being measured against
The trap: The bar is being covered, not being offered cover. South Dakota's rule says the child must not be covered under health insurance or a group health plan; whether a mere offer of a private plan bars a child was not published, so ask rather than assume.
Where I read this
- South Dakota Medicaid Coverage Groups — South Dakota Department of Social Services, read September 10, 2026
- South Dakota Administrative Rules, Article 67:46 — South Dakota Legislature, read September 10, 2026
- State plan S54 — Optional Targeted Low-Income Children — South Dakota Department of Social Services, read September 10, 2026
- 42 CFR 457.805 — Electronic Code of Federal Regulations, read September 10, 2026
- Continuous Eligibility in Medicaid and CHIP — Centers for Medicare and Medicaid Services, read September 10, 2026
- Medicaid HR1 Changes — South Dakota Department of Social Services, read September 10, 2026
- Cost Sharing — South Dakota Department of Social Services, read September 10, 2026