Written by a parent, not a doctor. Nothing here is medical advice.

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South Dakota program

Medicaid based on your child’s needs (Disabled Children’s Program)

Medicaid for a child whose care at home is as intensive as care in a facility. Your income is not counted.

What it is

Medicaid for a child whose care at home is as intensive as care in a facility. Your income is not counted.

This route can matter when family income is above ordinary child Medicaid limits. South Dakota looks at your child’s own money and the care needed at home. A cancer diagnosis alone does not settle the medical test.

Eligibility rules
  • This is South Dakota’s Katie Beckett/TEFRA state-plan option for children under 19. The posted 2026 limits are the child’s own monthly income under $2,982 and resources under $2,000; parents’ income and savings are not counted. DSS also checks disability, qualifying facility-level care, and the safety and cost of care at home.
  • Social Security or the state must find disability under Social Security standards. A physician must order home services that need a doctor’s or nurse’s skills.
  • Care must be comparable to a hospital, nursing facility or intermediate care facility. Home care must cost no more than facility care.
What you get
  • Medicaid coverage without counting parents’ income or savings.
  • A separate route for a child who needs hospital-level or other qualifying facility-level care at home.
What the help includes
  • There is no premium or fee. A disability-based decision is due within 90 days; ask the social worker to say which of the three reviews (money, disability, level of care) is still open if it runs long.
If you decide to apply
  1. Your hospital social worker can discuss a care assessment and help Economic Assistance identify the Disabled Children’s Program.
  2. Ask your child’s doctor or home nurse to describe the skilled care needed at home.
  3. Have records of your child’s own income and accounts ready for the financial review.

South Dakota Department of Social Services, with a disability decision from Social Security or the state: 877-999-5612 · Official page ↗

After you ask
  • Economic Assistance uses BEES or the joint medical-assistance application for general intake. Your hospital social worker can identify the Disabled Children’s Program so DSS arranges the specialized reviews.
Good to know

A medically stable child does not meet the state’s care-level test just because the diagnosis is serious.

Other details
  • Gifts or fundraising money held in your child’s name can affect the child’s resource limit. A benefits specialist can explain ownership before money is moved.
  • Other states call this route TEFRA or Katie Beckett.

Federal background: Katie Beckett/TEFRA and the Disabled Children’s Program’s disability-based Medicaid route. Other disability routes have separate rules.

Official sources
Ask your social worker

“Could our child’s care needs qualify for Medicaid without counting our income? What are the benefits and drawbacks, and could you help us seek the assessment if appropriate?”

Why I’m asking: I want to know whether the care our child needs opens another coverage route.

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

Ask for it by name, get the doctor's letter, and keep the child's own accounts under $2,000.

Your social worker

The oncology social worker gathers the clinical record that shows the level of care.

The care team

The oncologist or the home care nurse writes what care is needed at home and why it needs a nurse.

Who decides
The Department of Social Services decides the money side; Social Security or the state decides disability; a level-of-care review decides the nursing side.
Ask your social worker
“My income is over the children's line. Can we apply for the Disabled Children's Program, which ignores parents' income, and can the doctor document the level of care my child needs at home?”

How to apply

First step: Call 877-999-5612 and ask for the Disabled Children's Program by name.

  1. Call 877-999-5612 and ask for the Disabled Children's Program by name; it is not obvious on the application.
  2. Ask the oncologist to write what care your child needs at home and who has to give it.
  3. Check the child's own bank accounts and gifts stay under $2,000 in the child's name.

Official application / program page ↗

Where it starts: There is no separate published form. Apply at eaportal.sd.gov or call 877-999-5612 and ask for the Disabled Children's Program by name.

What to gather

  • A letter from the oncologist describing the care needed at home
  • Your child's Social Security number
  • Statements for any account in your child's name

How long: 90 days when a disability decision is needed. Start it the week the doctor first says home care will be heavy.

What a yes looks like

A Medicaid card for your child with your income never asked about again at renewal.

What a no looks like, and the next move

Ask whether the no was disability or level of care. If it was level of care, ask the doctor what would have to change and appeal by the date on the notice.

Watch out

  • Ask for it by name. It is a coverage group, not a separate application, and staff will not always raise it.
  • A medically stable child does not meet the level-of-care test, however serious the diagnosis.
  • The $2,000 limit is on the child's own savings. A gift or a fundraiser put in the child's name can break it.

Dates that change this

2026-09-11: South Dakota publishes the rules for this route but not a form, a premium, an assessment deadline or a typical waiting time. Ask for the Disabled Children's Program by name on 877-999-5612. (not yet confirmed against the final rule)

2026-01-01: The child's own monthly income has to be under $2,982 in 2026 and the child's own savings under $2,000. That figure is tied to the federal benefit rate and changes in 2027.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Full South Dakota Medicaid with your income ignored. The child's own income must be under $2,982 a month and savings under $2,000.

  • $2,982/month — The child's own monthly income ceiling in 2026 (300% of the federal benefit rate)
  • $2,000 — The child's own resource ceiling

Covers: Everything South Dakota Medicaid covers, including chemotherapy, hospital care and prescriptions · Private duty nursing and home health when approved · Rides, with meals and lodging for overnight travel · Anything medically necessary for a child aged 20 or younger, through the well-child benefit

Legal protection: Parents' income and resources are not considered · A child can hold this alongside a work plan, with Medicaid paying second

What it costs the family: No premium was published for this route. Ask when you apply.

The eligibility facts, as published

Age
under 19
Age max exclusive
19
Income
the child's own income only: under $2,982 a month in 2026, which is three times the federal benefit rate. Parents' income and resources are not considered.
Assets
the child's own resources under $2,000
Level of care
care at home comparable to a hospital, nursing facility or intermediate care facility. A medically stable child, even though disabled, is not considered to need that level of care.
Medical
disability established by the Social Security Administration or the Department of Social Services using Social Security's standards; home services must be ordered by a physician and need a physician's or nurse's skills
Cost test
the monthly cost of the child's care at home must be the same as or less than treating the child in a facility
Statute
section 1902(e)(3) of the Social Security Act, elected at optional group 13 of the South Dakota state plan
Processing standard
90 days when a disability determination is needed

Decisions this site cannot make: Disability decision by Social Security or the Department of Social Services · Level-of-care decision on the child's home nursing needs

Expect friction on: The state does not publish an application form, an assessment deadline or a waiting time for this route, so the family has to ask for it by name

The trap: The test is the level of care, not the diagnosis. A leukaemia diagnosis on its own does not open this; central-line care, tube feeding, oxygen, infusions or round-the-clock monitoring at home are what the state is looking for, and the doctor has to write it down. The state also checks that caring for the child at home costs no more than treating the child in a facility.

Where I read this

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