South Dakota program
Health insurance for you (Medicaid Expansion)
South Dakota Medicaid covers adults aged 19 to 64 who meet its income rules.
What it is
South Dakota Medicaid covers adults aged 19 to 64 who meet its income rules.
Your own health coverage can matter when work or pay changes during treatment. The adult income limit is lower than the children’s limit. South Dakota checks each person separately.
Eligibility rules
- Adults must be aged 19 to 64 and live in South Dakota. The effective income ceiling is 138% of poverty.
- The line is $1,835 a month for one person, $2,488 for two, $3,142 for three and $3,795 for four.
- Current monthly income and the state’s household rules control the decision.
- A relative caregiver may qualify in their own right. DSS checks age, Medicare status and the adult’s own household and income. Being the child’s legal parent is not required for expansion coverage.
What you get
- No premium for covered adult health care.
- Hospital care, clinic visits, mental health care and medicines.
What the help includes
- South Dakota removed Medicaid copays on July 1, 2024. Covered services still have their own rules.
If you decide to apply
- Your hospital social worker can check your own coverage options and help include you on the BEES application.
- Have your current income and insurance details ready, including any recent change in pay.
South Dakota Department of Social Services: 877-999-5612 · Official page ↗
After you ask
- The usual application decision standard is 45 days.
Good to know
Your child can qualify even if you do not. The adult and child income limits are different.
Other details
- From January 1, 2027, some adults must meet community-engagement rules. South Dakota lists an exception for someone caring for a child aged 13 or younger, or a disabled person of any age.
Official sources
“Could I get Medicaid as well as our child? What are the benefits and drawbacks with my current coverage, and could you help me apply if it fits?”
Why I’m asking: I want to keep my own care covered while we manage our child’s treatment.
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
Add yourself to the same application and report this month's income.
Your social worker
The hospital financial counsellor can file both at once.
The care team
Records and letters when the application asks for them.
- Who decides
- South Dakota Department of Social Services
- Ask the agency
- “Please add me to the same application as my child, under the adult expansion group.”
How to apply
First step: Add yourself to the same application at eaportal.sd.gov.
- Tick the box for yourself on the same application you file for your child.
- If a parent has just stopped work, report the new figure, not last month's.
Official application / program page ↗
Where it starts: eaportal.sd.gov or 877-999-5612, on the same form as your child's
What to gather
- This month's pay for each parent
- Your Social Security number
How long: 45 days.
What a yes looks like
A card in your own name.
What a no looks like, and the next move
If the no is income, ask about HealthCare.gov and the 60-day window after job cover ends.
Watch out
- The parent line is much lower than the children's line; a family can be over one and under the other.
- From January 1, 2027 some adults must show community engagement, with an exception for the carer of a young child or a disabled person.
Dates that change this
2027-01-01: From January 1, 2027 some adults on Medicaid Expansion have to show community engagement to keep it. South Dakota lists an exception for the carer of a child aged 13 or younger, or of a person with a disability of any age. A parent caring for a child with leukaemia should ask about that exception by name.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Medicaid for a parent up to $3,795 a month for a household of four.
- $3,795/month — Household of 4, published monthly ceiling for the adult group (138% of poverty)
- $3,142/month — Household of 3, published monthly ceiling
- $2,488/month — Household of 2, published monthly ceiling
Covers: Hospital, clinic and mental health care for the parent · Prescriptions
Legal protection: No copays for anyone on South Dakota Medicaid since July 1, 2024
What it costs the family: No premium.
The eligibility facts, as published
- Age
- 19 to 64
- Income
- at or below 133% of the poverty line plus five points, which is 138%, under Article XXI section 10 of the South Dakota Constitution
- Residency
- South Dakota
- Processing standard
- 45 days
Decisions this site cannot make: Department of Social Services MAGI decision for the adult group
Expect friction on: Community engagement rules for some adults start January 1, 2027
The trap: The adult line is much lower than the children's line. A family can be over it while the child is comfortably under the children's line; apply for both on one form and let the office sort it.
Where I read this
- South Dakota Medicaid Coverage Groups — South Dakota Department of Social Services, read September 10, 2026
- South Dakota Constitution, Article XXI section 10 — South Dakota Legislature, 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