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South Dakota received federal approval to initiate expansion as of July 2023, and for the specific benefits package that the newly eligible population is receiving. Under the new eligibility guidelines, a single adult qualifies for Medicaid in South Dakota with an income of up to about $20,782 in 2024.

South Dakota Medicaid may cover medically necessary dermatology services. However, it doesn't cover cosmetic treatments, so contact your DSS office to learn what services Medicaid covers. The state's Medicaid plan includes medically necessary physical therapy services.

Medicaid coverage under expansion in South Dakota began on July 1, 2023. Voters in South Dakota approved a ballot measure on November 8, 2022 which added Medicaid expansion to the state constitution.

Medicaid Online Portal South Dakota Medicaid recommends using the Medicaid Portal (Portal) to verify Medicaid eligibility. Providers who have access to the Online Provider Portal can use this system to determine if a recipient currently has a provider in either the Primary Care Provider or Health Home Provider program.

Individuals who are eligible are entitled to full South Dakota Medicaid coverage. A person must be age 18 or older and have quadriplegia. The income limit can be up to $2,829 in 2024 a month. The resource limit is $2,000 for an individual.

Medicaid covered services received more than 50 miles outside of the state of South Dakota, except Bismarck, ND, will require prior authorization. This applies to all Medicaid recipients, including those not in the PCP or HHP program.

South Dakota Medicaid Phone Listing Claims (Status, Payment Questions and Remittance Requests): Dental Claims Status: 877.841.1478. Recipient Eligibility Inquiries: Medicaid Fraud Hotline: 800.765.7867. Medicaid Recipient Hotline: 800.597.1603. Primary Care Provider (PCP) Program: 800.597.1603.

PRIOR AUTHORIZATION REQUIREMENTS The recipient's ND Primary Care Physician must submit a written request to North Dakota Medicaid for authorization for out-of-state services before scheduling an appointment.

Because each state has its own Medicaid eligibility requirements, you can't just transfer coverage from one state to another, nor can you use your Medicaid coverage when you're temporarily visiting another state, unless you need emergency health care.