South Dakota Application for Presumptive Eligibility for Medicaid

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Multi-State
Control #:
US-0538BG
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PDF
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Use this form to find out quickly if you qualify for presumptive eligibility for Medicaid. Presumptive eligibility offers you and your family immediate access to health care while you apply for regular Medicaid or other health coverage.

South Dakota Application for Presumptive Eligibility for Medicaid The South Dakota Application for Presumptive Eligibility for Medicaid is a critical tool that helps individuals determine their eligibility for immediate healthcare coverage in the state. This application is designed for individuals who believe they meet the requirements and criteria for Medicaid but have not yet completed the full application process. Presumptive eligibility allows qualified individuals to gain temporary Medicaid coverage while their full Medicaid application is being processed. This coverage can be crucial for those who urgently need access to medical services but may not have the immediate means to pay for them. The South Dakota Department of Social Services offers different types of applications for presumptive eligibility for Medicaid, each tailored to specific groups: 1. South Dakota Application for Presumptive Eligibility for Pregnant Women: This application is specifically designed for pregnant women who lack medical insurance and need immediate coverage for prenatal, maternity, and postpartum care. It ensures that expectant mothers receive the necessary healthcare services to ensure a healthy pregnancy and a successful delivery. 2. South Dakota Application for Presumptive Eligibility for Children: This application targets children under the age of 19 who may meet the eligibility requirements for Medicaid. It aims to provide essential healthcare services, such as doctor visits, immunizations, and hospitalization, to children from low-income families who might otherwise go without necessary medical care. 3. South Dakota Application for Presumptive Eligibility for Adults: This application offers temporary Medicaid coverage to qualifying adults who lack health insurance. It assists those who require immediate medical attention for conditions that could worsen or become chronic without timely intervention. Completing the South Dakota Application for Presumptive Eligibility for Medicaid involves providing various personal and financial information, including details about income, household size, and medical expenses. The application can be submitted online through the South Dakota Department of Social Services website, or applicants can request a paper application through their local Department of Social Services office. It is essential to note that presumptive eligibility is not a long-term Medicaid coverage solution. Once approved, individuals have a limited period (usually up to two months) to complete the full application process. If the full application is not submitted within this timeframe, Medicaid coverage is terminated. In conclusion, the South Dakota Application for Presumptive Eligibility for Medicaid plays a crucial role in providing immediate healthcare coverage to pregnant women, children, and qualifying adults who meet the state's eligibility criteria. By offering temporary Medicaid coverage, this application ensures that individuals in urgent need of medical care can access necessary services while their full application is being processed.

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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.

DSS began the process of unwinding from the continuous coverage requirement in February 2023 with disenrollment beginning April 2023. DSS has followed CMS' recommendation to review no more than 1/9 of its caseload per month.

Starting July 1, 2023, South Dakota's Medicaid expansion allows individuals to qualify for Medicaid by raising the income requirement to 138% of the Federal Poverty Level (FPL), up to $41,400 for a family of 4, and adding childless adults. Apply to find out if you are eligible.

The application process individuals use now is the same for Medicaid Expansion. It's easy to apply online at dss.sd.gov/applyonline. Paper applications can be located online at dss.sd.gov/formsandpubs, picked up at any local DSS office, or sent by mail, fax, or email from any DSS office.

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 $2,742 (2023) a month. The resource limit is $2,000 for an individual.

Parents of Dependent Children: Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

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SPA adds eligibility for former foster care children who have aged out of foster care in another state, are now a resident of South Dakota seeking Medicaid ... If you need assistance completing an application contact a Department of Social Services office nearest you or call 877.999.5612. An interview is not required ...hospital PE application and then require that the hospital help the applicant fill out the full Medicaid ... application if the individual chooses to do so.25 ... North Dakota residency; c. Gross income amount; d. Whether or not the applicant is currently enrolled in Medicaid; and e. That ... Apr 21, 2021 — The remaining seven states (Mississippi, Montana, North Dakota, South Carolina, South Dakota,. Texas, and Wyoming) do not cover LPRs who have ... Eligibility to individuals. You must participate as a North Dakota Medicaid provider to complete Hospital Presumptive Eligibility applications. Please complete ... Jun 11, 2012 — PE ends if applicant: Does not file full Medicaid application, by end of the following month, or. When eligibility determination is made ... Health care providers and Head Start programs can play a major role in finding and enrolling uninsured children through presumptive eligibility. Jan 21, 2016 — ... the addition of North Dakota, South Carolina, and South Dakota. A ... Presumptive eligibility is a longstanding option in Medicaid and CHIP ... Jan 1, 2020 — In 2019, North Dakota eliminated copayments for children in Medicaid and Wisconsin stopped ... complete and submit an online application for ...

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South Dakota Application for Presumptive Eligibility for Medicaid