South Dakota Medicaid is a federal and state-funded program providing medical coverage for people who meet certain eligibility standards. If you are eligible, South Dakota Medicaid will act as your insurance company and pay for covered medical services such as visits to the doctor, hospital, dentist and chiropractor. Payment of covered services is dependent upon each recipient’s compliance with all Medicaid rules and regulations. Remember to follow the rules in the Medicaid Recipient Handbook.
View the links on the right side of the page to find out more about services available for South Dakota Medicaid Recipients. Some common questions are listed below. If you have more questions, please view our Frequently Asked Questions.
How do I find out if I’m eligible for Medicaid or CHIP?
The Department of Social Services’ Division of Economic Assistance is responsible for administering the Medicaid and Children’s Health Insurance (CHIP) Programs to help low income individuals, families and children. Click here to find out more.
What services are covered by Medicaid?
Medicaid covers services that are medically necessary. A list of services covered by Medicaid is in the Medicaid Recipient Handbook. Please do NOT assume all services are covered and paid for by Medicaid. Before you get a medical service, ask your provider if the service is covered. You will have to pay for services not covered by Medicaid.
Some health care services are never covered by Medicaid. A list of non-covered services is in Administrative Rule of South Dakota. If you have questions regarding covered and non-covered services, please call 1.800.597.1603 or visit with your medical provider.
What is the Managed Care Program?
The Managed Care Program is intended to improve your access to medical care as well as improve the quality of care you get by giving you a medical home. Click here to find out more about the Managed Care Program or to select or change your PCP.
What is the Health Homes Program?
South Dakota’s Health Homes program offers enhanced health care services to eligible Medicaid recipients who have qualifying chronic conditions or a severe mental illness or emotional disturbance. Click here to find out more about the Health Homes Program.