Medical Eligibility

Families and Children

Family Support Services

Family Support Services provide Medical Assistance for South Dakotans with a developmental disability such as Down’s Syndrome, autism or cerebral palsy.

Eligibility Requirements

  • The individual must live in the family home on a full-time basis.
  • Only children living with natural, adopted, stepfamily or relatives who act in parental capacity may qualify.
  • The individual must be found disabled by the Social Security Administration or the Department of Social Services.
  • The individual's monthly income must be less than 300 percent of the SSI Standard Benefit Amount ($2,094) and resources must be less than $2,000. Resources include items such as checking and savings accounts and certificates of deposit. Income and resources of the parents are not considered to determine eligibility.

Covered Services

Eligible individuals are entitled to full Medical Assistance coverage. Covered services include:

  • doctor appointments,
  • hospital stays,
  • dental and vision services,
  • prescription drugs,
  • rehab/therapy,
  • chiropractic services

Medical coverage may begin three months prior to the application date. The start of medical coverage is based on the date the application is received in the local office.

In addition, the following services are available through Family Support Services:

  • Service Coordination: Includes services that will assist the individual to access needed services and the full range of medical assistance, as well as needed medical, social, educational and other services.
  • Respite Care: Includes services provided to individuals unable to care for themselves. It is furnished on a frequency determined in the individual’s care plan because of the absence or need for relief of those persons normally providing care.
  • Specialized Medical and Adaptive Equipment and Supplies: Includes devices, controls or appliances, that enable individuals to increase their abilities to perform activities of daily living, or to perceive, control or communicate with their environment.
  • Nutritional Supplements: Certain nutrition supplements that are not a covered service under the full range of medical assistance.
  • Personal Care: Assistance with eating, bathing, dressing, personal hygiene, or activities of daily living. This service may include assistance with preparation of meals, but does not include the cost of the meals themselves. When specified in the plan, this service may also include such housekeeping chores as bed making, dusting, and vacuuming, which are incidental to the care furnished, or which are essential to the health and welfare of the individual, rather than the individual’s family.
  • Companion Care: Non-medical service specifically for children in transition from childhood to adulthood and includes supervised integrated socialization, role modeling, and independent living skill development. This is a skill development service and may include such tasks as assistance and/or supervision of meal preparation, laundry, and shopping.
    • Examples of companion care services include: increasing skills in the areas of preparing a budget and shopping list, shopping, making appropriate choices and making the purchase; taking part in a community event to develop appropriate socialization skills and become integrated into the community; preparation of a meal, doing laundry or other household tasks.
  • Environmental Accessibility Adaptations (Home/vehicle modifications): Those physical adaptations required by the individual’s plan of care, which are necessary to ensure the health, welfare and safety of the individual, or which enables the individual to function with greater independence without which, the individual would require institutionalization.
    • Such adaptations may include the installation of ramps, and grab-bars, widening of doorways, modification of bathroom facilities, or installation of specialized electric and plumbing systems necessary to accommodate the medical equipment and supplies which are necessary for the welfare of the individual. May also include modifications to vehicles such as lifts and tie downs to accommodate wheelchairs. All services should be provided in accordance with applicable state of local building codes.

More Information

Visit the South Dakota Department of Human Services' website for more information.