Frequently Asked Questions

What is Medical Assistance?

Medical Assistance is a federal and state-funded program providing medical coverage for people who meet certain eligibility standards. If you are eligible, Medical Assistance acts as your insurance company and pays for medical services such as visits to the doctor, hospital, dentist, chiropractor, etc.

Do I qualify for the Medical Assistance Program?

Whether or not you qualify for a particular type of Medical Assistance depends on your income and circumstances.

• Medical Assistance Programs
• To apply, you can either print an application from the list of programs available or visit your local office.
• The following information is needed to determine your eligibility:

1. Financial information about income and resources.
   
2. Information about health insurance policies.
   
3. Information about family unit: children, spouse and parent
   (present or absent).
   
4. Certain medical information.
   
5. Citizenship information.

I am a Medical Provider, how can I enroll in the Medical Assistance Program?

To become a Medical Provider you must complete a provider application and agreement and submit it to:

• South Dakota Department of Social Services
  Division of Medical Services
  700 Governors Drive
  Pierre, SD 57501
• To obtain an application, call Medical Services at 605-773-4374 or print and fill out an application and agreement now:
  • In-State Provider Agreement and Application.
  • Out-of-State Provider Agreement and Application.

Is a Purple Referral Card physically required for Managed Care recipients?

No. A proper referral can be provided in many ways, i.e. a telephone referral, a physician order, a prescription, a certificate of medical necessity, etc as long as the referral mechanism used provides the "referred to" medical provider with the Managed Care necessary information to process the claim as indicated on a referral card (PCP name and #, length of referral, type of service to be provided, date, recipient name).

The referral card is simply a tool indicating the required information needed by the "referred to" provider.

More Questions?

If you have questions about covered services, contact your medical provider or the Division of Medical Services at (605) 773-3495 or
1-800-597-1603. You can also send an email to the Division of Medical Services at: Medical@state.sd.us