Medical Services

Medicaid State Plan

CHIP MAGI Eligibility

The South Dakota Department of Social Services intends to make changes to the South Dakota CHIP State Plan concerning the methodology used to determine eligibility for Targeted Low Income Children. Read a letter summarizing the changes here.

As pages of the State Plan Amendment are completed, they will be posted below:

Eligibility
These SPA pages assure that South Dakota will provide coverage not to exceed 12 months for children ineligible for Medicaid as a result of the elimination of income disregards as required by the PPACA.

MAGI-Based Income Methodologies
These SPA pages designate the income methodology South Dakota will use to make eligibility determinations in 2014.  South Dakota will use the Modified Adjusted Gross Income (MAGI) standards as required by the PPACA.  MAGI is an income calculation method that uses tax information to calculate household income for use in eligibility determinations. The Department has converted current income requirements to MAGI-equivalent standards. 

Non-Financial Eligibility
These SPA pages contain additional assurances relating to eligibility, including a mechanism to assure that CHIP is not used as a substitution of coverage, an assurance the state does not charge premiums, an assurance the state does not provide continuous coverage regardless of the family’s changing circumstances, and clarifies that the state does not allow presumptive eligibility for children or pregnant women.

CHIP XXI Medicaid Expansion
These SPA pages designate the income eligibility for children found eligible under 42 CFR 457.320(a)(2) and (3).

Eligibility Process
These SPA pages detail South Dakota’s eligibility and enrollment process, including the application for Medical Assistance, the renewal process, and assurance that the state will coordinate eligibility and enrollment with the federally facilitated marketplace.