South Dakota Medicaid Income Limits 2026: DSS Chart

South Dakota's expansion started in July 2023, and our national Medicaid income limits guide shows how it compares with other states.

South Dakota Medicaid Income Limits by Household Size (2026)

DSS lists 5 gross monthly income charts for its family and adult groups, each running from one to eight people, according to the DSS medical programs guide. We compared every figure with the 2026 HHS guideline, and the percentages below are Grantsights calculations from that comparison.

Source: South Dakota DSS, South Dakota Medicaid Coverage Groups (opens in a new tab), "Maximum Gross Monthly Income" charts, checked November 3, 2026. DSS doesn't list a per-person add-on above eight. The parent column works out to about 44% of poverty for one person, 37% for three and 29% for eight, because it's a fixed dollar standard rather than a percentage.

Yearly versions (Grantsights calculation, monthly limit times 12): the Expansion line is about $22,020 for one person, $37,704 for three and $45,540 for four. CHIP for uninsured children reaches about $57,108 a year for three.

What the federal table says

For South Dakota, the December 1, 2023 Medicaid.gov eligibility levels table (opens in a new tab) lists the state at 182% for children's Medicaid, 204% for separate CHIP, 133% for pregnancy, 46% for parents and 133% for Expansion adults. Add the 5% disregard and those become 187%, 209% and 138%, which line up with the DSS charts above.

How DSS Counts Income for South Dakota Medicaid

138% shows up twice on the DSS page, because South Dakota uses one income line for both Expansion adults and pregnant women. Both groups, along with children and parents, are judged under MAGI rules (Modified Adjusted Gross Income):

• Gross monthly income is the test. Every DSS chart is labeled "Maximum Gross Monthly Income," meaning pay before taxes and withholding.
• The 5% disregard is already inside the numbers. The Expansion chart's $1,835 for one person equals 133% of poverty plus 5%, the formula written into the state constitution.
• Tax households set household size. A parent counts the children they claim; a pregnant woman counts each baby she's expecting.
• Private insurance changes a child's chart. DSS lists one limit for children who already have private coverage and a higher CHIP limit for children without it.
• Who counts as a dependent child: a child under 18 living with a parent or caretaker relative, or an 18-year-old full-time high school student expected to finish before turning 19.

Seniors and people with disabilities follow SSI-based rules with resource limits, covered in the next section. Our federal poverty guidelines guide shows how the 2026 numbers are built.

South Dakota Medicaid for Seniors, Disability and Long-Term Care

The income cap for nursing home care and South Dakota's home and community-based waivers is $2,982 a month in 2026, according to the DSS coverage groups data, which describes it as 300% of the SSI Standard Benefit Amount. The resource limit for most of these groups is $2,000.

Source: South Dakota DSS, medical programs page (opens in a new tab), checked November 3, 2026. The 2026 SSI amount is $994 for one person.

A few details from the same page:

• People who lost SSI because of a cost-of-living increase or Social Security benefits may still get Medicaid through the Disabled Adult Child, Pickle or Early or Disabled Widow(er)s groups, with a $2,000 resource limit.
• The Medicare Savings Program can save someone up to $2,434.80 a year, which is 12 months of the Part B premium. DSS doesn't print the income chart. Federal law sets QMB at 100%, SLMB at 120% and QI-1 at 135% of poverty; calculated from the 2026 HHS guideline, that's about $1,330, $1,596 and $1,796 a month for one person.
• Adult foster care homes use a different test: income after deductions must be under the state's reimbursement rate to the home, with a $2,000 resource limit.

DSS's page doesn't list the personal needs allowance or the spousal protection amounts for 2026, so ask the local DSS office for those before you plan around them. For SSI itself, see our SSI income limits guide and SSI benefits guide.

South Dakota Medicaid Expansion: Amendment D, Amendment F and the 2026 Ballot

South Dakota voters put Medicaid Expansion into the state constitution on November 8, 2022, and coverage began July 1, 2023, according to the history note on Article XXI, Section 10 (opens in a new tab). The section covers people over 18 and under 65 with income at or below 133% of poverty plus 5%, and it bars the state from putting extra eligibility burdens on that group.

Three changes since then matter for anyone on Expansion today:

1. Amendment F (2024). Voters approved it November 5, 2024, effective July 1, 2025. It lets the state impose a work requirement on Expansion adults who haven't been diagnosed as physically or mentally disabled, to the extent CMS allows.
2. SDCareerLink was shelved. DSS had drafted a five-year 1115 demonstration with a work requirement. Its 1115 demonstrations page (opens in a new tab) now says DSS "will not be submitting" it and will instead implement the community engagement rules in the federal law.
3. The November 3, 2026 ballot. The 2025 Legislature put a constitutional amendment on the November 3, 2026 ballot that would repeal expanded Medicaid coverage if federal funding for expansion drops below 90%, according to the Attorney General's final ballot explanation release (opens in a new tab) of May 18, 2026. News coverage, not DSS, reports that the sponsors and the Attorney General disagree over whether it would end expansion automatically. Check the official result with the South Dakota Secretary of State. Approval wouldn't change anyone's coverage on its own unless federal funding fell below that 90% level.

KFF's Medicaid expansion tracker (opens in a new tab), a non-government compilation, lists South Dakota as adopted with a July 1, 2023 start, one of 41 jurisdictions with expansion as of October 2026.

Federal changes DSS has scheduled

Per the DSS Medicaid changes page (opens in a new tab), the federal law signed July 4, 2025 brings these dates:

How the work rule plays out: new applicants from January 1, 2027 must show 80 hours in the month before they apply. People already enrolled face it at their first regular renewal in 2027 and must show 80 hours in at least one month since the last renewal. Excluded groups include people who are pregnant or postpartum, caregivers of a child 13 or younger or of a person with a disability, American Indians and Alaska Natives including people eligible for IHS, medically frail people, veterans with a total disability rating, people meeting SNAP or TANF work rules, people in addiction treatment, former foster youth under 26 and people recently released from incarceration. DSS says it will check data sources first and began notifying affected enrollees in September 2026.

Worked Examples: South Dakota Families in 2026

For example, a family of three in South Dakota earning $3,500 a month, a dad in Sioux Falls with children aged 4 and 12 and no private insurance, gets this result:

1. Both children are under the $4,759 CHIP line for uninsured kids, so both are covered.
2. Dad is over the $842 Low-Income Families limit and over the $3,142 Expansion line. Specifically, he's $358 over Expansion. At about 154% of poverty ($3,500 divided by $2,277), he can get a Marketplace plan with a premium tax credit.
3. If dad's income dropped to $3,000 in 2027, he'd qualify through Expansion. Because he cares for a child 13 or younger, he'd be excluded from the work rule, but he'd still renew every six months.

A pregnant woman in Rapid City earning $2,300 a month who lives alone is a household of two once the baby is counted. She's under the $2,488 two-person line, so she qualifies, and her full coverage runs 12 months after delivery. The baby is covered from birth until the end of the month of the first birthday.

One retiree in Aberdeen, 82, with $2,600 a month in pension and Social Security and $1,700 in the bank, needs nursing home care. She's under the $2,982 income cap and the $2,000 resource limit, so she can qualify for South Dakota Medicaid in the nursing facility, with most of her income going toward the cost of care.

What South Dakota DSS Doesn't Tell You About These Limits

Grantsights analysis of the 5 income charts on the DSS medical programs page found 5 gaps worth knowing:

1. There's no date on the charts. DSS prints the 2026 nursing home figure but no effective date for the family charts. The amounts match 138%, 187% and 209% of the 2026 HHS guideline to the dollar, which is how Grantsights dated them.
2. Pregnancy uses the adult line. At 138% of poverty, a pregnant woman in a household of three qualifies only up to $3,142. North Dakota's pregnancy chart for the same household goes to $3,985, about 27% higher.
3. A child's insurance status picks the chart. The uninsured CHIP line for three ($4,759) is $501 higher than the Medicaid line for an insured child ($4,258). Families between those numbers who keep a private plan may find their child doesn't qualify at all.
4. The parent standard shrinks as families grow. The Low-Income Families limit is 44% of poverty for one person but 29% for a household of eight. Most parents 19 to 64 who are over it still fit under Expansion, where the 2027 rules apply.
5. "Gross" really means gross. Every chart says Maximum Gross Monthly Income, so a worker earning $1,900 before taxes is over the $1,835 Expansion line even if take-home pay is $1,600.

Common Mistakes and Red Flags

A common mistake is reading the $842 Low-Income Families limit as the cutoff for every parent. That limit only applies to that one group. A parent 19 to 64 earning up to $3,142 in a family of three can still qualify through Expansion.

More errors to watch:

• Keeping a costly private plan for a child to qualify. The insured-child limit is lower than the CHIP limit, so compare before dropping or keeping coverage.
• Forgetting the unborn child. A pregnant woman living alone uses the two-person line of $2,488, not $1,835.
• Assuming the ballot vote ended coverage. Nothing on the November 3, 2026 ballot changes current Expansion coverage today. Watch for a DSS notice before believing a rumor.
• Underestimating the 2027 paperwork. Six-month renewals and work reporting mean more mail; keep your address and phone number current in the BEES Customer Portal.
• Missing the 10-day window. You get 30 days to request a hearing, but only an appeal within 10 days keeps current benefits going.

Red flags for scams: applying for South Dakota Medicaid or CHIP costs nothing. Avoid anyone who asks for a fee, promises approval or asks for card or bank details by text or phone. Use the BEES Customer Portal, a local DSS office, or the Division of Economic Assistance at 877-999-5612.

How to Apply for South Dakota Medicaid and How Long It Takes

Federal rules give DSS up to 45 days to decide most Medicaid applications and 90 days when eligibility rests on a disability, under 42 CFR 435.912 (opens in a new tab). DSS lists three ways to apply on its Medical Eligibility page (opens in a new tab):

1. Online through the SD BEES Customer Portal, where you can also upload documents and sign up for text or email alerts.
2. On paper, by printing the application and returning it to a local DSS office.
3. With help from local DSS office staff, or by calling the Division of Economic Assistance at 877-999-5612.

Bring proof of income, Social Security numbers and immigration documents if they apply. Until December 31, 2026, Medicaid can be backdated up to 3 months before the application; from January 1, 2027, it's 1 month for Expansion and 2 months for other groups. Pregnant applicants should ask a clinic about starting prenatal care while DSS decides.

What to Do If You're Denied

You have 30 days after the notice of the action to request a hearing, under Administrative Rule 67:17:02:04 (opens in a new tab). For Medicaid, the request can be written or oral under Rule 67:17:02:03, as amended effective September 29, 2025.

• Where to send it: DSS Office of Administrative Hearings, 700 Governors Drive, Pierre, SD 57501; 605-773-6851; admhrngs@state.sd.us.
• Keep benefits: the DSS recipient handbook says people currently getting benefits can keep them during the appeal if they request a hearing within 10 days.
• Say what you're appealing. The rule asks you to name the DSS action or inaction you disagree with.
• Check the chart DSS used. A child placed on the insured chart instead of CHIP, or a missing unborn child, is a common and fixable error.
• Other complaints about services or payments go to the Division of Medical Services at 800-597-1603.

If You're Over the South Dakota Medicaid Limit

$15,960 to $63,840 a year is the 2026 range where one adult can usually get Marketplace premium tax credits, so it's the main option once you're over the $1,835 Expansion line. Other routes:

• Marketplace coverage: South Dakota uses HealthCare.gov (opens in a new tab). Children in the family may still qualify for CHIP even when the adults don't.
• Medicare and the Medicare Savings Program: once you're 65 or on Medicare through disability, the MSP can cover premiums with resources under $9,950 for one person.
• WIC: pregnant women and children under 5 may qualify up to 185% of poverty; see our WIC income limits guide.
• Food and heat: our SNAP income limits guide and LIHEAP income limits guide.
• Older adults and people with disabilities: our help for seniors programs guide and disability grants for individuals guide.
• Neighboring states: see our guides to North Dakota, Wyoming and Montana Medicaid income limits.

Want other programs to look at? Grantsights' free eligibility checker points you to official routes for help with food, rent and utilities. It can't decide whether you qualify for South Dakota Medicaid, and it doesn't apply for you; DSS makes that call.

When These Limits Change Next

South Dakota's poverty-based charts follow the HHS guidelines published each January, and the current DSS amounts match the 2026 guideline of $15,960 for one person and $33,000 for four, according to the HHS ASPE 2026 poverty guidelines data (opens in a new tab). DSS doesn't publish a fixed switch date, so check the medical programs page in spring 2027.

The $2,982 long-term care cap moves with the SSI rate each January 1. SSA's SSI payment amounts page (opens in a new tab) sets the 2027 individual rate at $1,029, so 300% becomes about $3,087 a month in 2027 (Grantsights calculation).

FAQ: South Dakota Medicaid Income Limits

What is the income limit for Medicaid in South Dakota in 2026?

$1,835 a month for one adult 19 to 64, $3,142 for three and $3,795 for four under Medicaid Expansion, which is 138% of the 2026 poverty guideline.

Did South Dakota expand Medicaid?

Yes. Amendment D passed November 8, 2022, and expansion began July 1, 2023. A November 3, 2026 ballot amendment would repeal it if federal funding drops below 90%. Check the official result with the Secretary of State; coverage would end only if federal funding falls below 90%.

What is the CHIP income limit in South Dakota?

$4,759 a month for a household of three and $5,748 for four for children without private insurance. Children with private insurance can get Medicaid up to $4,258 for three.

What is the South Dakota Medicaid income limit for pregnant women?

The same 138% line as adults: $2,488 a month for a household of two and $3,142 for three, counting the unborn baby. Coverage lasts 12 months after the pregnancy.

What is the income limit for nursing home Medicaid in South Dakota?

$2,982 a month in 2026 with a $2,000 resource limit, for both nursing homes and the HOPE waiver.

Does South Dakota have Medicaid work requirements?

From January 1, 2027, Expansion adults who aren't excluded must show 80 hours a month of work, training, volunteering or school. DSS dropped its SDCareerLink waiver.

How long do I have to request a Medicaid hearing in South Dakota?

30 days after the notice. Appeal within 10 days to keep current benefits during the hearing.

When do South Dakota Medicaid income limits change?

After the HHS guidelines each January for the family charts, and each January 1 for the SSI-based $2,982 cap, which rises to about $3,087 in 2027.

Sources

1. South Dakota DSS: South Dakota Medicaid Coverage Groups (opens in a new tab) - income charts, long-term care, waiver, MAWD, renal and MSP limits; checked November 3, 2026
2. South Dakota DSS: Medicaid Eligibility Changes Coming Soon (opens in a new tab) - community engagement, six-month renewals, retroactive coverage, cost sharing and noncitizen dates
3. South Dakota DSS: 1115 Demonstrations (opens in a new tab) - SDCareerLink not submitted
4. South Dakota DSS: Medical Eligibility and ways to apply (opens in a new tab)
5. South Dakota DSS: Medicaid Recipient Handbook (opens in a new tab), October 2025 - fair hearings and 10-day benefit continuation
6. South Dakota Constitution, Article XXI, Section 10 (opens in a new tab) - Amendment D (2022) and Amendment F (2024)
7. South Dakota Administrative Rule 67:17:02:04, Time limits for requesting hearing (opens in a new tab)
8. South Dakota Administrative Rule 67:17:02:03, Hearing requests (opens in a new tab), effective September 29, 2025
9. South Dakota Attorney General: Final ballot explanation on the Medicaid expansion amendment (opens in a new tab), May 18, 2026
10. Medicaid.gov eligibility levels table (December 2023 data), used here for South Dakota (opens in a new tab), as of December 1, 2023
11. KFF: Status of State Medicaid Expansion Decisions (opens in a new tab) (non-government compilation), October 2026
12. eCFR: 42 CFR 435.912, Timely determinations (opens in a new tab)
13. HHS ASPE: 2026 Poverty Guidelines (opens in a new tab)
14. SSA: SSI Federal Payment Amounts (opens in a new tab) - 2026 and 2027 amounts
15. HealthCare.gov: Medicaid expansion and you (opens in a new tab)