South Dakota Medicaid for Nursing Home Care (2026)
In South Dakota, nursing home Medicaid is called South Dakota Medicaid long-term care and is run by the South Dakota Department of Social Services. Here are the rules that decide who qualifies, in plain English, with links to the official sources.
Countable savings and property a single applicant can keep. The home, one car, personal belongings and a burial fund usually do not count.
A firm limit on gross monthly income. Someone with more can still qualify by setting up Medicaid income trust (ARSD 67:46:05:33.01).
What the resident keeps each month for personal items. Most other income goes to the nursing home.
Gifts or transfers for less than fair value in this window can delay coverage.
Figures for 2026. Checked against official sources October 2026.
If the applicant is married
Federal “spousal impoverishment” rules protect the spouse who stays at home, so they are not left without money.
- Savings the at-home spouse can keep: between $32,532 and $162,660 in 2026, depending on how South Dakota applies the rule and the couple’s total assets.
- Monthly income for the at-home spouse: at least $2,705 a month and up to $4,066.50, topped up from the resident’s income if needed.
- The home: usually protected while a spouse lives there. Without a spouse at home, equity above $752,000 (up to $1,130,000 in some states) can make an applicant ineligible.
How to apply
- Start early. States must decide most applications within 45 days, but missing paperwork often makes it longer. Ask whether coverage can be backdated to the months before you applied.
- Gather records: ID, Medicare and insurance cards, proof of income, and bank and investment statements (often for the full look-back period).
- Apply with the South Dakota Department of Social Services: official application page, or call 605-773-3165 (DSS main line; local DSS offices also take applications).
- Ask the nursing home for help. Most have a business office or social worker who handles Medicaid applications every week.
Good to know in South Dakota
A person with income above the SSI level generally must be in the nursing home for 30 days in a row before coverage starts. South Dakota's $100 personal needs allowance is among the more generous. The ombudsman program is run by the Department of Human Services.
Nursing homes in South Dakota that accept Medicaid
95 of the 96 nursing homes in South Dakota on Medicare’s list accept Medicaid. Medicaid beds can be limited, so ask each home whether it has one available and whether it will keep a resident who moves from private pay to Medicaid.
Find homes that accept Medicaid in South Dakota → All nursing homes in South Dakota Best-rated homes in South Dakota
Free help
The South Dakota Long-Term Care Ombudsman (1-833-663-9673) helps nursing home residents and families with problems, including Medicaid admissions and discharges, at no cost. For planning around a home, savings or a spouse, a certified elder law attorney can advise on what is allowed.
Questions about Medicaid in South Dakota
Does Medicaid pay for nursing homes in South Dakota?
Yes. South Dakota Medicaid long-term care pays for long-term nursing home care for people who need that level of care and meet the income and asset rules. Medicare, by contrast, covers only short rehab stays after a hospital admission.
How much money can you have to qualify for Medicaid in South Dakota?
A single applicant can have up to $2,000 in countable assets (2026 figure). The home, one car and personal belongings usually do not count.
What is the Medicaid look-back period in South Dakota?
60 months. Gifts or sales below value during that time can cause a period when Medicaid will not pay for care.
How much income does a nursing home resident on Medicaid keep in South Dakota?
$100 a month for personal needs. Most other income goes toward the cost of care, after any allowance for a spouse at home.
Sources
- Resource limit $2,000 individual / $3,000 couple both entering care (sdlegislature.gov)
- Ineligible when income exceeds 300% of the maximum SSI standard… (sdlegislature.gov)
- Personal needs deduction of $100/month for nursing facility residents (sdlegislature.gov)
- 60-month look-back period (sdlegislature.gov)
- CMS 2026 standards (medicaid.gov, PDF)
- Long Term Care Application (dss.sd.gov)
- Long-Term Care Ombudsman Program, SD Department of Human Services,… (dakotaathome.sd.gov)
- Corroborates 2026 $2,000/$2,982 limits, $100 personal needs… (medicaidplanningassistance.org)
- CMS: 2026 SSI and spousal impoverishment standards
- CMS: spousal impoverishment standards effective July 1, 2026
This page explains the general rules and is not legal or financial advice. Medicaid rules change, and each case depends on the details: confirm with the state agency before making decisions. Medicare vs. Medicaid · Nursing home cost planner · VA benefits for veterans