South Dakota Medicaid: Income Limits, Eligibility and How to Apply
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Medicaid in South Dakota is run by the South Dakota Department of Social Services. South Dakota adopted the Affordable Care Act expansion in July 1, 2023, by constitutional amendment, so an adult under 65 qualifies on income alone at or below 138% of the poverty guideline: $1,835 a month for one person in 2026. Children are covered through South Dakota CHIP, and the application is at eaportal.sd.gov or 800-597-1603. Every figure below is dated 2026-09-23.
| Program | South Dakota Medicaid |
|---|---|
| Children | South Dakota CHIP |
| Agency | South Dakota Department of Social Services |
| Apply | eaportal.sd.gov · 800-597-1603 |
| Expansion | Yes, since July 1, 2023 |
| Adult income limit, 2026 | $22,025 a year for one person; $45,540 for four |
| Work requirement | January 1, 2027 |
Who qualifies in South Dakota
Adults 19 to 64 not on Medicare qualify at or below 138% of poverty (133% plus a 5% disregard), on household modified adjusted gross income, with no asset test. The 2026 figures:
| Household size | Annual income at 138% | Monthly | 100% of poverty (marketplace floor) |
|---|---|---|---|
| 1 | $22,025 | $1,835 | $15,960 |
| 2 | $29,863 | $2,489 | $21,640 |
| 3 | $37,702 | $3,142 | $27,320 |
| 4 | $45,540 | $3,795 | $33,000 |
| 5 | $53,378 | $4,448 | $38,680 |
Computed from the 2026 HHS poverty guidelines (January 15, 2026).
Children (South Dakota CHIP), pregnant women, parents, seniors and people with disabilities use other limits that South Dakota sets above the federal minimums.
How South Dakota compares
South Dakota expanded in 2023, later than most; no state has expanded since. On the work requirement it is not among the early starters (Arkansas, Iowa, Montana, Nebraska), so members have until January 1, 2027. South Dakota uses the plain "Medicaid" name, so the card and letters say what they are.
How to apply for South Dakota Medicaid
- Apply online at eaportal.sd.gov, or call 800-597-1603. HealthCare.gov also takes Medicaid applications and forwards them to South Dakota. There is no enrollment period; any day works.
- Report this month's income.
A South Dakota Medicaid case also qualifies you for a free phone (South Dakota carriers, paperwork) and shares documents with South Dakota SNAP.
What changes in South Dakota
South Dakota has set its own start for the federal work requirement: January 1, 2027. Six-month renewals for expansion adults begin with renewals scheduled on or after January 1, 2027. The nationwide changes are on the hub with CMS sources.
South Dakota specifics
- South Dakota says that from January 1, 2027 some expansion adults must show community engagement; a 2024 ballot amendment authorized the state to impose it.
- Offices serve Sioux Falls, Rapid City, Aberdeen and every county; hospitals and health centers also employ enrollment assisters.
Whether South Dakota Medicaid pays for dental or weight-loss drugs is South Dakota's choice; see does Medicaid cover.
Common questions
What is the Medicaid income limit in South Dakota for 2026?
$22,025 a year for one adult, $29,863 for two and $45,540 for four (138% of the 2026 poverty guideline); children go higher through South Dakota CHIP.
Does South Dakota have a Medicaid work requirement?
Yes: South Dakota has set January 1, 2027, for expansion adults 19 to 64 (80 hours a month, with exemptions listed on the hub).
Sources
- South Dakota Medicaid: state program page
- HHS: 2026 poverty guidelines
- HealthCare.gov: Medicaid expansion and you (138%)
- Federal Register: community engagement interim final rule (June 3, 2026)
- CMS: 2025 law section-by-section overview
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