South Dakota · South Dakota Medicaid / CHOICES Waiver
Medicaid for Nursing Homes in South Dakota (2026)
Medicaid in South Dakota can pay for skilled nursing home care — including room, board, and medical services — when applicants meet financial limits and nursing-facility level-of-care requirements. Use our free screener below, then verify details with South Dakota Medicaid / CHOICES Waiver caseworkers.
State helpline: 1-866-854-5465
Medicaid Nursing Home Requirements in South Dakota
Income limit
~$2,829/mo
Asset limit (individual)
~$2,000
Look-back period
60 months
Program
South Dakota Medicaid / CHOICES Waiver
- Medicaid in South Dakota covers skilled nursing facility room, board, and care for eligible residents — unlike assisted living, where housing is usually private pay.
- South Dakota Medicaid / CHOICES Waiver requires financial eligibility and a clinical level-of-care determination (typically nursing-facility level).
- Countable assets must generally be at or below $2,000 for an individual ($3,000 for couples) — with spousal impoverishment protections in many cases.
- Transfers of assets during the 60-month look-back period may trigger a penalty period before Medicaid nursing home coverage begins.
How to apply for nursing home Medicaid
- Gather financial documents: bank statements, property deeds, income verification, and insurance policies.
- Apply for South Dakota Medicaid through your county or state human services office (many states offer online applications).
- Complete a level-of-care assessment — South Dakota must confirm nursing-facility or waiver-level need.
- Choose a Medicaid-certified nursing home that accepts South Dakota Medicaid / CHOICES Waiver residents.
- Call South Dakota ADRC/Area Agency on Aging at 1-866-854-5465 for free application help.
Federal Medicaid rules allow states to seek estate recovery for nursing home costs paid after age 55. A primary home may be protected while a spouse or dependent lives there — verify current South Dakota rules with an elder law attorney.
Compare CMS nursing home star ratings in Sioux Falls before choosing a Medicaid-certified facility.
No phone number required. This screening tool is 100% free and private. Results are educational only — not legal or financial advice.
Assisted living & waiver programs
Nursing home Medicaid covers room and board in skilled nursing facilities. Assisted living is different — South Dakota Medicaid / CHOICES Waiver may cover care services in participating waiver settings, but housing is often private pay.
- • South Dakota CHOICES waiver provides HCBS.
- • Assisted living centers must be certified.
- • Sioux Falls and Rapid City have most options.
South Dakota Medicaid Nursing Home FAQs
Does Medicaid pay for nursing homes in South Dakota?▾
Yes — South Dakota Medicaid (South Dakota Medicaid / CHOICES Waiver) covers skilled nursing facility care for eligible residents, including room and board when clinical and financial criteria are met. This differs from assisted living, where housing is typically private pay. Contact South Dakota ADRC at 1-866-854-5465 for application help.
What is the Medicaid nursing home income limit in South Dakota?▾
The typical individual income screening limit for South Dakota Medicaid long-term care is approximately $2,829/month. Limits are updated annually — confirm with your state Medicaid office before applying.
What is the Medicaid nursing home asset limit in South Dakota?▾
Countable assets are generally limited to about $2,000 for an individual and $3,000 for a couple in South Dakota. A primary home, one vehicle, and personal belongings are often excluded. Spousal impoverishment rules may allow a community spouse to keep additional assets.
What is the Medicaid look-back period in South Dakota?▾
South Dakota follows the federal 60-month Medicaid look-back period. Asset transfers below fair market value during this window may trigger a penalty period before nursing home Medicaid coverage begins. Consult an elder law attorney before gifting property or restructuring assets.
How do I qualify for Medicaid nursing home care in South Dakota?▾
You must meet three pillars: (1) income at or below ~$2,829/mo, (2) countable assets within limits, and (3) a state-approved level-of-care assessment confirming nursing-facility need. South Dakota Medicaid / CHOICES Waiver requires financial eligibility and a clinical level-of-care determination (typically nursing-facility level).
How do I apply for Medicaid nursing home in South Dakota?▾
Gather financial documents: bank statements, property deeds, income verification, and insurance policies. Apply for South Dakota Medicaid through your county or state human services office (many states offer online applications). Complete a level-of-care assessment — South Dakota must confirm nursing-facility or waiver-level need. Choose a Medicaid-certified nursing home that accepts South Dakota Medicaid / CHOICES Waiver residents. Call South Dakota ADRC/Area Agency on Aging at 1-866-854-5465 for free application help.
Does Medicaid pay for assisted living in South Dakota?▾
South Dakota Medicaid / CHOICES Waiver may cover care services in participating assisted living or waiver settings, but room and board is often still private pay. Use our checker above for a preliminary screening — nursing home Medicaid has broader room-and-board coverage.