South Dakota Medicaid Eligibility Calculator 2026

South Dakota Medicaid eligibility at a glance

South Dakota MedicaidProgram
AdoptedExpansion status
138% FPLPeople under 65
51% FPL (approx.)Parents and caretakers
138% FPLPregnancy
209% FPLChildren (up to)
800-597-1603Agency phone
Official siteAgency website

South Dakota income limits for ages 19–64, 2026 (138% FPL)

Household size	Monthly limit	Yearly limit
1	$1,835	$22,025
2	$2,489	$29,863
3	$3,142	$37,702
4	$3,795	$45,540
5	$4,448	$53,378
6	$5,101	$61,217
7	$5,755	$69,055
8	$6,408	$76,894

South Dakota Medicaid income limits by group, 2026

Household	Parents /mo	Pregnancy /mo	Teens 6–18 /mo	Children, top /mo
1	$678	—	—	—
2	$920	$2,489	$3,372	$3,769
3	$1,161	$3,142	$4,257	$4,758
4	$1,403	$3,795	$5,143	$5,748
5	$1,644	$4,448	$6,028	$6,737
6	$1,885	$5,101	$6,913	$7,726

Children, pregnancy and parent limits use the Medicaid.gov eligibility levels table (state decisions as of December 1, 2023, the latest shown there), plus the 5% disregard, converted to dollars with 2026 poverty guidelines. States can change these, so confirm with your agency.

South Dakota's children's limit of up to 209% of poverty ranks toward the lower end nationally, and its pregnancy limit of 138% is toward the lower end nationally. Compare all states' income limits.

Who qualifies for Medicaid in South Dakota?

People: South Dakota has adopted Medicaid expansion, so most people under 65 can qualify with income up to 138% of the federal poverty level.
Parents: with one child and a household of two, the parent limit is about $2,489 a month.
Pregnant people: a household of two (you and your expected baby) can qualify up to about $2,489 a month.
Children: a family of four can have up to about $5,143 a month for teens under Medicaid, and up to $5,748 depending on age and program.
Seniors and people with disabilities: a common benchmark is $1,014 a month and $2,000 in assets for one person. South Dakota's rules may differ, so confirm with the agency.

South Dakota Medicaid eligibility calculator: person reviewing coverage options

South Dakota Medicaid examples

A single person earning $1,735 a month is under the $1,835 limit, so likely eligible.
A single person earning $2,035 a month is over the limit and should compare Marketplace plans.
A pregnant person in a household of three earning $2,942 a month is within the pregnancy limit.
A family of four earning $4,943 a month has teens within the Medicaid limit, even if the parents are over theirs.

Federal poverty levels used for South Dakota

Household	100% FPL	138% FPL	150% FPL	200% FPL
1	$15,960	$22,025	$23,940	$31,920
2	$21,640	$29,863	$32,460	$43,280
3	$27,320	$37,702	$40,980	$54,640
4	$33,000	$45,540	$49,500	$66,000
5	$38,680	$53,378	$58,020	$77,360
6	$44,360	$61,217	$66,540	$88,720
7	$50,040	$69,055	$75,060	$100,080
8	$55,720	$76,894	$83,580	$111,440

Yearly dollars from the 2026 HHS poverty guidelines for the 48 contiguous states and DC. Divide by 12 for a monthly figure.

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How to apply for Medicaid in South Dakota

Check your estimate with the South Dakota Medicaid calculator above.
Gather proof of identity, address, income and household.
Apply through the South Dakota Medicaid agency, by calling 800-597-1603, or at HealthCare.gov. Applying is free.
Answer any requests for more information before the deadline.
Look for a decision, usually within 45 days, or 90 days if it depends on a disability.

See our full Medicaid application guide and who qualifies.

What South Dakota Medicaid covers

Like every state, South Dakota must cover hospital care, doctor visits, lab tests and X-rays, nursing facility care, home health, family planning, rides to medical care and EPSDT services for children. Optional benefits, such as dental care for people 21 and older and eyeglasses, are up to the state. Ask the agency or your health plan for the current South Dakota benefit list.

South Dakota Medicaid work requirements

Because South Dakota has adopted expansion, most expansion enrollees aged 19 to 64 will need to complete 80 hours a month of qualifying activities starting no later than January 1, 2027. Exemptions include people who are pregnant, medically frail or caring for young children. Check with South Dakota for its start date and how to report.

Seniors and long-term care in South Dakota

Older people and people with disabilities in South Dakota may qualify for coverage, help with Medicare costs, nursing home care or home care through waiver programs. These use separate income, asset and care-need rules, and a 60-month look-back on asset transfers applies to long-term care. See our guide to Medicaid for seniors.

Keeping your South Dakota coverage

Update your address with the agency when you move.
Respond to every renewal letter by its deadline.
Report changes in income or household as required.
If you're denied, read the notice and ask about a fair hearing, usually within 90 days.

Free help in South Dakota

Trained helpers can assist with applications at no cost. Dial 211, or find a local navigator at LocalHelp.HealthCare.gov. Be careful of anyone charging a fee to apply. South Dakota residents on Medicaid can also check Lifeline phone discounts and food programs.

South Dakota Medicaid FAQs

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

Most people aged 19–64 can qualify up to 138% of poverty, about $1,835 a month for one person and $3,795 for a family of four.

Did South Dakota expand Medicaid?

Yes. South Dakota is among the 41 jurisdictions that have adopted expansion.

How do I apply for South Dakota Medicaid?

Apply online through the state agency or HealthCare.gov, or call 800-597-1603. It is free and you can apply at any time.

Can pregnant women get Medicaid in South Dakota?

Yes. The published limit is about 138% of poverty, or $2,489 a month for a household of two.

Does South Dakota cover children through Medicaid or CHIP?

South Dakota covers children through Medicaid and a separate CHIP program, up to about 209% of poverty.

Is the South Dakota Medicaid calculator official?

No. It is an independent estimate. Only the South Dakota Medicaid agency can make a decision.

Agency details from Medicaid.gov. Check the agency site for current contact information.

Other state Medicaid calculators

Tennessee Medicaid calculator · Texas Medicaid calculator · Utah Medicaid calculator · Vermont Medicaid calculator · Virginia Medicaid calculator · Washington Medicaid calculator