Key Facts
Medicaid Expansion in South Dakota
Exciting news for South Dakotans! South Dakota became one of the most recent states to expand Medicaid after voters approved Constitutional Amendment D in November 2022. Expanded coverage began on July 1, 2023, opening the door to health coverage for tens of thousands of previously uninsured adults.
Who Now Qualifies for South Dakota Medicaid?
- Adults ages 18-64 with income up to 138% FPL ($20,783/year for individuals)
- Adults without dependent children (this is new under expansion!)
- South Dakota residents who meet citizenship or immigration requirements
- Not currently enrolled in Medicare
Medicaid Benefits
South Dakota Medicaid provides comprehensive coverage including:
- Doctor visits and preventive care
- Hospital inpatient and outpatient services
- Emergency services
- Prescription drug coverage
- Mental health and substance abuse treatment
- Laboratory services
- Maternity and newborn care
How to Apply
You can apply for South Dakota Medicaid through:
- Online at dss.sd.gov
- By phone: 1-800-305-3064
- In person at your local Department of Social Services office
- Through a certified application counselor or navigator
Health Insurance Marketplace
South Dakota uses the federal Health Insurance Marketplace at HealthCare.gov. If you earn more than 138% FPL or prefer private coverage, the marketplace offers various plan options with premium tax credits available.
Available Plan Types
- Bronze: Lower premiums, higher out-of-pocket costs (60% coverage)
- Silver: Moderate premiums and costs (70% coverage) - best for subsidies
- Gold: Higher premiums, lower out-of-pocket costs (80% coverage)
- Platinum: Highest premiums, lowest out-of-pocket costs (90% coverage)
Enrollment Periods
Open Enrollment: November 1, 2024 - January 15, 2025
South Dakota Medicaid accepts applications year-round, so you can apply anytime you think you might qualify.
Average Costs in South Dakota
Health insurance costs in South Dakota vary based on your age, location, plan type, and tobacco use. Here are typical monthly premiums before subsidies:
| Plan Type | Individual (Age 40) | Family of 4 |
|---|---|---|
| Bronze | $450 - $530 | $1,400 - $1,700 |
| Silver | $550 - $650 | $1,750 - $2,100 |
| Gold | $640 - $750 | $2,000 - $2,400 |
| South Dakota Medicaid | $0 | $0 |
Frequently Asked Questions
Has South Dakota expanded Medicaid?
Yes! South Dakota expanded Medicaid in July 2023 after voters approved expansion in November 2022. Adults ages 18-64 earning up to 138% of the federal poverty level ($20,783 for an individual in 2025) now qualify for Medicaid coverage.
When did South Dakota expand Medicaid?
South Dakota voters approved Medicaid expansion in November 2022 through Constitutional Amendment D. Expanded coverage became effective on July 1, 2023. This makes South Dakota one of the most recent states to expand Medicaid.
When is Open Enrollment for South Dakota health insurance?
Open Enrollment for 2025 marketplace coverage runs from November 1, 2024 through January 15, 2025. South Dakota uses the federal marketplace at HealthCare.gov. South Dakota Medicaid accepts applications year-round.
How much does health insurance cost in South Dakota?
The average monthly premium for a benchmark Silver plan in South Dakota is approximately $550-650 before subsidies. Many South Dakota residents qualify for premium tax credits or now qualify for free coverage through Medicaid expansion.
Need Help Finding South Dakota Coverage?
Our licensed agents can help you determine if you qualify for the new Medicaid expansion or find the best marketplace plan for your situation.
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