Medicaid in South Dakota (2026): Eligibility and How to Apply

What Is South Dakota Medicaid?

Medicaid is a joint federal-state health insurance program that provides free or low-cost coverage to people who meet income and eligibility requirements. In South Dakota, the Medicaid program is called South Dakota Medicaid. It is administered by the state but jointly funded by state and federal governments.

South Dakota Has Expanded Medicaid

South Dakota expanded Medicaid under the ACA, extending coverage to adults with household income up to 138% of the federal poverty level (approximately $21,597 for a single adult in 2026). This means non-disabled adults without children who meet the income threshold can now qualify for South Dakota Medicaid — a major change from pre-expansion rules that limited Medicaid to narrow eligibility categories.

South Dakota Medicaid Eligibility Categories

Beyond the general adult expansion (in states that expanded), Medicaid covers several other groups:

• Children: All states cover children in families at much higher income thresholds than adult Medicaid, often up to 200-300% FPL or more through CHIP
• Pregnant women: Covered at higher income thresholds (typically 185-250% FPL) in all states
• People with disabilities: SSI recipients and people with qualifying disabilities are eligible in all states
• Elderly adults: Adults 65+ with limited income and resources qualify through the Medicare Savings Programs

Marketplace as Alternative in South Dakota

If you don’t qualify for South Dakota Medicaid, the ACA marketplace is your primary option. South Dakota marketplace carriers include: Avera Health Plans, Sanford Health Plan and Wellmark of South Dakota... ACA premium tax credits are available for households earning between 100% and 400% FPL (~$15,650–$62,600 for a single adult in 2026).