South Dakota Medicaid long-term care: who qualifies
Medicaid is the biggest payer of long-term care in the country — nursing homes, and increasingly care at home — and Medicare is not. Qualifying turns on two tests: a financial one, which is the tables below, and a functional one, which asks how much help you need with daily life. You have to pass both.
Read this before you read the numbers.
These figures are a starting point for a conversation, not a decision. Medicaid eligibility is decided by the South Dakota Department of Social Services on the whole picture — income, assets, the look-back, your medical need, and rules that differ for a married couple in ways no table holds. Nothing here is legal advice.
The 2026 limits in South Dakota
Income limits are monthly. Asset limits count only what South Dakota treats as countable — a home you live in and one car usually sit outside that, within limits.
Nursing facility, assisted living and home care (institutional) Medicaid
Level of care needed: A doctor and the state must both agree you need the level of care a nursing home provides — help with daily activities such as bathing, dressing, eating or moving about, or skilled nursing care.
One person applying
- Monthly income limit:
- $2,982 a month
- Countable asset limit:
- $2,000
Married, both applying
- Monthly income limit:
- Not published
- Countable asset limit:
- Not published
Married, one applying — the other stays at home
- Monthly income limit:
- Not published
- Countable asset limit:
- Not published
HOPE waiver home and community based services
Level of care needed: You must need the same nursing-home level of care, but you get the care at home or in the community instead of moving into a facility.
One person applying
- Monthly income limit:
- $2,982 a month
- Countable asset limit:
- $2,000
Married, both applying
- Monthly income limit:
- Not published
- Countable asset limit:
- Not published
Married, one applying — the other stays at home
- Monthly income limit:
- Not published
- Countable asset limit:
- Not published
"Not published" means South Dakota does not publish a separate figure for that combination — not that there is no limit. Ask the South Dakota Department of Social Services rather than assuming another row applies.
The look-back period
60 months
That is 5 years. When you apply, South Dakota looks back over that window at money and property given away or sold for less than it was worth. Transfers found there can trigger a penalty period — a stretch of time during which Medicaid will not pay, calculated from the amount transferred. It is the single most common way a family gets a nasty surprise.
Particular to South Dakota
- South Dakota prints both the rule and the figure: the monthly income limit is 300 percent of the SSI standard benefit amount, $2,982 in 2026. The same limit applies to people in assisted living or a nursing facility and to HOPE waiver participants living in their own home.
- The resource limit is $2,000.
- South Dakota publishes no separate figures for regular aged, blind and disabled Medicaid on its public pages. It is a 1634 state, meaning the Social Security Administration decides Medicaid eligibility for people receiving SSI, so there is no separate state table to print.
- The look-back is sixty months — the state's own medical assistance application asks whether, in the last sixty months, you or your spouse transferred anything.
- South Dakota's only public document carrying community spouse resource figures is dated February 2024 and says on its face that the amounts will change with inflation, so no allowance figure is shown here.
Verified 2026-08-02 against South Dakota Department of Social Services, South Dakota Medicaid Coverage Groups, with the Department's medical assistance application form EA-240 (effective 2026-01-01)
Who to ask, and in what order
This page is not legal advice. It is a transcription of published limits, and limits are the easy part. Whether a particular house, annuity, trust or transfer counts — and what to do about it — depends on facts we cannot see.
the South Dakota Department of Social Services decides
Only the state agency can determine eligibility, and only their published materials are authoritative. If what you read here ever disagrees with what they say, they are right and we are wrong — please tell us.
An elder-law attorney is the right professional
For anything involving a house, a transfer already made, a trust, a second marriage, or a spouse staying at home, this is a job for a lawyer who does Medicaid planning in South Dakota — not for a form-filling service. The National Academy of Elder Law Attorneys ↗ keeps a directory. Many will do a paid first meeting for a fixed fee; ask what it costs when you book.
Free help first, if money is tight
The free counseling program in South Dakota will talk any of this through at no charge and sells nothing, and the Eldercare Locator (ACL): 1-800-677-1116 ↗ connects you to the area agency on aging for your county.
Estimate only — not financial, tax, legal, or insurance advice. Only the South Dakota Department of Social Services can determine your actual amounts. Limits change — sometimes in January, sometimes on a schedule of the state's own — and a figure that was right last year may not be right today. The date we last checked these against the South Dakota Department of Social Services is printed in the stamp above.
Common questions
- What are the Medicaid long-term-care limits in South Dakota?
- South Dakota sets a monthly income limit and a countable asset limit, and both depend on which program you are applying to and whether you are single or married. The figures on this page are transcribed from the state agency's own published materials, with the date we checked them printed beside the table.
- Does the house count against the asset limit?
- Usually not while you or a spouse live in it, and often not up to an equity limit — but the rules are specific, they differ by state, and estate recovery after death is a separate question. This is exactly the kind of thing to take to an elder-law attorney rather than settle from a web page.
- Can I give money away to qualify?
- No. South Dakota looks back at transfers made in the years before an application and can impose a penalty period of ineligibility for gifts made during it. Get advice before moving any money.