South Dakota’s Medicaid program offers limited personal care services to eligible individuals in their homes. The program’s primary objective is to prevent the premature placement of persons in skilled nursing facilities. This goal is achieved by offering program participants support to remain living at home, such as assistance with shopping for food and other household essentials.
To avoid confusion, it should be mentioned that there is also a Medicaid Waiver in South Dakota called the HOPE Waiver, which provides similar, but not identical services. One cannot simultaneously receive assistance from both programs.
Personal Care Services is open to anyone over the age of 18 who is qualified for Medicaid and found to be medically in need of assistance.
South Dakota’s Regular Medicaid program (under which personal care is an option) has different, more restrictive, financial eligible guidelines than does the state’s HCBS Medicaid Waiver.
Income Limits
As of 2023, single applicants are permitted monthly income up to $914. Married applicants’ monthly combined income limit is set at $1,371.
Asset Limits
An applicant’s countable resources, excluding the value of one’s home, given the equity value is under $688,000, must be no greater than $2,000. Also excluded are a single vehicle, personal items, and home furnishings. Married applicants’ asset limit is $3,000 (in 2023).
Candidates who would otherwise qualify but have incomes and resources in excess of these limits might consider working with a Medicaid planning professional to help them gain eligibility. There are several types of Medicaid planners, some offer free assistance and others provide fee-based services. Learn more about Medicaid planning here.
Medicaid has a 60-month look-back period in which all transfers within this time frame are scrutinized. Assets are not allowed to be gifted in order to meet financial requirements, otherwise the individual will be penalized with a period of Medicaid ineligibility.
Personal Care Services are intended to prevent nursing home placement by helping individuals remain living at home. Therefore, the specific types of assistance are chosen with that in mind. Benefits can include the following:
Services are only provided during weekday work hours, and most program participants have primary caregivers supporting them outside that time frame. This program limits the annual hours of personal care any one Medicaid beneficiary can receive to 500 hours. This is approximately 10 hours a week.
To begin the application process, one can use the online referral form available on the Department of Human Services website. Alternatively, one can call the South Dakota Long Term Services and Supports line at 866-854-5465.
Very limited information about Personal Care Services can be found on the South Dakota Department of Human Services’ website.