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Healthcare Assistance for Single Mothers in South Dakota

South Dakota Healthcare Assistance for Single Mothers: Medicaid, CHIP & More [2025]

Last updated: September 2025

This is a practical, no‑fluff hub with direct links, phone numbers, real dollar amounts, and timelines. Everything here comes from official South Dakota and federal sources, checked for 2025.


Quick help box

Why this guide is different (what other pages miss)

  • All 2025 income limits and dollar figures pulled straight from the South Dakota Department of Social Services (DSS) medical programs page and related official pages below. No guessing. (dss.sd.gov)
  • Exact phone numbers for the offices that actually process your case and the hotlines that solve common snags (eligibility, travel, dental prior auth). (dss.sd.gov)
  • Reality checks on timelines and the new online system (BEES), plus what to do if your case stalls. (sdpb.org)
  • Plan B options when Medicaid/CHIP doesn’t fit: Title X family planning clinics (SD PLAN), WIC, FQHC sliding‑fee clinics, IHS/tribal services, and 211. (doh.sd.gov, fns.usda.gov, communityhealthcare.net, ihs.gov)

Quick Reference Cheat Sheet

Start here: Apply for South Dakota Medicaid or CHIP

  • Best first step: submit an application online via the BEES Customer Portal. It screens you for all medical programs (Medicaid expansion adults, pregnant women, children/CHIP, caretaker relatives, and disability pathways). BEES Customer Portal (official). (eaportal.sd.gov)
  • If online is glitchy or confusing, print a paper application (Medicaid/CHIP or combined with SNAP/TANF) and file at your DSS office, or mail/fax it. Recipient Forms (official) and Local DSS Offices list (official). (dss.sd.gov)
  • Track or update your case in BEES, or call Economic Assistance 877‑999‑5612 if you can’t get updates. If your issue is coverage/billing after approval, the Medicaid Recipient Hotline is 800‑597‑1603. (dss.sd.gov)
  • Reality check on timelines: DSS reported an average processing time of about 21 days in May 2024, but backlogs have caused some cases to take longer (weeks). If you’re past 30 days without a decision, call your local office and the Medicaid Recipient Hotline. Ask for a supervisor if needed. (sdpb.org)

What to do if this doesn’t work:

  • Call 211 to connect with a navigator who can help complete the application, upload documents, or locate a clinic that will see you while you wait. (helplinecenter.org)

2025 income limits at a glance (Medicaid & CHIP)

These are the official 2025 maximum gross monthly income limits DSS uses. If you are close, still apply—deductions and circumstances can change the decision. Source: South Dakota Medicaid Coverage Groups (official). Federal poverty guidelines used by these limits: HHS 2025 Poverty Guidelines (official). (dss.sd.gov, aspe.hhs.gov)

Table 1 — Monthly income limits (most common groups)

Household Adult Group (Expansion) Pregnant Women (Full Coverage) Low‑Income Families (Caretaker Relative)
1 $1,800 $1,800 $590
2 $2,433 $2,433 $740
3 $3,065 $3,065 $842
4 $3,698 $3,698 $941
5 $4,331 $4,331 $1,042
6 $4,963 $4,963 $1,145
7 $5,595 $5,595 $1,244
8 $6,228 $6,228 $1,343

(dss.sd.gov)

Table 2 — CHIP monthly income limits (under age 19)

Household CHIP (Child has private insurance) CHIP (Child is uninsured)
1 $2,438 $2,725
2 $3,297 $3,685
3 $4,153 $4,642
4 $5,010 $5,599
5 $5,868 $6,558
6 $6,725 $7,516
7 $7,581 $8,473
8 $8,439 $9,432

(dss.sd.gov)

Notes:

  • Newborns of moms on Medicaid are eligible through the month they turn age one, regardless of family income changes, if they remain SD residents. (dss.sd.gov)
  • Postpartum Medicaid coverage is 12 months from the end of pregnancy for those starting postpartum on or after July 1, 2023. (dss.sd.gov)

Medicaid for adults (expansion group)

Most single moms age 19–64 with household income at or below the Adult Group limit qualify. This includes many who don’t have kids at home or whose kids are already on CHIP.

Reality check on work requirements:

  • South Dakota voters approved a constitutional amendment (Nov. 2024) allowing state lawmakers to add work requirements for the expansion group. In mid‑2025, the state said it would withdraw its own waiver because new federal work requirements were signed into law on July 4, 2025. Federal rules are slated to take effect in 2027 following HHS rulemaking in 2026; pregnant people and caregivers are expected to be exempt, but paperwork could still be burdensome. Watch for state notices in 2026–2027. South Dakota Searchlight report, July 23, 2025 and KFF explainer on the 2025 law. (southdakotasearchlight.com, kff.org)

What to do if this doesn’t work:

Medicaid for pregnant women (plus BabyReady Whole Pregnancy Care)

  • Eligibility: income at/under the Pregnant Women monthly limit (Table 1). Full coverage during pregnancy and 12 months postpartum (for postpartum beginning on/after July 1, 2023). Coverage Groups (official). (dss.sd.gov)
  • BabyReady Whole Pregnancy Care: If you’re <32 weeks, ask your OB/midwife to enroll you. BabyReady gives you a team to coordinate food, mental health, transportation, breastfeeding, and dental care. BabyReady (official). (dss.sd.gov)
  • Costs: Medicaid copays are removed (see policy effective July 1, 2024). Cost Sharing (official). (dss.sd.gov)

What to do if this doesn’t work:

  • Use a Title X clinic (SD PLAN) for prenatal counseling, pregnancy testing, and referrals, with a sliding fee scale regardless of insurance. Clinic numbers: Brookings 605‑697‑1968, Sioux Falls 605‑312‑8350, Rapid City 605‑721‑8939, Watertown 605‑882‑1852, Winner 605‑842‑7100, etc. SD PLAN – South Dakota Department of Health. (doh.sd.gov)
  • If you’re tribal/eligible for IHS, contact the IHS Great Plains Area (Aberdeen) at 605‑226‑7581 or call your service unit (e.g., Pine Ridge Hospital 605‑867‑5131). (ihs.gov)

Health coverage for kids: Medicaid and CHIP

  • If your child is uninsured or privately insured but your income is under the CHIP limits (Table 2), apply for coverage. South Dakota’s CHIP covers doctor visits, hospital, dental, vision, prescriptions, and mental health care. Coverage Groups – CHIP (official). (dss.sd.gov)
  • Newborns are covered through the month they turn one when born to a mom on Medicaid, regardless of income changes, if they stay SD residents. (dss.sd.gov)
  • Dental for kids is comprehensive under Medicaid/CHIP (exams, cleanings, fluoride, sealants, x‑rays, fillings, crowns, root canals). Find a Medicaid dentist or get pre‑approval questions answered by Delta Dental at 877‑841‑1478. Medicaid Dental – Recipients (official). (dss.sd.gov)

What to do if this doesn’t work:

Parents/caretaker relatives (Low‑Income Families)

What to do if this doesn’t work:

  • If your income is slightly over, apply anyway (household count and allowable deductions matter). If denied, consider Marketplace coverage with a premium tax credit and cost‑sharing reductions. HealthCare.gov. (healthcare.gov)

What Medicaid covers (and key extras that help single moms)

Dental, vision, and preventive care

  • Adult dental: two exams/cleanings per year, fluoride, fillings, x‑rays, extractions, crowns, root canals on front teeth, dentures (no more than once every 5 years). Adult dental is capped at **2,000∗∗perstatefiscalyear(July1–June30).Medicallynecessaryemergencyservices,preventiveservices,anddentures/partialsareexemptfromthe2,000** per state fiscal year (July 1–June 30). Medically necessary emergency services, preventive services, and dentures/partials are exempt from the 2,000 cap. Questions? Delta Dental 877‑841‑1478. Medicaid Dental – Recipients (official). (dss.sd.gov)
  • Adult vision and well‑adult services are covered; call the Medicaid Recipient Hotline 800‑597‑1603 for details or see the recipient pages. Recipients page (official). (dss.sd.gov)

Non‑Emergency Medical Travel (NEMT)

Cost sharing/copays

  • South Dakota stopped collecting Medicaid copays starting July 1, 2024. Providers should not bill you for former copays. This does not change long‑term care “post‑eligibility” cost‑share calculations. Cost Sharing (official). (dss.sd.gov)

What to do if this doesn’t work:

  • If a provider tries to collect a Medicaid copay, show them the DSS cost‑sharing notice and call the Medicaid Recipient Hotline 800‑597‑1603. (dss.sd.gov)

Application checklist (bring these to speed things up)

Use this to avoid back‑and‑forth and speed your approval. If a document is hard to get, submit your application now and update your case through BEES.

  • Photo ID and proof of SD residency (driver’s license, lease, utility bill)
  • Social Security numbers for everyone applying (or proof applied for an SSN)
  • Proof of income for the last 30 days (pay stubs, employer letter, unemployment, child support statements)
  • Pregnancy verification (if applying as pregnant)
  • Proof of current health insurance (if any), premium amounts, and policy number
  • For self‑employed: most recent tax return or profit/loss

Where to send or ask questions:

  • Upload in BEES (online portal), call Economic Assistance 877‑999‑5612, or visit your local DSS office (office finder link above). (eaportal.sd.gov, dss.sd.gov)

Realistic timelines and how to track your case

  • Average processing time was about 21 days in May 2024, but some applications took longer due to system rollout and backlogs. If you haven’t heard after 30 days, call your local DSS office and the Medicaid Recipient Hotline 800‑597‑1603. If needed, request a supervisor or the Constituent Liaison. SDPB reporting on BEES and timelines. (sdpb.org)
  • Track your case: BEES portal (eaportal.sd.gov) shows status, lets you upload docs, complete renewals, and request appeals. (eaportal.sd.gov)

Table 3 — Who to call for what

Need Who Phone
Application status / eligibility Economic Assistance 877‑999‑5612
Coverage/billing after approval Medicaid Recipient Hotline 800‑597‑1603
Non‑Emergency Medical Travel NEMT Services 866‑403‑1433
Dental authorizations/claims Delta Dental of SD 877‑841‑1478
Pharmacy prior authorization Optum Rx 855‑401‑4262
Local office help (in‑person) DSS office finder See directory (Sioux Falls 605‑367‑5444, Rapid City 605‑394‑2525, Pierre 605‑773‑3612)

Sources: Medicaid phone list (official) and Local office directory (official). (dss.sd.gov)

Common mistakes to avoid

  • Waiting to apply until you’ve gathered every document. Apply now; upload missing items later in BEES or take them to a local office.
  • Reporting gross income incorrectly. Use your gross pay before taxes. If hours vary, include several recent pay stubs.
  • Not opening mail or portal messages. DSS deadlines matter—missed responses can close your case.
  • Skipping a prenatal Medicaid application because you “might be over.” Pregnant women qualify at higher income limits than the adult group.
  • Letting dental bills stack up. Adult dental has a $2,000 yearly cap; ask your dentist to seek pre‑approval so you know what’s covered. (dss.sd.gov)

What to do if this doesn’t work:

  • Call 211 to locate a navigator or legal aid that can help you fix application errors and meet deadlines. (helplinecenter.org)

If you don’t qualify or you’re stuck in limbo: fast Plan B options

  • Title X clinics (SD PLAN): birth control, STI testing, Pap/HPV, pregnancy testing, and referrals on a sliding fee scale. Brookings 605‑697‑1968, Sioux Falls 605‑312‑8350, Rapid City 605‑721‑8939, Watertown 605‑882‑1852, Winner 605‑842‑7100, Pierre Urban Indian Health 605‑224‑8841, Spearfish 605‑717‑8920. SD PLAN (official). (doh.sd.gov)
  • Sliding‑fee community health centers (FQHCs): primary care while you wait—no one turned away for inability to pay. Find clinics via CHAD’s Community Health Centers page. (communityhealthcare.net)
  • WIC (pregnant, postpartum, kids under 5): nutrition package, breastfeeding help, and referrals. Call 605‑773‑3361 or 800‑738‑2301, or apply online from the SD Department of Health’s WIC page via USDA. (fns.usda.gov)
  • Indian Health Service and Tribal programs: If you’re eligible, contact Great Plains Area IHS (605‑226‑7581) or your local service unit (e.g., Pine Ridge Hospital 605‑867‑5131). (ihs.gov)
  • 211: call 211 or text your ZIP to 898211 for fast local referrals (dental, mental health, prescriptions aid, transportation). (helplinecenter.org)

Local organizations and clinics that actually help

Region snapshots (where to go first)

  • Sioux Falls area: DSS office 605‑367‑5444; Falls Community Health (FQHC) via CHAD; SD PLAN clinic (Sanford Midtown) 605‑312‑8350; 211 for mental health/dental slots. (dss.sd.gov, doh.sd.gov)
  • Rapid City area: DSS office 605‑394‑2525; Oyate Health Center 605‑355‑2500 (tribal); SD PLAN clinic 605‑721‑8939; 211. (dss.sd.gov, greatplainstribalhealth.org, doh.sd.gov)
  • Pierre/Central SD: DSS local 605‑773‑3612; Pierre Urban Indian Health 605‑224‑8841 (SD PLAN site); 211. (dss.sd.gov, doh.sd.gov)

Documents you’ll need (and where to get them quickly)

Table 4 — Common verifications and fast sources

Verification What counts Quick source
Identity/age Driver’s license, state ID, birth certificate DMV or prior case records
Residency Lease, utility bill, mail to your address Landlord, utility portal
Income Pay stubs (last 30 days), employer letter, unemployment statements Employer HR, SD UI portal
Pregnancy Provider note or positive test with EDD OB/midwife/clinic (SD PLAN if needed)
Insurance Card or portal screenshot Employer/insurer portal

Submit via BEES upload, fax/mail to your local office, or hand‑deliver at the front desk. Contacts: Economic Assistance 877‑999‑5612; local office finder link above. (dss.sd.gov)

Extra programs many single moms miss

What to do if this doesn’t work:

  • Ask 211 for a benefits navigator or disability advocate near you; they regularly help with waiver paperwork and appeals. (helplinecenter.org)

Diverse communities: tailored pointers and contacts

  • LGBTQ+ single mothers: SD PLAN (Title X) offers confidential, judgment‑free reproductive health and STI/HIV services on a sliding fee scale. Call a clinic directly (see numbers above). (doh.sd.gov)
  • Single mothers with disabilities or children with disabilities: Family Support 360 and CHOICES waivers can cover respite, equipment, and home modifications; 2025 income standard is 2,901/month∗∗(3002,901/month** (300% SSI) with **2,000 resource limit (individual). Start with DSS and the Department of Human Services Division of Developmental Disabilities (linked from the DSS coverage groups page). (dss.sd.gov)
  • Veteran single mothers: You can enroll children in CHIP while you receive care through VA. For mixed coverage households, still apply to DSS; the agency will coordinate payers. For community connections and crisis support, call 211 or 988. (helplinecenter.org)
  • Immigrant and refugee single moms: If you’re lawfully present and meet income rules, you may qualify for Medicaid/CHIP (some statuses have a waiting period; children and pregnant women often have more options). Apply through DSS; use the DSS language options on the Medicaid site or bring an interpreter—DSS must provide language access. [Medicaid general page shows language options at the bottom.] (dss.sd.gov)
  • Tribal citizens: You can enroll in Medicaid/CHIP and still use IHS/tribal clinics. Coordinate with IHS benefit offices. Great Plains Area IHS 605‑226‑7581; Pine Ridge Hospital 605‑867‑5131. (ihs.gov)
  • Rural single moms: Horizon Health Care and other CHAD member clinics cover large rural areas with sliding fees and help with transportation planning. If you need a ride, call NEMT 866‑403‑1433 first. (communityhealthcare.net, dss.sd.gov)
  • Single fathers: The same DSS income rules apply to single dads and caretaker relatives. Apply through BEES; if denied, call Economic Assistance 877‑999‑5612 for a re‑check. (eaportal.sd.gov, dss.sd.gov)
  • Language access: DSS Medicaid pages display quick language options (Español, Tiếng Việt, नेपाली, etc.). Your local office can arrange interpretation at no cost to you. Medicaid General Info (languages shown). (dss.sd.gov)

Table 5 — Fast links you’ll actually use

Task Best link
Apply / upload docs BEES Customer Portal (official)
Paper forms Recipient Forms (official)
Eligibility numbers by group Coverage Groups (official)
Find local DSS office Office Finder (official)
Dental benefits and pre‑approvals Medicaid Dental – Recipients (official)
Pregnancy/BabyReady BabyReady (official)
Title X family planning SD PLAN clinics (official)
WIC USDA FNS – SD WIC
IHS – Great Plains Area IHS Great Plains (official)
211 Helpline Center 211 – contact

(eaportal.sd.gov, dss.sd.gov, doh.sd.gov, fns.usda.gov, ihs.gov, helplinecenter.org)

Table 6 — Realistic timeline with action steps

Week What to do Why it matters
Week 0 Submit BEES application. If stuck, file paper at DSS office the same day. Start the clock on your case; protects your application date. (eaportal.sd.gov, dss.sd.gov)
Days 1–7 Upload income proof and pregnancy verification (if applicable). Many delays are from missing docs.
Days 7–14 If no portal updates, call Economic Assistance 877‑999‑5612; document call. Keeps your case moving. (dss.sd.gov)
Days 14–21 If you need care now, schedule with an FQHC or SD PLAN clinic using sliding fees; ask about 340B prescription discounts. Care while you wait; avoid ER bills. (communityhealthcare.net, doh.sd.gov)
Day 21+ If no decision, call your local office and the Medicaid Recipient Hotline 800‑597‑1603; ask for supervisor review. Average was ~21 days in 2024; delays happen. (sdpb.org)
Day 30+ Ask for Constituent Liaison help or file an appeal if denied. Another path to resolve. (dss.sd.gov)

10 South Dakota‑specific FAQs (quick answers)

  • What income counts for Medicaid/CHIP?

    Gross (before taxes). Use the monthly limits above. If your income varies, DSS averages. Apply even if close. Coverage Groups (official). (dss.sd.gov)

  • Are there copays?

    South Dakota stopped charging Medicaid copays on July 1, 2024. Providers should not collect them. Cost Sharing (official). (dss.sd.gov)

  • How long does approval take?

    DSS reported about 21 days on average in mid‑2024, but some cases take longer. Call if you go past 30 days. (sdpb.org)

  • Can I get coverage while pregnant if I’m over the adult limit?

    Yes. Pregnant women have higher income limits (see Table 1) and get 12 months postpartum coverage. (dss.sd.gov)

  • My newborn—do I need to apply?

    Babies born to moms on Medicaid are eligible through the month they turn age one as long as they live in SD. (dss.sd.gov)

  • Does Medicaid cover adult dental?

    Yes, with an annual cap of $2,000 (July–June). Dentures/partials and preventive/emergent services are exempt. Call Delta Dental 877‑841‑1478. (dss.sd.gov)

  • I can’t get to appointments—any help?

    Call Non‑Emergency Medical Travel at 866‑403‑1433 before your visit. (dss.sd.gov)

  • Are there changes coming with work requirements?

    A new federal law (signed July 4, 2025) will require work/community engagement for expansion adults starting in 2027 after HHS rules. Expect exemptions for pregnancy/caregivers but more paperwork. Watch DSS notices in 2026. (kff.org)

  • Where do I get fast help finding a doctor or clinic?

    Call 211 or text your ZIP to 898211 to reach the Helpline Center. They can locate clinics taking new patients and sliding‑fee options. (helplinecenter.org)

  • Who do I call for pharmacy prior authorization?

    Optum Rx PA line is 855‑401‑4262. For eligibility/coverage, Medicaid Recipient Hotline 800‑597‑1603. (dss.sd.gov)

About This Guide

Compiled by the ASingleMother.org Editorial Team

This guide uses official sources from South Dakota Department of Social Services, South Dakota Department of Health, Indian Health Service, and established nonprofits (Helpline Center, Community HealthCare Association of the Dakotas).

This guide is produced based on our Editorial Standards using only official sources, regularly updated and monitored, but not affiliated with any government agency and not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.

Last verified September 2025, next review April 2026.

Please note that despite our careful verification process, errors may still occur—email info@asinglemother.org with corrections and we respond within 72 hours.

Disclaimer

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