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SD Disabled Children's Program - Medical Assistance

The Disabled Children's Program provides Medical Assistance for certain disabled children in South Dakota. The program is intended for children with disabilities who have medically fragile conditions that would require skilled nursing care in a medical facility if they were not being cared for at home.

Eligibility Requirements

To be eligible for services:

      Children must be under age 19.

      Children must be found disabled by the Social Security Administration or the Department of Social Services using disability standards from the Social Security Act.

      Children must require medical care in the home that is comparable to a level of care needed in a hospital, nursing facility or Intermediate Care Facility for the Mentally Retarded (ICF-MR).

      Health care services received in the home must have been ordered by a physician and could only be performed by physicians or nurses if provided in a medical facility.

      The cost of the monthly health care services at home must be the same or less than the cost of providing the services within a medical facility.

      The child's monthly income must be less than 300% of the SSI Standard Benefit Amount and resources must be less than $2,000. (Resources include items such as checking and savings accounts and certificates of deposit.)

NOTE: Income and assets of parents are not considered in determining eligibility. The income and resource definitions and exclusions that apply to the Long Term Care program are applicable to the Disabled Child Program.

Covered Services

Children who are eligible are entitled to full Medical Assistance coverage. Covered services include doctor appointments, hospital stays, dental and vision services, prescription drugs, rehab/therapy, chiropractic, etc. (For a list of services under full Medical Assistance coverage, see: http://www.state.sd.us/social/Medical/Recipient/covered.htm.)

Children eligible for Medical Assistance are also entitled to Healthy Kids Klub checkups. (For more information, see: http://www.state.sd.us/social/Medical/Recipient/KidsKlub/Looks.htm.)

Medical coverage may begin three months prior to the application date.

Source:

http://www.state.sd.us/social/MedElig/families/Disabled.htm

Back to:

Office of Medical Eligibility - Overview

South Dakota Department of Social Services (DSS)

Welcome and Introduction to the South Dakota Benefits Information System


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