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SD Medical Assistance for Pregnant Women

The South Dakota Department of Social Services (DSS) provides Medical Assistance to pregnant women who meet income and resource limits and the general Medical Assistance eligibility requirements. Pregnant women may qualify for full coverage or, if they don't meet the income or resource criteria, for limited coverage.

Full Coverage for Pregnant Women:

Some pregnant women are eligible to receive full Medical Assistance.

The financial eligibility requirements in 2006 (until March, 2007) are as follows:

(Amount increases with each additional member.)
* Include the unborn child in family size.

The resource limit is $1,000. Resources include items such as checking and savings accounts and certificates of deposit (CDs). (Certain assets such as the home in which you live and 1 vehicle are not counted.)

If under age 18 and living with a parent(s), a portion of the parents' income and resources are countable.

Covered Services:

Pregnant women who meet the above eligibility requirements are entitled to full Medical Assistance. Covered services include doctor appointments, hospital stays, dental and vision services, prescription drugs, rehab/therapy, chiropractic, etc. (For a full list of covered services see: http://www.state.sd.us/social/Medical/Recipient/covered.htm.

Medical Assistance may begin up to three months prior to the month the application is received if the person received medical services and if they would have been eligible for assistance.

The start of medical coverage is based on the date the application is received in the Social Services office that serves your county.

Limited Coverage for Pregnant Women

Some pregnant women are only eligible for pregnancy-related services through Medical Assistance. The financial eligibility requirements require that monthly gross earned income must be at or below 200% of the Federal Poverty Guidelines (FPL). The countable family income must be at or below 133% of the Federal Poverty Guidelines (FPL). Round up to the next dollar amount. Include the unborn child in family size.

The resource limit is $7,500. Resources include items such as checking and savings accounts and certificates of deposit (CDs). (Certain assets such as the home in which you live and 1 vehicle are not counted.)

If under age 18 and living with a parent(s), a portion of the parents' income and resources are countable.

Eligibility Worksheet:

DSS has available on its website a worksheet that is provided as a guide to estimate your eligibility. It is available at: http://www.state.sd.us/social/MedElig/Women/Pregnant.htm.

Covered Services:

Pregnant women who meet the above eligibility requirements will only receive coverage for pregnancy-related medical services such as doctor, hospital, prescriptions, etc. If a woman has health insurance, Medical Assistance will pay the deductibles, co-payments and allowed pregnancy services not covered by the policy.

Medical Assistance may begin up to three months prior to the month the application is received if the person received medical services and if they would have been eligible for assistance. The start of medical coverage is based on the date the application is received in the Social Services office that serves your county.

Source:

http://www.state.sd.us/social/MedElig/Women/Pregnant.htm.

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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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