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Insurance and Health Related Programs

Insurance and Health Related Programs

Children's Health Insurance Program, SD Department of Social Services
http://dss.sd.gov/medicaid/generalinfo/medicalprograms.aspx
877-999-5612
The South Dakota Children's Health Insurance Program, more commonly referred to as CHIP, provides quality health care (including regular check-ups, Well-Child Care exams, dental and vision care) for children and youth.

Who can apply?

  • Must be under the age of 19 and current resident of South Dakota.
  • Children who are uninsured or already have health insurance may be eligible for CHIP based on income and eligibility guidelines. Please click on the link above for the guidelines.

Cochlear Implant Program, SD Department of Human Services
https://dhs.sd.gov/rehabservices/cochlear.aspx
800-265-9684
605-773-4644
This program is designed to provide financial assistance to an eligible individual who is uninsured or to help offset the deductible or coinsurance for an individual with an insurance plan that covers cochlear implants. The program provides funding for the cost of the implant surgery for one ear or both ears, one or two implant devices, surgeon fee, hospital fee, the initial mapping and up to a maximum of 12 follow up mappings within one-year post surgery.

Who Can Apply?

  • Individual less than 21 years of age at the time of application
  • Is a resident of South Dakota
  • Has a severe to profound hearing loss as diagnosed by an audiologist
  • Is medically recommended for a cochlear implant by the individual's cochlear implant surgeon

How to Apply?

Disabled Children's Program, SD Department of Social Services
http://dss.sd.gov/medicaid/generalinfo/medicalprograms.aspx
877-899-5612

Pierre
605-773-4678
The Disabled Children's Program provides South Dakota Medicaid for certain disabled children in South Dakota. The program is intended for children with disabilities who have medically fragile conditions requiring skilled nursing care in a medical facility if they were not being cared for at home.

Who Can Apply? 

  • South Dakota child under age 19.
  • The child must be found disabled by the Social Security Administration or the Department of Social Services using disability standards from the Social Security Act.
  • The child must require medical care in the home comparable to a level of care needed in a hospital, nursing facility or intermediate care facility. A child who is medically stable, even though disabled, is not considered in need of a level of care. A child is medically stable if his or her health care and medical needs are such that he or she would not require care in a medical institution.
  • Health care services received in the home must have been ordered by a physician and could only be performed by a physician or nurse if the child were in a medical facility.
  • Cost of the child's monthly health care services at home must be the same or less than the cost of treating the child within a medical facility.
  • The child's monthly income must be less than 300 percent of the SSI Standard Benefit Amount ($2,313) and resources must be less than $2,000. (Resources include items such as checking and savings accounts and certificates of deposit.) Income and resources of the parents are not considered to determine eligibility.

How to Apply?  

  • Visit a local office or you can apply by printing out an application and mailing, faxing, or delivering your application to a Department of Social Services local office.
  • You may also contact your nearest Department of Social Services office or call 1.800.305.3064 to request an application be sent to you. You can also apply online.

Family Support 360 Program, SD Department of Human Services
http://dhs.sd.gov/dd/family/index.aspx
800-265-9684
The Statewide Family Support Program is designed to assist families who have a child with a developmental disability, age birth to 22, living in the home. A flexible pool of limited funds is available to eligible families, regardless of income, for the purchase of services or supports that may not otherwise be available (incontinence supplies, therapeutic devices, home and vehicle modifications, other needs). Once eligibility has been established, a family will receive support through the Statewide Family Support Program while waiting for the opportunity to transfer to the Family Support 360 Waiver. The Family Support 360 Waiver provides service coordination, a wide array of services, and potential access to Medicaid for the eligible child. The Family Support 360 Waiver allows the family to choose service providers and direct the services they receive.

How to Apply for Children

  • You must complete a Statewide Family Support application including documentation of the disability - birth-to-3 evaluations, psychological-educational testing scores or other evaluations pertinent to the child's diagnosis. 
  • You can get an application by calling the Division of Developmental Disabilities at 800-265-9684 or print one out and mail. Application

How to Apply for Adults
You must complete a Family Support 360 application including documentation of the disability - most recent psychological evaluation, Individual Education Plan (IEP) or any other documentation with diagnostic information. You can download the application here, or call the Division of Developmental Disabilities:
Pierre              800-265-9684
Brookings        877-647-0024
Sioux Falls       888-510-9388
Rapid City        888-895-4502

Foundation for Health Coverage Education
www.coverageforall.org
Our mission is to simplify public and private health insurance eligibility information to help more people to access coverage.

Get Covered South Dakota
www.getcoveredsouthdakota.org
888-872-8305
605-275-2423
Get Covered South Dakota for a new state of health. Find local help to learn about affordable healthcare options. Enrollment specialists provide free assistance and connect you with resources that help you get covered.

HealthCare.gov
www.healthcare.gov English and Spanish
800-318-2596 English, Spanish and other Languages
TTY: 855-889-4325
Information on health insurance and Marketplace Exchange plans. Enroll in an insurance plan online or by phone.

Hearing Aid Assistance Program (HAAP)
http://dhs.sd.gov/rehabservices/servicesandprograms.aspx
800-265-9684

711 South Dakota Relay
HAAP will help with the cost of hearing aid(s) and associated ear mold(s) for South Dakota children, younger than 19, with progressive or permanent hearing loss who would benefit from hearing aid(s).

Who Can Apply?

  • Must be a resident of South Dakota
  • Must not have received hearing aid(s) from HAAP or S.D. Medicaid within three years prior to date of application
  • Must be financially eligible (household income of less than 400% of federal poverty guidelines)

How Can I Apply?

  • Complete an application
  • Can be picked up at many audiologist offices across the state
  • Can be mailed upon request by calling the number listed above

Medicaid, SD Department of Social Services
http://dss.sd.gov/medicaid/
877-999-5612 (Eligibility)
800-597-1603 (Claims)

Medicaid provides health care (including regular check-ups, well-child exams, dental and vision care) for low income children and youth.

How to apply? You can complete an on-line application or complete a paper application and mail or drop off at your local Department of Social Services. A list of local offices can be found online at https://dss.sd.gov/offices/

What you may need to apply:

  • Social Security Numbers (or documents for any eligible immigrants who need coverage)
  • Employer and income information for everyone in your family (for example, from pay stubs, W-2 forms, or wag and tax statements
  • Policy numbers for any current health insurance
  • Information about any job-related health insurance available to your family

Medical Assistance for Workers with Disabilities (MAWD)
https://dhs.sd.gov/rehabservices/docs/FS%20Medical%20Assistance%20for%20Workers%20with%20Disabilties%20(MAWD).pdf
MAWD is an incentive for people with disabilities to return to work or remain working and allows an individual to remain on, or become eligible for, health insurance through Medicaid.

Who Can Apply? The individual must be employed, have a significant disability, and have countable resources less than $8,000.00, and have less than $694.00 in monthly unearned income such as SSDI or VA benefits

How Do I Apply? Contact one of the following:

Supported Employment Services, Division of Rehabilitation Services
http://dhs.sd.gov/rehabservices/servicesandprograms.aspx
800-265-9684

Pierre
605-773-3195
Supported employment is when an individual with the most severe disabilities is working in the community alongside individuals who do not have disabilities. Supported employment is receiving the training at the job site and having available the necessary ongoing supports to help maintain the employment.

Who Can Apply? Any individual with the most severe disabilities who has been unable to obtain or maintain competitive employment because of their disability, and because of their disability need intensive supported employment services. Individuals should apply for services at their local DRS Office.

Premium Assistance Program, SD Department of Social Services
888-828-0059
Provides financial assistance for private insurance premiums to Medicaid eligible children and adults on a case-by-case basis. For more information, or to apply, please contact the number listed.

South Dakota QuitLine
http://sdquitline.com/
866-SD-QUITS (866-737-8487)
Free access to online quit tools, support from other tobacco users who are trying to quit, and other information to make your quit attempt easier. Enrollment with the SD QuitLine for telephone quit coach support is available and free medication is available with the telephone program.

South Dakota Division of Insurance
http://dlr.sd.gov/insurance/
Pierre
605-773-3563
Consumer information and protection. Find agencies licensed to sell insurance in South Dakota, help for insurance issues.

Supplemental Security Income (SSI) for Children, Social Security Administration
www.ssa.gov/ssi (multiple languages)
800-772-1213
TTY: 800-325-0778
SSI is a Federal income supplement program designed to help children who are blind or disabled under the age of 18. In South Dakota, SSI beneficiaries also receive medical assistance (Medicaid).

The child may be considered "disabled" if they have a medically determinable physical or mental impairment, (including an emotional or learning problem) that:

  • Results marked and severe functional limitations; and
  • Can be expected to result in death; or
  • Has lasted or can be expected to last for a continuous period of not less than 12 months.

Blindness in their disability program means:

  • You have a central visual acuity of 20/200 or less in your better eye with use of a correcting lens; or
  • You have a visual field limitation in your better eye, such that the widest diameter of the visual field subtends an angle no greater than 20 degrees.

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