Benefits for seniors in South Dakota

Medicaid for people 65 and over

South Dakota Medicaid is run by DSS. For people 65 and over, the main ways to qualify are:

• You get SSI. If you get Supplemental Security Income, you get Medicaid automatically. Social Security decides this.
• You used to get SSI. Some people who lost SSI when their Social Security went up can still qualify. This includes the "Pickle" group and some widows and widowers. DSS decides this. You must meet Medicaid income and resource rules.
• You need nursing-home-level care. See long-term care below.

The resource limit for these groups is $2,000 for one person. Medicaid fills many gaps that Medicare leaves.

South Dakota does not list a separate Medicaid group for older adults at home based only on low income. If you do not get SSI, the Medicare Savings Program may still help you.

Long-term care Medicaid

Medicaid can pay for care in a nursing home, an assisted living center, or your own home through the HOPE Waiver. You must be 65 or older (or blind or disabled) and need nursing-home-level care. Your income must be under 300% of the SSI federal payment. In 2026 that is $2,982 a month. Resources must be under $2,000. Medicaid can also help in an adult foster care home if your income after allowed deductions is below the state rate.

Estate recovery: South Dakota recovers Medicaid costs from the estates of people who were 55 or older and got nursing home, home care, hospital or drug services, and of people who lived in a nursing home. It waits while a spouse, a child under 21, or a blind or disabled child survives.

Help paying Medicare costs

DSS runs three Medicare Savings Programs. The federal limits apply.

• QMB (Qualified Medicare Beneficiary): Pays your Part A and Part B premiums, deductibles and coinsurance.
• SLMB (Special Low-Income Medicare Beneficiary): Pays your Part B premium.
• QI-1 (Qualified Individual): Pays your Part B premium.

Income: To get at least one of these programs in 2026, your monthly income must be under $1,816 for one person or $2,455 for a couple. QMB has a lower limit of $1,350 for one person. These include the $20 monthly income disregard.

Savings: $9,950 or less for one person, $14,910 for a couple. Your home, one car, burial plots, up to $1,500 set aside for burial, and a limited irrevocable burial trust are not counted.

The Part B premium is $202.90 a month in 2026, so this can save you a lot over a year. If you get any of these programs, you also get Extra Help automatically.

Prescription drug help

South Dakota's DSS pages do not list a separate state drug program for seniors. Your main help is Extra Help, which lowers Part D premiums and copays. Copays are no more than $5.10 for generics and $12.65 for brand-name drugs. Apply with Social Security at 1-800-772-1213 (TTY 1-800-325-0778). SHIINE volunteers can help you compare Part D plans for free.

Extra state payment with SSI

South Dakota pays a small optional state supplement to SSI recipients who live at home and have no other income. It also pays a supplement to some people in licensed assisted living centers and adult foster homes. DSS runs these payments. Check the current amount with DSS at 605-773-3165.

The federal SSI payment in 2026 is $994 a month for one person.

Food help

SNAP (Supplemental Nutrition Assistance Program) helps you buy groceries. If someone in your home is 60 or older or disabled:

• Only the net income test applies, not the gross income test.
• Higher resource limit: $4,500 instead of $3,000. Your home and one vehicle do not count.
• Medical costs count. Doctor bills, pharmacy costs and insurance premiums can raise your benefit. Bring proof.

Apply online at eaportal.sd.gov or at your local DSS office.

Senior food boxes (Commodity Supplemental Food Program): If you are 60 or older with income at or below 150% of the poverty level, you can get a monthly box of USDA foods. Contact Feeding South Dakota in Sioux Falls at 605-335-0364 or in Rapid City at 605-348-2689.

Help staying at home

• HOPE Waiver: For people 65 and over (or adults 18 and over with a disability) who need nursing-home-level care and meet Medicaid limits. It can pay for in-home help, respite and caregiver support, meals, safety and mobility help, adult day services, community living homes and assisted living. There is also a Structured Family Caregiving option.
• Dakota at Home: The state's front door for long-term services. Call 1-833-663-9673, Monday to Friday, 8 a.m. to 5 p.m. Central time. Call them to learn what help is available and how to apply.
• PACE: Ask Dakota at Home whether a PACE program serves your area.

Property tax and housing help

The Department of Revenue runs these programs. Apply with your County Treasurer.

• Assessment freeze: If you are 65 or older (or disabled) and own and live in your home, your home's assessed value can be frozen. For 2026 applications, income must be under $56,595 for a one-person household or $66,885 for more than one person. The home's value must be $514,500 or less, unless you qualified before. The deadline is April 1.
• Property tax deferral (Homestead Exemption): If you are 70 or older, you can delay paying property taxes until the home is sold. The taxes become a lien and interest applies. Deadline April 1.
• Rapid City residents: A municipal tax reduction for older and disabled residents is available through the Pennington County Treasurer.
• Sales tax refund: If you are 65 or older (or disabled) and lived in South Dakota all year, you can get back part of the sales tax you paid. For 2025 taxes, income had to be $17,215 or less if you live alone, or $23,265 for a household. The 2026 deadline was July 1. Apply online at sddor.seamlessdocs.com/f/2050 or call 1-800-829-9188, option 1.

Property tax questions: 1-800-829-9188, option 2.

Help with energy bills

LIEAP (Low Income Energy Assistance Program) helps pay heating costs. Payment goes straight to your energy supplier. Income limits are based on about 200% of the poverty level, counted over the last three months. Check the current limit with DSS. Send the application with proof of income and a recent heating bill to the Office of Energy Assistance, 700 Governors Drive, Pierre, SD 57501, or email [email protected].

• Emergency help (ECIP): If you have a shutoff notice or your fuel tank is below 20%, call 1-800-233-8503 right away.
• Weatherization: Free home repairs such as insulation and furnace repair. Older adults get priority. Apply through your local community action agency.

Free help and counseling

• SHIINE (Senior Health Information and Insurance Education): South Dakota's free Medicare counseling program. Call 1-888-854-5321 or visit shiine.net. Volunteers can also help you fill out the Medicare Savings Program application.
• Dakota at Home: 1-833-663-9673. Run by the South Dakota Department of Human Services, Division of Long Term Services and Supports. This is where to start for home care, meals, caregiver help and other services for older adults.
• DSS benefits specialists: 1-877-999-5612 (TTY 1-877-486-2048).

How to apply

Check what you may qualify for