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Medicaid Waiver Guide – South Dakota

Parenting a neurodivergent child is a journey filled with love, joy, and unique challenges. It’s like navigating a labyrinth, especially when understanding the South Dakota Medicaid system. Fear not, dear reader! This blog post is here to be your compass, helping you find your way through the maze of South Dakota Medicaid.

South Dakota Medicaid: The Basics

Before we delve into the details, let’s understand what South Dakota Medicaid is. Simply put, it’s a program that provides health coverage for low-income individuals and families, including some low-income adults, children, pregnant women, elderly adults, and people with disabilities. For parents of neurodivergent kids, it’s a crucial support system, offering a variety of resources and assistance.

you might wonder, “What makes my child eligible for South Dakota Medicaid?” Good question! The eligibility criteria are based on a few key factors:

  • Income: Your family’s income is a significant factor. South Dakota Medicaid uses the Federal Poverty Level (FPL) as a guideline.
  • Age: Kids under the age of 19 may be eligible for coverage.
  • Disability: Neurodivergent kids, or kids with thinking and learning differences, may qualify under disability criteria.

Applying for South Dakota Medicaid: A Step-by-Step Guide

So, your child is eligible for South Dakota Medicaid. Great! But how do you apply? Here’s a step-by-step guide to help you through the process:

  1. Gather your documents: You’ll need proof of income, residency, and disability (if applicable).
  2. Fill out the application: You can apply online, by mail, or in person at a local Department of Social Services office.
  3. Wait for a decision: After you submit your application, it will be reviewed. You should receive a decision within 45 days.
south dakota medicaid. two parents meet with a medicaid specialist.

Using tools like Goally can help manage your child’s daily routines and tasks. At the same time, you navigate the Medicaid application process. It’s a win-win!

Goally Waiver ScorecardScore
Website clarity and ease of navigation4/5
Access and requirements of qualification4/5
Healthcare coverage3/5

Other online resources for South Dakota:

  • A great list of South Dakota Agencies for People with Disabilities
  • South Dakota Autism Center is set up to answer questions about the state’s resources
  • South Dakota Parent connection has advice, parent training, and information by parents for parents.

Telephone Resources

You can call South Dakota’s Behavioral Services at 605.773.3123

South Dakota Medicaid Waivers: Your Key to More Services

For neurodivergent kids, South Dakota Medicaid waivers can be a lifesaver. These waivers allow the state to “waive” certain Medicaid rules, providing services that might not be under regular Medicaid. This can include home and community-based services, specialized therapies, and more.

Understanding and applying for waivers can feel like a maze. Don’t worry; we’ve got you covered. Here’s a brief overview of the different types of waivers, their eligibility criteria, and benefits:

WaiverEligibilityBenefits
CHOICES WaiverChildren under 21 with a disabilityHome and community-based services
Family Support WaiverChildren under 18 with a developmental disabilityRespite care, specialized medical equipment, etc.

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An assortment of interactive video class thumbnails, including dental care and cooking, on the best tablet for kids by Goally.

Our apps teach executive function, language, emotional regulation, finger dexterity skills, and more.

As your child develops new skills, you can increase the difficulty level of the tasks in the app to challenge and motivate them even further. This helps your child grow and progress at their own pace, while also keeping them engaged and excited about their development.

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Remember, while navigating the South Dakota Medicaid system may seem daunting, you’re not alone. You can make the system work for your family with the right information and guidance. And remember, every step you take is not just navigating a system – advocating for your child. That’s the most important job of all.

At Goally, we understand the challenges and are here to support you on this journey. Our learning tablet for kids is to help neurodivergent kids thrive, giving you one less thing to worry about as you navigate the South Dakota Medicaid system.

Who Can Apply?

Circumstances/Diagnosis: Children and adults of all ages who have a diagnosis with developmental disabilities like autism, cerebral palsy, and Down’s Syndrome. The state requires that individuals need at least an intermediate care facility level of care to qualify. This has a technical definition but essentially just means that the individual is unable to get through their day without a lot of supervision.
Income: Income eligibility is only based on the child’s income and not the parents income. This means that your child is financially eligible for the waiver if they don’t have an income (or they earn less than $2,300 a month).

What do I get?

Service Coordination, Respite Care, Specialized Medical and Adaptive Equipment and Supplies, Nutritional Supplements, Personal Care, Companion Care, Environmental Accessibility Adaptations (Home/vehicle modifications), and standard medicaid benefits.

How do I apply?

Contact your local office to apply, find out more information, and to determine if this is your best medicaid waiver option.

What does the Goally Team Think?

South Dakota has a great setup where eligibility for medicaid is expanded for different vulnerable groups, but better than that they provide individualized medicaid applications that provide additional services right off the bat. It seems as though there might be a short waitlist to get these expanded services but based on our research on other states this shouldn’t be longer than a few months. Once your child ages out of the based medicaid services and needs employment and independent living supports you can coordinate moving to a new adult waiver program with your case manager.

This post was originally published on 02/16/2021. It was updated on 09/17/2023.