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South Dakota · checked September 2026
How South Dakota helps pay for long-term care, who to call when you need help or something's wrong, and how to check a facility before you sign.
The first question
Yes, for the care. HOPE Waiver (Home and Community-Based Options and Person-Centered Excellence) helps pay for care in assisted living. Rent and meals are usually still paid by the resident, often from Social Security.
South Dakota's Medicaid rules for long-term care, and the programs that pay for care outside a nursing home.
$2,982
2026
300% of SSI for nursing home and HOPE waiver Medicaid. Confirm with the state Medicaid office before relying on it.
$2,000
2026
Single applicant. Confirm with the state Medicaid office before relying on it.
We couldn't confirm whether this state uses a Miller trust or a spend-down. Ask the Medicaid office or an elder law attorney.
Look-back on gifts and transfers: 60 months.
Apply for South Dakota Medicaid
South Dakota Department of Social Services (DSS), Division of Economic Assistance
South Dakota's Medicaid waiver for people 65+ (and adults 18+ with disabilities) who need nursing-home-level care. It can pay for care services in an assisted living center or at home, plus respite, caregiver help, meals and adult day services, but the person still pays rent and meals in assisted living. Start by calling Dakota at Home at 1-833-663-9673.
Waitlist: No waitlist information found on pages that could be read.
Free, and on your side. Start with the aging office if you don't know where to begin.
The state's aging office and its local agencies explain your options, screen for programs and help with applications.
A free, independent advocate for residents of nursing homes and assisted living. Call about any problem with care, rights, billing or a discharge.
You don't need proof to report. If someone is in immediate danger, call 911.
Unbiased Medicare help from counselors who don't sell anything: plans, bills, appeals, and programs that lower costs.
Help spotting and reporting Medicare fraud, billing errors and scams.
In South Dakota, assisted living is licensed as: Assisted Living Center. Read inspection reports before you sign anything.
Confirm a community's license here, and ask the agency how to see its inspection reports.
File a complaint
Medicare rates every nursing home on staffing, inspections and quality, with full inspection reports.
State veterans homes are often far cheaper than private care for eligible veterans and, in many states, their spouses.
South Dakota Department of Veterans Affairs
Hot Springs
skilled nursing, memory care, domiciliary
Free legal help for older adults on issues like benefits, housing, powers of attorney and elder abuse.
Can a family member be paid to provide care? Yes, in some programs.
Likely yes. Dakota at Home lists Structured Family Caregiving providers that pay family members who care for a Medicaid-eligible relative at home. Ask Dakota at Home which providers serve your area and how this works with the HOPE waiver.
Statewide help for family caregivers of older adults: case management, training, respite (short breaks) and some supplemental services. Call Dakota at Home to start.
One-on-one caregiver coaching, support groups, and classes such as Powerful Tools for Caregivers and Savvy Caregiver for dementia care.
Free training for family caregivers and community members on how to care for and support someone with Alzheimer's or another dementia.
After a Medicaid recipient 55+ dies, the state may seek repayment from their estate for nursing home and home care costs. It will not collect while a spouse is living or if there is a surviving child under 21 or who is blind or disabled.
Partnership long-term care insurance policies let you protect some assets if you later need Medicaid.
Lower-income South Dakotans can post a civil legal question online and get an answer from a volunteer lawyer.
Yes, for the care part. In South Dakota, HOPE Waiver (Home and Community-Based Options and Person-Centered Excellence) can pay for care in assisted living. Rent and meals are generally paid by the resident.
$2,000 for a single person (2026). Single applicant. Confirm with the state Medicaid office before relying on it.
The Long-Term Care Ombudsman Program (SD Department of Human Services): 1-833-663-9673. It's free and independent.
Researched from 30 sources, official pages first. Last checked .