South Dakota CHIP: Children's Health Insurance Program
Updated August 2026
South Dakota CHIP covers children under 19 whose household income is above the standard Medicaid threshold. Per the SD DSS "Medicaid Coverage Groups" page, South Dakota sets two separate CHIP income ceilings depending on whether the child already has private health insurance — a lower limit for children with private coverage and a higher limit for children who are uninsured. The same DSS application that screens for Medicaid also screens for CHIP — you do not need to apply separately.
$5,143–$5,748/mo
Family-of-4 CHIP income limit (varies by insurance status)
Under 19
Age group covered
2 income tiers
Limit differs for insured vs. uninsured children
South Dakota covers children through Medicaid and CHIP, with the CHIP income limit varying by insurance status
South Dakota covers children under 19 through a combination of Medicaid and the state CHIP program. Per the SD Department of Social Services, the CHIP monthly income limit for a family of four is $5,143 for children who already have private health insurance and $5,748 for children who are uninsured. Apply through the DSS Electronic Assistance Portal at eaportal.sd.gov or by calling 1-888-828-0059. A single application determines which program your child qualifies for.
Who qualifies for South Dakota CHIP
- Child must be under age 19
- Monthly income limit for children WITH private health insurance: $2,487 for household of 1; $5,143 for household of 4
- Monthly income limit for children WITHOUT private health insurance: $2,780 for household of 1; $5,748 for household of 4
- Child must be a U.S. citizen, national, or qualifying immigrant
- Child must reside in South Dakota
CHIP benefits in South Dakota
South Dakota CHIP provides comprehensive coverage for enrolled children. The benefit package aligns with the EPSDT-equivalent children's coverage and includes the same categories of services as Medicaid for children. South Dakota administers CHIP on a fee-for-service basis — the same model used for most of South Dakota Medicaid.
- Well-child visits and developmental screenings
- Immunizations
- Doctor visits and specialist referrals
- Prescriptions
- Emergency and urgent care
- Inpatient hospital care
- Mental health and substance use services
- Dental care (comprehensive EPSDT scope)
- Vision care and eyeglasses
- Physical, occupational, and speech therapy
Cost-sharing for CHIP in South Dakota is minimal — small co-pays may apply for some services at higher income levels. Federal CHIP rules cap annual family out-of-pocket costs at 5% of family income.
How to apply for South Dakota CHIP
Apply through the DSS Electronic Assistance Portal at eaportal.sd.gov. The same application screens for both South Dakota Medicaid and CHIP — the system determines which program your child qualifies for based on household income.
You can also apply using the paper application (Form FSSA, available at dss.sd.gov/formsandpubs), by calling 1-888-828-0059, or by visiting your local county DSS office. Applications are processed within 45 days under federal rules.
A family of four with a monthly income under $5,748 likely qualifies for South Dakota CHIP or Medicaid for their children (the exact CHIP ceiling depends on whether the child already has private insurance — see the eligibility list above). Many families assume they earn too much for public coverage — it's worth applying to find out. The DSS prescreening tool at dss.sd.gov/economicassistance/medical_programs.aspx can help you assess eligibility before applying.
South Dakota Medicaid vs. CHIP: how children are covered
Source: South Dakota DSS "Medicaid Coverage Groups" page (dss.sd.gov). A single DSS application determines which program applies based on household income.
| Program | Monthly income limit (household of 4) | Premiums |
|---|---|---|
| South Dakota Medicaid (children) | Lower income range | None |
| South Dakota CHIP — child has private insurance | Up to $5,143/mo | Minimal at higher incomes |
| South Dakota CHIP — child is uninsured | Up to $5,748/mo | Minimal at higher incomes |
South Dakota Medicaid (children)
- Monthly income limit (household of 4)
- Lower income range
- Premiums
- None
South Dakota CHIP — child has private insurance
- Monthly income limit (household of 4)
- Up to $5,143/mo
- Premiums
- Minimal at higher incomes
South Dakota CHIP — child is uninsured
- Monthly income limit (household of 4)
- Up to $5,748/mo
- Premiums
- Minimal at higher incomes
What CHIP is nationally
CHIP — the Children's Health Insurance Program — is a federal-state partnership that covers children in families whose income is too high for Medicaid but too low to afford private insurance. Congress created CHIP in 1997 under Title XXI of the Social Security Act. Like Medicaid, CHIP is jointly funded by the federal government and each state, and each state administers its own program.
CHIP serves children up to age 19 (some states cover to 21 for children in foster care). It is not available to adults — CHIP is specifically designed to address the coverage gap for children in working families. Nationally, CHIP covers approximately 7 million children, according to CMS data.
South Dakota Medicaid
- DSS Electronic Assistance Portal: eaportal.sd.gov
- South Dakota DSS phone line: 1-888-828-0059
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