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STATE PROFILE • Last updated: April 23, 2026

South Dakota Elder Care & Medicaid

South Dakota offers income-cap Medicaid for seniors, with the HOPE Waiver providing crucial home and community-based services, including paid family caregiving, to prevent nursing home placement.

leaderboard RANKED #9
GRADE A
FEATURED

Medicaid Coverage Guide for South Dakota

Full breakdown of HOPE Waiver for seniors: waiver programs, nursing home eligibility, income and asset limits, spend-down rules, and how to apply.

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Program
HOPE Waiver
Income cap
$2,982/mo
Medically-needy
No

Elder Care Index Report Card

5-pillar composite scoring vs other states

A Grade
AFFORDABILITY STRONG
QUALITY MODERATE
STAFFING CRITICAL
ACCESS MODERATE
MEDICAID SUPPORT MODERATE

Composite score: 54.2 / 100

Methodology arrow_forward
South Dakota state capitol

South Dakota At a Glance

Nursing Home Facilities
97
Senior Medicaid Waivers
1
National Rank
#9 / 51

Senior Care Costs in South Dakota

Nearby States

TOPICAL GUIDES — HOW MEDICAID WORKS

EXPLORE SOUTH DAKOTA