Medicare-Medicaid Pay-Down of Assets
State law and regulations impose income and asset limits on persons applying for Medicaid.
The income limit for the institutional Medicaid program and certain home and community-based waiver programs is determined by the South Dakota’s Department of Social Services’ Division of Economic Assistance. For 2025, the maximum Medicaid income limit for aged, blind, or disabled persons $2,901 per month.
Regarding resources, this value cannot exceed $2,000. Resources include homes, checking and savings accounts, and similar holdings; however, the personal assets in the home, one vehicle, and most personal items will be excluded from this total.
If the protected spouse is in a medical facility with a long-term care policy that has paid benefits, the resource eligibility is equal to the amount of the benefits paid plus $2,000.
The look-back period for the transfer of asset is 60 months. If, during this look-back period, the person seeking Medicaid benefits transfers assets for less than fair market value, there will be a penalty period where the person will be ineligible for benefits. The penalty period will be calculated by dividing the assets transferred by the Statewide Average Payment for Skilled Nursing Care. The period starts when the person applies for the benefits or when the person is eligible for the benefits. If the person is already receiving South Dakota Long-Term Care Medicaid at the time of the transfer, the period starts then month following the month when the transfer occurred or the date after the prior period of ineligibility ends.
South Dakota Department of Social Services: Eligibility
Medical Programs Available in South Dakota
Medicaid Spousal Care Handbook: Protecting your Income and Assets
Medical Eligibility and the South Dakota Long-Term Care (LTC) Partnership Program