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South Dakota CHIP: Children's Health Insurance Program

Last verified: June 2026

Informational overview of South Dakota CHIP

For current eligibility thresholds and enrollment, visit https://dss.sd.gov/medicaid. CHIP and Medicaid applications are processed together in most states — apply once and both programs are considered.

South Dakota covers children through Medicaid and CHIP up to 207% FPL

South Dakota covers children under 19 through a combination of Medicaid and the state CHIP program up to 207% of the Federal Poverty Level. 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

South Dakota CHIP covers children under 19 whose household income is above the standard Medicaid threshold but at or below 207% FPL. The same DSS application that screens for Medicaid also screens for CHIP — you do not need to apply separately.

  • Child must be under age 19
  • Family income at or below 207% FPL
  • Monthly income limit: approximately $2,598 for household of 1; $5,345 for household of 4 (2026)
  • Child must be a U.S. citizen, national, or qualifying immigrant
  • Child must reside in South Dakota
  • Child must not have access to affordable employer-sponsored coverage

Source: South Dakota DSS; 2026 HHS Federal Poverty Guidelines. Contact DSS at 1-888-828-0059 to confirm current limits for your household size.

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.

Apply regardless of income — South Dakota's 207% FPL ceiling is broader than you may think

A family of four with a monthly income under $5,345 (2026) likely qualifies for South Dakota CHIP or Medicaid for their children. 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

Program FPL range Premiums
South Dakota Medicaid (children) Lower income range None
South Dakota CHIP Gap up to 207% FPL Minimal at higher incomes

Source: South Dakota DSS; 2026 HHS Federal Poverty Guidelines. A single DSS application determines which program applies based on household income.

What CHIP is

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. In most states, it is a seamless part of the broader children's health coverage system alongside Medicaid.

What CHIP covers

Federal law requires CHIP to cover certain core benefits. States may add to the list. Standard CHIP coverage includes:

  • Doctor visits, including well-child checkups and sick visits
  • Hospital care — inpatient and outpatient
  • Emergency room and urgent care services
  • Prescription drug coverage
  • Mental health and substance use disorder services
  • Dental care — preventive and restorative
  • Vision care, including eye exams and glasses
  • Laboratory and imaging services
  • Physical, occupational, and speech therapy
  • Medical equipment, such as wheelchairs or hearing aids when medically necessary

How to apply for South Dakota CHIP

Apply through South Dakota Medicaid — the same application covers both Medicaid and CHIP. Online applications are typically fastest and allow document uploads. You can also apply by phone or in person at a local eligibility office.

See the how to apply page for the complete application process, required documents, and what to expect during review.

CHIP and Medicaid income ranges overlap — apply regardless

If you're not sure whether your child qualifies for Medicaid or CHIP, apply anyway. The eligibility system determines which program applies based on your income. A child who earns out of Medicaid may qualify for CHIP, and vice versa. Don't let uncertainty about which program applies prevent you from applying.

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