I. What You Should Expect to Pay for Home Care in South Dakota

You can choose between two types of home-based care depending on the services you need. Home care includes nonmedical services such as housekeeping and laundry, companionship, transportation, meal preparation and help with daily living activities such as bathing and dressing. Home health care includes skilled nursing services such as occupational therapy, medical monitoring and medication administration. Despite differences in scopes of care,  reveals, home care and home health care each cost $5,911 per month in South Dakota, according to the 2021 Genworth Cost of Care Survey.

The Cost of Home Care and Home Health Care in Nearby States

South Dakota is among the more expensive places in the Midwest for home-based care, with both levels of care costing $5,911 per month. By comparison, national home care and home health care costs average $4,957 and $5,148, respectively.

In North Dakota, seniors pay $5,689 for home care and home health care, and in Wyoming, monthly fees are a little lower at $5,529. Seniors in Montana pay $5,339 for either care type, and in Nebraska, rates are relatively competitive at $5,148 for home care and $5,339 for home health care. In Minnesota, service costs are considerably higher than in South Dakota, with residents paying $6,673 for home care and $6,912 for home health care.

Home Care  Home Health Care 
South Dakota  $5,911 $5,911
United States  $4,957 $5,148
North Dakota  $5,689 $5,689
Wyoming  $5,529 $5,529
Montana  $5,339 $5,339
Nebraska  $5,148 $5,339
Minnesota  $6,673 $6,912

The Cost of Home Care vs. Other Types of Care

Home-based care is one of the most expensive care options in South Dakota, with residents paying $5,911 per month for in-home care and home health care. Even so, it’s an affordable alternative to nursing home care, which costs $7,118 for semiprivate accommodations. If you want to live at home and save money on care costs, you may consider attending adult day health care, which is less than half the cost of home-based care at $2,600 per month. Alternately, you may save money by obtaining care in assisted living, which averages $3,350 monthly.

II. Can Medicaid Help You Pay for Home Care in South Dakota?

South Dakota’s Medicaid program, which is administered by the South Dakota Department of Social Services, provides comprehensive health insurance coverage to those with limited resources. Along with covering medical services such as preventative care, health screenings and hospitalization, the state’s Medicaid plan pays for in-home care for qualifying individuals. The Personal Care Services program, which is part of regular Medicaid, includes assistance with daily living activities such as personal hygiene, bathing, grooming, eating and toileting. It covers up to 500 hours of care annually, which works out to about 10 hours per week.

In addition to the regular Medicaid coverage for in-home care, the program pays for services under the Home and Community-Based Options and Person Centered Excellence Waiver. While the Personal Care Services program is an entitlement you’re guaranteed to get if you meet eligibility criteria, the waiver program has enrollment caps and wait lists.

Home Care Waiver Programs in South Dakota

Home and Community-Based Options and Person Centered Excellence Waiver 

The HOPE waiver provides coverage for in-home care, enabling older adults to obtain services in their own homes as an alternative to assisted living or nursing home placement. This nursing home diversion program helps you or your loved one avoid institutionalized care by getting the services you need at home. Services provided under the HOPE waiver include:

  • Adult companion services
  • Adult day services
  • Chore services
  • Community transition coordination and support
  • Emergency response systems
  • Home and vehicle modifications
  • Homemaker services
  • Home-delivered meals
  • Skilled nursing services
  • Personal care services
  • Respite
  • Specialized medical equipment and supplies

The services you receive depend on the results of a needs assessment, which a case worker conducts prior to your acceptance into the program. To qualify for services, you must be at least 65 years old or have a qualifying disability. You must require nursing home level care and receive one or more services covered by this waiver at least once monthly.

While eligibility for this waiver program includes income and asset limits, these limits are much more generous than the criteria for regular Medicaid. This may make the waiver a good option for you if your retirement income isn’t enough to cover care but you don’t qualify for Medicaid.

To learn more about this waiver or to apply for services, visit your local Department of Human Services office.

How to Know if You're Eligible for Medicaid in South Dakota

Medicaid coverage is for intended those with limited resources. To qualify for coverage, you must have an annual income of no more than $10,092. All sources of income count toward this limit, including wages, pensions, withdrawals from investment accounts and stock dividends. You may have up to $2,000 in countable assets. This doesn’t include your personal belongings, primary dwelling or your vehicle, but it does include assets such as vacation properties, cash, stocks and bonds. If you’re married, both your income and assets and your spouse’s count, but the limits are $15,132 for annual household income and $3,000 for combined assets.

2022 Medicaid Income Limits for Seniors in South Dakota
  Income Limits*  Asset Limits 
Single Person  $10,092 $2,000
Two-Person Household  $15,132 $3,000

*Per year

In addition to meeting financial eligibility criteria, you must also be:

  • In need of the services Medicaid provides
  • A permanent resident of South Dakota
  • A U.S. citizen or legal resident

How to Apply for Medicaid in South Dakota

To apply for Medicaid, you may submit an online application through the SD DSS Online System. You may also print off the application for Long Term Care related programs and mail, fax or deliver it in person to your local Department of Social Services office.

What Information You Will Need 

Along with a Medicaid application, you must submit supporting documents showing that you’re eligible for coverage. This may include:

  • Driver’s license or state-issued ID
  • Statements for checking and savings accounts
  • Proof of income
  • Policy numbers for primary health insurance coverage, including TRICARE and Medicare
  • Proof of U.S. citizenship or legal residency
  • Proof of home address

How to Get Help Applying for Medicaid 

Navigating South Dakota’s Medicaid program can be tough, but fortunately, you have access to numerous programs and agencies that can help. The following table highlights statewide resources you can connect with for the information and personalized assistance you need to understand the enrollment process, benefits and options for filing appeals if coverage is denied.

Contact  Area Serviced  Services Provided 
Dakota Plains Legal Services (605) 856-4444 Statewide Dakota Plains Legal Services provides free assistance with enrolling in public benefits, including Medicaid. Contact or visit your nearest office to speak one-on-one with a licensed legal professional who can help you determine whether you qualify for services, as well as to submit an application and appeal denied coverage.
American Council on Aging Online Only Statewide The American Council on Aging publishes easy-to-read information on Medicaid’s financial eligibility requirements, Medicaid programs and your options if your income and assets exceed the program’s limits. It also has a directory of Medicaid planners who help you use various strategies to meet Medicaid’s eligibility requirements while safeguarding your financial security.
Department of Social Services (800) 452-7691 Statewide The Department of Social Services has a toll-free number you can call for assistance with filling out a Medicaid application or obtaining in-home care.
Medicaid Fraud Control Unit Medicaid Fraud Complaint Form Statewide At the Medicaid Fraud Control Unit, experts investigate reports of Medicaid abuse and provider fraud. If you are billed for services your doctor didn’t order or if a health care provider gives you unnecessary and unsolicited medical supplies, you may file a fraud report with this unit.

III. Can You Use Medicare to Pay for Home Care in South Dakota?

Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.

Below is an overview of some of the services typically covered by Medicare for those who are eligible:

  • Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
  • Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
  • Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
  • Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.

Read our guide to Medicare and Home Care Coverage for more information.

IV. Other Financial Assistance Options for Home Care in South Dakota

While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.

V. Free Resources for Aging in Place in South Dakota

Along with Medicaid-funded programs that reduce out-of-pocket home care expenses, South Dakota is home to a range of agencies and community-based programs that can help you obtain affordable care. Through the following resources, you can find options counselors, advisors and information specialists along with programs that can save you money on living expenses.

Contact  Area Served  Services Provided 
Dakota at Home (833) 663-9673 Statewide Dakota at Home is the Aging and Disability Resource Center for South Dakota. This free program provides unbiased information, advice and referrals to help you connect with community-based services that may help you age in place. Through this program, you can find prescription drug assistance programs, weatherization services, utility and housing assistance, home-delivered and congregate meals and wellness services. To get help, you can call the toll-free helpline or browse your county’s resource directory.
South Dakota Department of Veterans Affairs (605) 773-3269 Statewide The South Dakota Department of Veterans Affairs operates county offices throughout the state where you can meet one-on-one with a benefits specialist to be screened for eligibility for Aid and Attendance, pension benefits and disability compensation, which can reduce your care and living expenses. The department can also help you access state veterans’ benefits such as property tax exemptions, the Veterans Bonus and special hunting and fishing licenses.
South Dakota Adult Nutrition Program Online Contact Form Statewide The South Dakota Adult Nutrition Program prevents food insecurity and promotes social opportunities for older residents in the state. It operates nearly two dozen sites serving congregate meals every weekday, each of which provides a third of your daily dietary needs.
Senior Health Information and Insurance Education Program Contact Nearest SHIINE Office Statewide SHIINE is a free statewide resource that helps you make important decisions regarding your Medicare coverage. Trained volunteers can answer questions about your Original Medicare coverage and help you compare Medigap and Medicare Advantage Plans available in your region. SHIINE counselors can also help you determine whether you qualify for Medicaid and the HOPE waiver, which can help you pay for in-home care.
Division of Long Term Services and Supports Contact Your Region Office Statewide South Dakota’s Division of Long Term Services and Supports administers a broad range of programs to help those aged 60 and over remain in their homes throughout their retirement years. Through your local field office, you can access information, referral services and help with accessing in-home care and community-based services, which can reduce what you pay out of pocket for private-pay care.
Helpline Center 2-1-1 Statewide The Helpline Center is a free phone referral program that helps South Dakota residents find programs and services in their areas. Through this service, you can get one-on-one help from information specialists regarding weatherization services, home-delivered meals, tax breaks and volunteer-based transportation services.
South Dakota Community Assistance Program (605) 773-3165 Statewide The South Dakota Community Assistance Program operates Community Action Programs throughout the state. Your local CAP can help you access free and low-cost utility assistance, home modifications, home-delivered meals and chore assistance to supplement paid services. Some locations also provide long-term care options counseling and Medicare assistance.

VI. Vaccination Requirements & COVID-19 Rules for Home Care Aides in South Dakota

While there is no state or federal mandate that requires home care attendants to be vaccinated against COVID-19, federal rules require home health care providers who administer skilled nursing services to be fully vaccinated against the virus unless a caregiver has an exemption. This rule is in effect as of April 2022, but due to the changing nature of the pandemic, new rules may be put in place over time. Contact your Area Agency on Aging or your county health department for more current information on the rules for home care agencies.

Additionally, some home care agencies may have additional guidelines and procedures in place beyond what the law requires, including rules about regular COVID screening, mask-wearing and vaccine requirements. If you’re concerned about being exposed to COVID-19, ask your home care agency about the rules it has in place to protect clients.

VII. Rules and Regulations for Home Care Providers in South Dakota

Home care providers in South Dakota aren’t licensed or regulated, meaning that agencies can create their own policies regarding staff training, screening practices and creating care plans

What Types of Care Can Be Provided?

Home care agencies can provide homemaker and companion services. This may include assistance with personal care such as bathing and dressing, along with meal preparation, light housekeeping, transportation, mobility assistance and help with budgeting and paying bills. 

Are Care Plans Required? 

Agencies may have their own processes for assessing clients’ needs and ensuring they obtain the services necessary to continue living at home. The state doesn’t have rules for care plans that home care agencies must follow.

Can Home Care Providers Assist with Medication Management?

Home care providers can give medication reminders and assist with self-administered medications. This includes actions the individual would be able to do themselves were it not for age or disability, such as retrieving stored medication and opening packaging. Caregivers aren’t permitted to administer medications. 

Are There Special Requirements for Screening Home Care Aides?

The state doesn’t mandate screening requirements for prospective caregivers. However, some agencies may require background checks or prior work experience to ensure a high standard of care.

Are Home Care Aides Required to Undergo Special Training? 

Home care agencies aren’t required by the state to administer special training to caregivers, but agencies may provide on-the-job training and have metrics in place to measure proficiency.

Does Medicaid Cover Home Care in South Dakota? 

Seniors who qualify for Medicaid in South Dakota may obtain coverage for home care under the regular Medicaid plan as well as the Home and Community-Based Options and Person Centered Excellence Waiver. 

How Do I Report Abuse of Myself or a Loved One?

If you or someone you know is experiencing abuse, neglect or exploitation, you can submit the online Adult Protective Service Referral Form, which sends your complaint to the Department of Human Services. Alternately, you can file a report with your local law enforcement agency. 

VIII. How to Find a Home Care Provider in South Dakota

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.

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