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Important Changes Coming Soon to Medicaid

Due to COVID-19 federal public health emergency, federal regulations did not allow Medicaid coverage to close even if individuals were not eligible. Effective April 1, 2023, federal regulations will once again allow for closure of ineligible cases.

Over the next several months, DSS staff will be redetermining Medicaid eligibility. The process focuses first on cases most likely to be ineligible based on those who:

  • no longer meet a coverage group
  • aged out of a coverage group
  • a coverage group time limit has expired
  • income has increased

Prior to a redetermination, individuals with Medicaid will receive a Medicaid review form. Once the form is received, it must be completed immediately.

How can Medicaid recipients prepare?

Report any changes in contact information or circumstances

Individuals should call or email their local DSS office today to report any change in:

  • Address, phone, income, or other contact information; and
  • Circumstances, such as income, household members, or insurance status

Individuals can also use the DSS-EA-310 Change Report Form. Only areas with a change need to be completed and all forms must be signed.

Check for mail from DSS; Complete renewal form if you receive one

When they receive a Medicaid form, they must complete it right away. If they do not complete the review process, they will no longer be eligible for medical assistance. 

What happens if I am no longer eligible for Medicaid?

You will receive a notice in the mail if you are no longer eligible for Medicaid. Individuals may still be able to get health insurance and help pay for it through the Health Insurance Marketplace. Plans are affordable and provide comprehensive coverage. For more information on the Health Insurance Marketplace, please call (800) 318-2596 (TTY: 1-855-889-4325) or visit www.healthcare.gov.

Local trained navigators are available to help individuals find a plan and assist individuals in the Health Insurance Marketplace enrollment process. To connect with local navigator resources, visit www.getcoveredsouthdakota.org.

For even more information and resources, visit South Dakota Medicaid’s Webpage.

SOUTH DAKOTA MEDICAID