Paying for assisted living in South Dakota
Most South Dakota families begin by paying for assisted living out of pocket, often using a mix of retirement income, savings, the sale of a home, a pension, or a long-term care insurance policy. Costs vary widely depending on the community, the level of care a resident needs, and where in the state you are looking, from Sioux Falls and Rapid City to smaller rural towns. You can compare typical pricing for communities in the pricing tables below.
Beyond private pay, two programs come up most often: South Dakota Medicaid and Medicare. It is important to understand what each one will and will not cover before you commit to a community.
Does South Dakota Medicaid (the HOPE Waiver) cover assisted living in South Dakota?
South Dakota Medicaid can help pay for the care portion of assisted living through the Home & Community-Based Options and Person Centered Excellence (HOPE) Waiver, administered by the Department of Human Services, Division of Long Term Services and Supports together with the Department of Social Services.
A few key points:
- The HOPE Waiver can cover personal care and supportive services for people who need a nursing-facility level of care but choose to live in an assisted living community instead.
- It does not pay for room and board. You remain responsible for the housing and meal portion of the bill.
- To qualify, a person generally must meet a nursing-home level-of-care need and meet Medicaid's income and asset limits for long-term care.
You apply through the South Dakota Department of Social Services. Dakota at Home, the state's Aging and Disability Resource Connection, can help you understand the waiver and start the process.
Does Medicare cover assisted living in South Dakota?
No. Medicare does not pay for assisted living room and board or for ongoing custodial care (help with bathing, dressing, and other daily activities), and that is true in South Dakota as it is nationwide.
Medicare may still cover medically necessary services a resident receives, such as doctor visits, hospital stays, short-term skilled nursing or rehabilitation after a qualifying hospital stay, and some home health care. For free, unbiased help understanding your Medicare coverage and options, contact South Dakota's SHIP program, SHIINE (Senior Health Information and Insurance Education).
