Medicaid Unwinding in South Dakota: What You Need to Know
Key takeaways:
Automatic Medicaid renewals will stop due to the end of the COVID-19 public health emergency on May 11, 2023.
The South Dakota Department of Social Services is deciding who remains eligible for Medicaid and Children’s Medicaid (CHIP). This process is called the unwinding.
You could lose your Medicaid coverage in South Dakota as early as April 1, 2023. If this happens, you may have other health insurance options such as a plan on the Affordable Care Act marketplace.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020. It renewed that declaration a dozen times through February 2023.
During the PHE, states provided continuous Medicaid coverage without renewals. Now that the PHE is ending, you will once again need to renew your Medicaid every year. These changes are part of a process called the unwinding of Medicaid.
The South Dakota Department of Social Services (SDDSS) has started to review who remains eligible for Medicaid. Anyone who does not qualify for Medicaid or Children’s Medicaid (CHIP) could lose their benefits as soon as April 1, 2023.
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Why is Medicaid changing nationwide?
When the PHE ends on May 11, 2023, COVID-19 will remain a public health priority, but will not be an official emergency. Part of getting back to a new normal is resuming Medicaid renewals.
Medicaid cases will be reviewed for eligibility during the unwinding. This process is taking place in all 50 states plus the District of Columbia and 5 U.S. territories. Millions of people are at risk of losing Medicaid coverage during this period.
What’s happening with Medicaid renewal in South Dakota?
The South Dakota Department of Social Services has started its unwinding process. If the agency determines you are no longer eligible for Medicaid or CHIP, you could lose your health insurance as early as April 1, 2023.
The SDDSS will try to contact you about renewal by mail. Make sure that the agency has your current contact information so that you can be reached. You will need to complete a renewal form. Return the completed form to your local office or answer the questions online.
If any of these things have changed for you over the last few years, your Medicaid or CHIP coverage could be affected:
Your income
The number of people living with you
Your disability status
If you left a prison, a long-term care facility, or a mental health facility
If you moved without updating your contact information
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Note that even though some people could lose their Medicaid in South Dakota as part of the unwinding, a Medicaid expansion in the state will take effect on July 1, 2023. With this change, an estimated 30,000 adults ages 19 to 64 will become eligible for Medicaid in South Dakota.
What should I do if I lose my Medicaid coverage in South Dakota?
If you lose your Medicaid coverage in South Dakota, you will receive a notice of non-renewal in the mail. If you lose your benefits but think you still qualify, you should reapply for Medicaid.
If you are not eligible for Medicaid or CHIP benefits, you could be uninsured for a while. If that happens, you can consider using free and low-cost healthcare options. You can also use GoodRx to save money on your prescription medications.
Here are additional insurance options you might also qualify for based on your situation:
Affordable Care Act marketplace: If you qualify for a premium subsidy, you can get coverage for as low as $10 or less per month through the Affordable Care Act (ACA) exchange. If your Medicaid coverage is terminated, it will trigger a special enrollment period that will last from March 31, 2023 to July 31, 2024. During this time, you can purchase an insurance plan through the ACA marketplace.
Employer plan: You may now have a job that offers employer-sponsored insurance.
Medicare: You can enroll in Medicare at any age if you have a qualifying condition or disease.
Partner’s plan: Your spouse or domestic partner might be able to add you to their insurance during an open enrollment or special enrollment period.
Special plans: Short-term insurance is an option, as well as alternative and limited-benefit plans.
Student health plan: Students who are currently enrolled in a college or university might be eligible to participate in a campus health plan.
Veterans Affairs: Service members (both active duty and veteran) may qualify for TRICARE coverage or Veterans Affairs (VA) benefits.
South Dakota Medicaid resources
South Dakota Medicaid agency: Visit the South Dakota Department of Social Services website for general information about Medicaid in the state.
South Dakota Medicaid expansion and unwinding: Fewer residents in South Dakota could lose Medicaid than those in other states because voters approved a Medicaid expansion for adults ages 19 to 64 effective on July 1, 2023. Learn more here.
South Dakota Medicaid self-service portal: You can log in to your Medicaid account 24/7 through this online portal to update your information or renew your Medicaid and CHIP.
South Dakota Medicaid eligibility: Most of the people covered by Medicaid in South Dakota are children, but you can find out more about everyone who qualifies for coverage and income limits.
Special populations: Get information about Medicaid in South Dakota for youth formerly in foster care and refugees who entered the U.S. within the last year.
American Indians/Alaska Natives: The National Indian Health Board projects that about 236,000 American Indian/Alaska Native people will lose coverage because of the unwinding, including American Indian/Alaska Native people in South Dakota. Learn how this group can prepare for coming changes in Medicaid.
The bottom line
Automatic Medicaid renewals will stop nationwide on March 31, 2023. As a result, Medicaid and CHIP cases are being reviewed for eligibility across the U.S.
If you live in South Dakota and receive Medicaid, you will need to complete a renewal form to verify eligibility. Otherwise, your and your household’s Medicaid and CHIP benefits could be terminated as early as April 1, 2023.
If you do lose your coverage, you have other health insurance options including plans on the Affordable Care Act marketplace.
Why trust our experts?
References
Centers for Medicare & Medicaid Services. (n.d.). Renew your Medicaid or CHIP coverage.
Kaiser Family Foundation. (n.d.). Who could Medicaid reach with expansion in South Dakota?
Kaiser Family Foundation. (2023). Status of state Medicaid expansion decisions: Interactive map.
Medicaid.gov. (n.d.). Renew your Medicaid or CHIP coverage.
National Indian Health Board. (2023). Medicaid unwinding. Tribal Health Reform Resource Center.
South Dakota Department of Social Services. (n.d.) Medical programs available in South Dakota.
South Dakota Department of Social Services. (2023). Important changes coming soon to Medicaid eligibility.
South Dakota Department of Social Services. (2023). Medicaid expansion and unwinding.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
U.S. Administration for Strategic Preparedness & Response. (2020). Determination that a public health emergency exists.
U.S. Administration for Strategic Preparedness & Response. (2023). Renewal of determination that a public health emergency exists.
U.S. Department of Veterans Affairs. (2022). VA/DoD health affairs.
