South Dakota Long-Term Care Resources

Discover state-specific information on long-term health care costs, taxes, rules, care options, and other information for South Dakota residents.

State Information

South Dakota participates in the federal/state long-term care partnership program, offering those with a qualified LTC Insurance policy dollar-for-dollar asset protection. Quality care options are available statewide, and several insurance solutions are available.

There are a variety of quality care options available throughout South Dakota. However, long-term health care costs are rising. These rapidly increasing costs for care services throughout the state are becoming burdensome on residents and their families for those who do not have Long-Term Care Insurance.

The variety of quality care options available throughout South Dakota for those who require long-term health care services include:

  • adult day care centers
  • assisted living facilities
  • continuing care retirement communities
  • home health care providers
  • memory care facilities
  • rehabilitation facilities
  • traditional nursing homes

Top insurance companies have several insurance options to help residents safeguard income and assets, protect lifestyles, and preserve a legacy. Plus, policyholders will have access to quality care options giving loved ones the time to be family instead of caregivers.

Plus, all tax-qualified Long-Term Care Insurance policies in South Dakota have several consumer protections in addition to federal tax benefits.

Federal Partnership Program

The South Dakota Long-Term Care Partnership Program, administered by the Department of Social Services and Division of Insurance, provides an alternative to spending down or transferring assets by forming a partnership between Medicaid and private long-term care insurers.

This public-private partnership is an innovative program offering individuals quality, affordable long-term care insurance and a way to receive the care they need without depleting all their assets. The greatest and most unique benefit of a Partnership policy is Medicaid asset protection.

This feature provides “dollar for dollar” asset protection: for every dollar that a partnership policy pays out in benefits, a dollar of assets can be protected from the long-term care Medicaid resource limit. When determining long-term care Medicaid eligibility, any assets you have up to the amount the Partnership policy paid in benefits will be disregarded.

Policy Example

For example, if your Partnership policy paid $200,000 in benefits, South Dakota's Medicaid program would allow you to keep $200,000 in assets and still qualify for Medicaid assistance. The amount of assets you are able to protect under the Partnership is in addition to the $2,000 everyone is allowed to keep, including any assets your spouse may be allowed to retain. The Partnership Program also protects those assets after death from Medicaid estate recovery.


Most states have reciprocity with other states' long-term-care partnership programs including South Dakota. This means if you move from or to South Dakota your partnership asset protection follows you as well.


Long-Term Care Medicaid spend down is $2,000. A spouse’s minimum asset allowance is minimum of $26,076 up to a maximum of one-half of countable assets up to $130,380.   Your spouse’s minimum monthly income allowance is $2,155. * The home equity limit is $603,000.

For more information about the Medicaid program visit

Rate Stability Rules

In addition, South Dakota consumers enjoy additional peace-of-mind as the state has adopted Long-Term Care Insurance Rate Stability Rules.  These rules, developed the National Association of Insurance Commissioners, makes it much harder for an insurance company to get an approved rate increase.

Products Approved in South Dakota

A variety of products are approved in South Dakota for Long-Term Care planning. This includes the traditional plans, including partnership certified policies, short-duration policies, and asset-based “hybrid” policies.

Tax Incentives

South Dakota does not offer any state tax incentive for qualified long-term care insurance; however, federal tax incentives are still available.

Reverse Mortgages in South Dakota 

Reverse mortgages are available in South Dakota. A reverse mortgage is a home equity loan where the borrower does not have to make payments.

If you have significant equity in your home and you and your spouse are at least 62 years old, you can get a reverse mortgage to turn your equity into funding long-term health care, pay for an LTC Insurance policy, pay bills and add to your retirement lifestyle.

This type of mortgage can increase monthly income, eliminate mortgage payments, and even fund Long-Term Care Insurance. However, South Dakota has many rules on these products, and you should seek the help of a qualified and licensed mortgage broker. 

The home must be the principal residence without any tax liens. 

Learn more about reverse mortgages by clicking here.

*The federal government sets a new minimum and maximum amounts each year, but states can set their own minimum requirements at any level between the federal limits. This information is based on the best available sources.

South Dakota state emblem

State Breakdown

State Partnership Program
State Tax Incentives
Federal Tax Incentives
Medicaid Spend Down $2,000
Minimum Asset Allowance $29,724
Minimum Monthly Income Allowance $2,288.75
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South Dakota Cost of Care Calculator

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Long-Term Care Throughout South Dakota

Sioux Falls

Sioux Falls is the largest metro area in South Dakota. The average cost of a skilled nursing facility runs $7,906 a month. The cost of an Assisted Living Facility averages $3,226 a month. Adult Day Care Centers average $1,700 a month. Care at home, based on a 44-hour week, averages $4,921 a month.

Remember, assisted living cost estimates are for base costs. These long-term health care facilities will also have surcharges that will be added to the bill based on additional services that the care recipient requires. 

Rapid City

Rapid City is the second-largest population center in South Dakota. The average cost of a skilled nursing facility runs $9,044 a month. The cost of an Assisted Living Facility averages $4,052 a month. Adult Day Care Centers average $1,566 a month. Care at home, based on a 44-hour week, averages $5,315 a month.

More Locations

Other population areas in South Dakota include Aberdeen, Brookings, Huron, Mitchell, Pierre, Spearfish, Vermillion, Watertown, and Yankton.

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