Many states have a portion of their Medicaid program that is designed to cover the cost of medical care for pregnant women. In South Dakota, the program is called Women’s Services. A woman can receive limited medical coverage, or full medical coverage, through it.
Medicaid is a public, or government run, form of health insurance. It is designed to cover individuals and families who are low-income and who cannot afford to purchase a health insurance plan from a private company. Medicaid is funded by both the federal government and the government of an individual state.
In South Dakota, the Medicaid program is administered by the South Dakota Department of Social Services’ Division of Economic Assistance. It runs all portions of the Medicaid program, including CHIP and Women’s Services.
The Women’s Services program “provides medical assistance to pregnant women who meet income and resource limits and general eligibility guidelines”. There are two different parts to the program.
One will give a pregnant woman limited medical coverage, and the other will give a pregnant woman full medical coverage. The portion that offers limited coverage has wider guidelines for income and resource limits than are required for full coverage.
Women who qualify for limited medical coverage will receive coverage for things directly related to their pregnancy and delivery. It also includes 60 days postpartum care and family planning services. Women who qualify for full medical coverage receive the same coverage plus a whole lot more. It includes inpatient and outpatient hospital coverage, personal care, doctor visits, podiatry, mental health, dental, vision, wheelchair transportation, prescriptions, and more.
Many states cover pregnant women from the moment they apply for this type of coverage. It is called presumed eligibility, and allows women to get the care they need for themselves and their baby right away. In South Dakota, this is not the case.
Women who see a doctor before eligibility for medical coverage is determined will be paying for it out of pocket. The exact wording on the South Dakota website is:
“Although we cannot advise you on when you should seek medical attention, the following may assist you. The Department of Social Services has 45 days to process an application; although it normally does not take that long. Submitting the requested documentation (i.e., pay stubs) with the application or as soon as possible after submitting the application, will speed up the time required to complete an application. The start of medical coverage is based on the date the application is received in the local office.”
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