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Understanding Medicaid Estate Recovery in South Dakota

When a Medicaid recipient passes away, the South Dakota Department of Social Services (DSS) may seek reimbursement from the recipient’s estate for Medicaid benefits paid on their behalf. This process, known as Medicaid estate recovery, generally applies to individuals who were 55 or older when they received long-term care services. You can limit or avoid recovery by obtaining a hardship waiver.

Eligibility for a Hardship Waiver

Under South Dakota law, DSS may waive estate recovery if it determines that recovery would cause undue hardship to surviving family members. See SDCL § 28-6-83 (estate recovery and waivers).

Common hardship factors include:

• Surviving spouse, minor or disabled child residing in the home
• Equity in the inherited property that, if sold, would leave dependents homeless
• Monthly income and living expenses that make it impossible to pay the lien amount

Step-by-Step Application Process

1. Gather Documentation. You’ll need:
   • Death certificate of the Medicaid recipient
   • Letters testamentary or letters of administration
   • Proof of relationship (e.g., marriage certificate, birth certificates)
   • Financial statements showing income, assets, and monthly expenses
   • Property appraisal reflecting current market value
2. Obtain the Hardship Waiver Form. Download DSS Form 470 (Application for Hardship Waiver) from the DSS website: https://dss.sd.gov/foodmedicaid/estate/470.pdf.
3. Complete the Form. Fill in all sections accurately. Attach all supporting documents.
4. Submit to DSS Estate Recovery Unit. Mail or hand-deliver your application packet to:
   
   South Dakota Department of Social Services
   Estate Recovery Unit
   700 Governors Drive
   Pierre, SD 57501
   
5. Await DSS Decision. By statute, DSS must review your application and issue a written determination within 90 days of receipt. If DSS denies your waiver, you may request an administrative appeal within 30 days. See SDCL § 28-6-84 (appeals and reviews).

Helpful Hints

• Start the application early—gathering documents can take weeks.
• Get a professional property appraisal to support your hardship claim.
• Keep copies of all forms and correspondence with DSS.
• Consult a probate or elder law attorney for guidance on complex estates.
• If denied, consider mediation before filing a formal appeal.

Disclaimer: This article is for educational purposes only. It does not constitute legal advice. Consult a qualified attorney for advice about your specific situation.