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South Dakota • Rare/Genetic
If you or your child have Fragile X Syndrome in South Dakota, you may be eligible for SSI, SSDI, Medicaid, and ABLE accounts, depending on age, income, and disability severity. This guide covers how to apply, what’s different in South Dakota, and ways to protect your benefits.
Fragile X Syndrome is considered a medical condition that may qualify you for federal disability benefits if it causes ‘marked and severe functional limitations’ (for children) or prevents you from working (for adults). The Social Security Administration (SSA) provides two main programs: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). SSI is for children and adults with limited income and resources, while SSDI is for adults who have worked and paid Social Security taxes. For adults, your disability must prevent you from earning more than $1,620 per month (2025; $2,700 if blind), and the condition must last at least 12 months or be terminal. For children, the SSA looks at how the condition affects their ability to function compared to other children their age. Family members may also qualify for benefits based on your work record[2][3].
South Dakota follows federal SSI and SSDI rules, but has its own Medicaid programs for people with disabilities. Children with Fragile X Syndrome may qualify for the Disabled Children’s Program, which provides Medicaid even if family income is too high for regular Medicaid. For adults, South Dakota offers Medicaid for Workers with Disabilities, letting you keep coverage if you work but still have significant disabilities. The state also has waivers for home and community-based services (HCBS), which can fund extra supports—like respite care, therapies, or PCA services—for people with high needs. The income threshold for continued Medicaid under 1619(b) is $53,022 per year (2025)[1][4]. South Dakota’s Department of Human Services can help families navigate these options and apply for waivers. State-specific information is limited; start with these official resources to see what’s available for your situation.
Start by gathering medical records, school reports (for kids), work history (for adults), and proof of income and resources. Apply for SSI or SSDI online at SSA.gov, by phone (1-800-772-1213), or in person at a Social Security office. For South Dakota Medicaid, complete an application through the Department of Social Services. Contact the South Dakota Benefits Specialist Network (1-800-224-5336) for free help with applications and appeals.
The main federal programs for Fragile X Syndrome are SSI, SSDI, and ABLE accounts. SSI provides monthly cash assistance to children and adults with limited income/resources. SSDI offers monthly payments to adults who have worked enough to qualify. ABLE accounts let you save up to $100,000 without affecting SSI eligibility. Medicare starts after 24 months on SSDI (sooner for certain conditions). Work incentives like Plan to Achieve Self-Support (PASS) and Impairment-Related Work Expenses (IRWE) help you earn income without losing benefits[1][2][3].
South Dakota offers Medicaid coverage for people with disabilities through several pathways. If you get SSI, you usually get Medicaid automatically. The state also has the Disabled Children’s Program for kids who don’t qualify for regular Medicaid due to family income. For adults, Medicaid for Workers with Disabilities supports those who work but still need coverage. South Dakota Medicaid waivers (HCBS) can fund services like respite care, personal care attendants, and therapies—critical for families with Fragile X Syndrome. Waivers often have waiting lists, so apply early. The South Dakota Department of Social Services manages these programs. ABLE accounts, recognized by South Dakota, protect savings from affecting state benefits. State-specific work incentives and resource exclusions may apply[1][4].
ABLE accounts let people with disabilities save up to $100,000 without losing SSI or Medicaid. They can be used for education, housing, transportation, health, and other disability-related expenses. South Dakota recognizes ABLE accounts, and they’re a smart way to plan for the future. See your state’s ABLE program online for details and to sign up.
In 2025, SSI has strict income and resource limits—for a single person, countable income must be below $943/month and resources below $2,000. For couples, limits are higher. Some income and resources don’t count (like a first car or home). Medicaid under 1619(b) continues until income reaches $53,022/year (2025). Always report income changes right away to avoid overpayments[1].
You must report changes in income, living situation, or disability status to Social Security and South Dakota DSS. Overpayments happen if you get more benefits than you’re owed and must be repaid. South Dakota’s Expedited Reinstatement lets you restart SSI/SSDI if you lose benefits due to work but become unable to work again within 5 years. Keep good records and report changes quickly[1].
The South Dakota Benefits Specialist Network (1-800-224-5336) offers free, expert help with SSI, SSDI, and Medicaid applications—including appeals. They know the state’s rules and can walk you through each step. Call them for one-on-one support.
South Dakota’s Medicaid HCBS waivers (for therapies, respite, personal care) often have long waiting lists. Apply as soon as you’re eligible, even if you don’t need services right away. Ask the Department of Human Services about your place on the list and other emergency options.
ABLE accounts let families save for disability expenses without losing SSI or Medicaid. Funds can pay for education, housing, transportation, and health—key for Fragile X Syndrome. South Dakota recognizes ABLE accounts, and you can open one from any state program.
Yes, if the child meets Social Security’s definition of disability and the family’s income and resources are within SSI limits. Medical and school records showing how Fragile X affects the child’s daily life are key to approval[2][3].
South Dakota offers home and community-based services (HCBS) waivers that may cover extra supports, but these waivers often have waiting lists. Apply early and contact the Department of Human Services for current options[4].
For SSI-linked Medicaid, income must be below SSI limits. The Disabled Children’s Program may cover kids with higher family incomes. Medicaid under 1619(b) continues until earnings reach $53,022/year (2025)[1][4].
Work may reduce SSI/SSDI, but special rules and state programs like Medicaid for Workers with Disabilities let you keep some benefits. Always report earnings and explore work incentives[1][4].
Yes, with an ABLE account. ABLE accounts let you save up to $100,000 without affecting SSI or Medicaid eligibility, as long as funds are used for qualified disability expenses.
Apply online at SSA.gov, by phone, or in person at a Social Security office. For Medicaid, apply through the South Dakota Department of Social Services. Get free help from the South Dakota Benefits Specialist Network[1][2][4].
Disclaimer: This guide is for informational purposes only and does not constitute legal or financial advice. Consult with a qualified professional or agency before making decisions about your benefits.
You have the right to appeal. Start the appeal within 60 days of denial. Free help is available from the South Dakota Benefits Specialist Network. Keep all your medical and work records for the appeal[1].
South Dakota Medicaid waivers may fund therapies, respite care, and other supports. These services often have waiting lists, so apply early and ask about all available waivers[4].
Adults can get SSDI if they have enough work credits and meet Social Security’s disability rules. If not, they may qualify for SSI if their income and resources are low enough[2][3].
No, but it often qualifies if it causes severe functional limitations. Social Security reviews each case based on medical evidence, not diagnosis alone[2][3].
