ElderCareCost
B

#14 most affordable (out of 50 states)

South Dakota Assisted Living Affordability Score: B ($4,100/mo)

South Dakota is moderately affordable. Assisted living is below the national average — not dramatically, but meaningfully.

1% more affordable than the national average.

State Living

$49,200/yr

Median Income

$68,381/yr

% of Income

71.9%

nat. avg 72.4%

How the grade is calculated

We divide annual assisted living by median household income to get the cost burden ratio. Then we compare South Dakota's ratio against the national average. Grades reflect how much more or less families pay here relative to what families pay nationally.

A+
25%+ cheaper
A
10–25% cheaper
B
0–10% cheaper
C
0–10% pricier
D
10–25% pricier
F
25%+ pricier

Sources: Genworth/CareScout Cost of Care Survey 2025; U.S. Census Bureau ACS 2023 (median household income).

South Dakota vs. national average

South Dakota 71.9% of income
National average 72.4% of income

South Dakota families spend $4,800/year less on assisted living than the national average ($54,000/yr nationally vs. $49,200/yr here).

South Dakota assisted living affordability: common questions

How affordable is assisted living in South Dakota?
South Dakota earns a B for elder care affordability. Annual assisted living costs $49,200 ($4,100/month), which is 71.9% of the state's median household income of $68,381. That's 1% below the national average burden of 72.4%.
How much does assisted living cost in South Dakota per month?
Assisted living in South Dakota averages $4,100/month in 2026. Memory care runs 20–30% higher. In-home aide care averages somewhat less depending on hours needed. Full nursing home care is the most expensive option at $8,000–$15,000+/month in most states.
Does Medicare cover assisted living in South Dakota?
Medicare does not cover assisted living room and board in South Dakota or any state. It covers only skilled nursing care (up to 100 days after a qualifying hospital stay) and home health care. Medicaid may cover assisted living through waiver programs if the resident qualifies financially. Long-term care insurance is the main private option — premiums average $2,000–$4,000/year when purchased before age 60.
Why does South Dakota get a B for elder care affordability?
The grade compares South Dakota's annual assisted living cost as a percentage of local median income against the national average of 72.4%. South Dakota's ratio of 71.9% is 1% below the national baseline. States with lower labor costs, less expensive real estate, and higher median incomes tend to grade better.

What does this mean for your family?

The grade is based on median income. Your actual cost burden depends on your specific income and situation. Use the calculator to see your numbers.

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