Health insurance in South Dakota to Save Maximum Amount

By: Astoria
Updated: September 27, 2022
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Health insurance in South Dakota is easy to get. South Dakotans can buy affordable and cheap health insurance on the state insurance exchange, which the federal government governs. Avera Health Plans Inc. and Sanford Health Plan are the two insurers that now offer health insurance quotes to residents of South Dakota.

The average monthly premium for health plans in South Dakota for 2022 is $671, a 24 percent increase from the previous year.

This is $128 more expensive than in 2021 for a 40-year-old.

According to our investigation, the Sanford Simplicity $4,750 Silver health plan is the least expensive option in most South Dakota counties. The lowest Silver plan in the state is the Sanford TRUE, $4,750, but it is only offered in three counties.

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Health insurance in South Dakota with the lowest metal tier

To make it easy for you to evaluate the various rates and advantages throughout the levels, we looked into every policy offered in the state. We determined the cheap health insurance options in South Dakota for each metal tier. For instance, the least expensive Silver plan is the Sanford TRUE $4,750, which has a $460 monthly premium and a $4,750 deductible. Sanford TRUE $1,750, the cheapest Gold plan, costs $10 more per month but has a $1,750 deductible instead. If you already have primary health insurance, then you should also check for secondary health insurance plans.

The four categories currently on the market in South Dakota are Catastrophic, Expanded Bronze, Silver, and Gold. The prices and features offered by these programs vary. The monthly premium is often larger the higher the metal tier. Another critical element impacting your monthly premium is age: Regardless of the metal tier, your monthly health insurance expenses will rise as you age. In the following topics, you can also see if health insurance is good in South Dakota.


Locating the best health insurance in South Dakota

Your health insurance will depend on your financial status, residence, and health care needs. Following these general recommendations will help you navigate the state health insurance marketplace in South Dakota.

Higher metal tier policies, such as Silver and Gold, typically feature higher monthly premiums for lower out-of-pocket costs, including copays, coinsurance, and deductibles. These health insurance plans are best in South Dakota if you anticipate getting sick or have significant ongoing medical expenses due to chronic conditions.

A lower-tier plan, like Expanded Bronze or Catastrophic, may be more cost-effective for young, healthy people who don’t anticipate incurring many medical expenses.


Best for high anticipated medical costs are gold plans.

The gold plan offers the highest metal tier in South Dakota, which often covers the largest percentage of out-of-pocket expenses and has reduced deductible, copays, and coinsurance.

Gold health insurance plans are the most cost-effective option if you anticipate high medical costs, such as chronic diseases or expensive prescription drugs. Approximately 80 percent of your medical expenditures should be covered under these policies, with the other 20% being your responsibility.

The Sanford TRUE $1,750 Gold plan is the least expensive option in South Dakota.


Silver plans are best for people with low incomes or typical medical costs

Consider silver plans if you seek a health insurance choice that compromises the costs and benefits of health insurance.

For instance, the Sanford TRUE $4,750 Silver plan has a $4,750 deductible, which means you must pay this sum before the plan starts to pay for your expenses. Although the $4,750 deductible is less than the $7,000 deductible on the Sanford TRUE $7,000 Expanded Bronze plan, it is greater than the $1,750 deductible on the Sanford TRUE $1,750 Gold plan.

However, if you are not eligible for premium tax credits, Silver health plans can still be rather expensive. Insurance companies are now responsible for paying the cost-sharing reduction (CSR) subsidies rather than the federal government. Companies may decide to raise their Silver premiums as a result.

Many people ask if South Dakota has low-income health insurance. If your household has a modest income, you may be qualified for CSR subsidies with a Silver health plan, which would further lower out-of-pocket payments. The standard Silver plan covers around 70% of your medical bills, and the other 30% is your responsibility. However, you may be eligible for a Silver plan through CSR subsidies, covering up to 94 percent of your medical expenses.

The Sanford TRUE $4,750 Silver plan is the least expensive option in South Dakota.


Catastrophic and bronze plans are ideal for young, healthy individuals.

Although catastrophic plans may have the least monthly premiums, they are only available to those under the age of 30 or those exempt. Additionally, premium tax credits cannot be used to offset the costs. These health plans also offer the least coverage and should only be chosen if you have the resources to pay for most of your medical expenses in an emergency.

All-inclusive bronze plans have less comprehensive coverage and higher deductibles than higher metal tier plans, but they also have lower monthly premiums. Therefore, if you want medical attention throughout the year, you will need to spend more out of cash until coverage begins. A Bronze plan will typically pay for 60% of your medical expenses, leaving you to fund the remaining 40%. Expanded or extensive Bronze plans increase coverage to approximately 65% while charging you about 35%.

The Sanford TRUE $7,000 is the least expensive Expanded Bronze plan available in South Dakota. The Sanford TRUE $8,700 Catastrophic plan is the least costly option.


Companies of Health insurance in South Dakota

Avera Health Plans Inc. and Sanford Health Plan are the only two health insurance providers available on the South Dakota state exchange. The number of insurers in South Dakota hasn’t changed in recent years, and both businesses are still listed on the market. Both insurance providers are available in all counties; however, the monthly costs for their health plans may vary based on where you live.


South Dakota’s cost of health insurance on average for several family members

The number of people who need coverage and their ages will affect the monthly premium when choosing a family health insurance plan, so keep that in mind. Each child you add to your health insurance plan will have a flat fee for coverage up until the age of 15 if you do so. The monthly payment will rise as they get older, beginning at age 15.

For instance, in South Dakota, a family of three with two parents who are 40 and a child enrolled in a Silver health insurance plan would pay an average monthly premium of $2,108. The plan’s monthly cost would rise by $486 if you added a second child. Therefore, the total monthly cost of health insurance for a family of 4 people would be $2,594.

Health insurance in south Dakota


Health Insurance in South Dakota rate changes

The Average cost of health insurance for a 40-year-old in South Dakota has gone up by 24 percent, or $128, since 2021. Each metal tier has different premiums, with Gold coverage seeing the biggest price hike for 2022 plans – a 26 percent rate increase.

The smallest average price rise, 21 percent, was seen for expanded bronze health insurance plans, but a 40-year-old in South Dakota still must pay $102 more monthly.


Cheap Health Insurance in South Dakota Has High Out-of-Pocket Maximums

It may make sense for younger people with modest medical expenditures to choose a plan with lower premiums and higher out-of-pocket maximums. If you want to do this, bear in mind that you might have to make additional out-of-pocket payments if you incur high medical costs or unplanned medical issues.

The Sanford TRUE $8,550 plan from Sanford Health Plan is the least expensive insurance policy in South Dakota with a high deductible. For a 26 year old person, this costs on average $188 per month.


Low Out-of-Pocket Maximums on South Dakota’s Cheapest Health Insurance

For consumers anticipating large medical bills, a plan with higher premiums and lower out-of-pocket maximum payments can make a lot of sense. Even though you pay more each month, recurrent medical costs like prescription medications and doctor visits will hasten the process of reaching your out-of-pocket maximum. The insurance provider will begin paying for your medical expenses when you cross that threshold.

The Avera 4500 HSA Eligible HDHP by Avera Health Plans is the cheapest choice for a plan with a low out-of-pocket maximum in South Dakota. The typical 40-year-old male may anticipate paying about $697 in monthly premiums for this plan.

If a plan’s out-of-pocket expenses are less than $4,250, we often consider it a low out-of-pocket maximum plan. The Avera 4500 HSA Eligible HDHP plan has the lowest out-of-pocket maximum in the state and the most affordable annual premiums. Still, it has a slightly higher maximum out-of-pocket price of $4,500 per year.


South Dakota’s most affordable HMO/PPO health insurance plan

Your healthcare requirements and preferences might significantly influence the sort of plan you choose to buy. Most plans in South Dakota are for Health Maintenance Organizations (HMOs). The state additionally provides Preferred Provider Organization (PPO) plans. You can also go through EPO Plans and reviews.

HMO plans are typically less expensive than other types, but you must remain in your provider network to receive treatments. PPO plans typically cost more, but they have a more extensive network and don’t require a referral to see a specialist.

The following Silver-tier plans are the least expensive for each kind of plan:

  • The Sanford TRUE $4,750 plan from Sanford Health Plan is the least expensive HMO Silver plan. Males in their 40s will pay $473 monthly on average.
  • Avera Health Plans’ Avera 3000 plan is the least expensive PPO Silver option. The monthly cost for a 40-year-old is $646.


Cheapest HSA-Eligible Plan in South Dakota

A Health Savings Account (HSA) might be an excellent choice for people in good health who don’t visit the doctor often. You can contribute on your own, pre-tax, to these less expensive plans to pay for medical costs. You can put this money toward savings if you decide not to utilize it for medical costs.

We discovered that the following healthcare plans in South Dakota are the least expensive ones with an HSA option in each tier:

  • Expanded Bronze: Sanford Health Plan’s Sanford TRUE $6,900 HSA/HDHP. A 40-year-old male pays $348 on average each year.
  • Silver: Avera Health Plans’ Avera 4500 HDHP, which is HSA-eligible. For a male 40 years of age, the cost is on average $697 annually.

It’s crucial to keep in mind that HSAs typically have higher deductibles. If you incur an unforeseen medical bill, your savings may be impacted.


What should people know about Health Insurance in South Dakota?

Our sample rates were used in this study based on information on private plans obtained from the South Dakota insurance market. You may be able to locate a more affordable plan on the health insurance market, depending on your circumstances. Medicaid or Medicare, typically substantially less expensive than marketplace insurance, may be available to low-income citizens or retirees in South Dakota.


Marketplace for private health insurance in South Dakota

The South Dakota marketplace for private health insurance has many metal categories. The plans with the highest out-of-pocket expenses and the lowest premiums are Catastrophic and Expanded Bronze. Conversely, Silver and Gold plans have larger premiums and cheaper overall costs.

Even though they all adhere to local, state, and federal health insurance regulations, tiers of health insurance plans each have advantages and disadvantages.

  • Catastrophic: Plans in this category provide the lowest benefits imaginable, with limited coverage, significant out-of-pocket expenses, and high deductibles. Only those under 30 or experiencing financial difficulties can enroll in these plans. Even though catastrophic plans don’t provide much coverage, they are inexpensive. Only individuals who earn more than 400 percent of the federal poverty threshold are eligible for premium tax credits.
  • Expanded Bronze: The Expanded Bronze plan features fewer out-of-pocket expenses and more coverage than the catastrophic plan.
  • Silver: Plans in this category fall between Catastrophic and Gold coverage. Compared to Catastrophic and Extended Bronze insurance, they have lower maximum out-of-pocket payments, but their monthly premiums are typically greater.
  • Gold: Gold plans can be much more expensive than the lower-tier alternatives, but they have significantly lower deductibles and out-of-pocket expenses than any previously listed plans. However, a Gold plan could help you save money on health insurance if you anticipate needing big medical coverage soon.

Depending on your income, you might be eligible for even more affordable plans or a more comprehensive range of coverage options.

Your income must be 400% of the federal poverty threshold to qualify for premium tax credits. A 2 person household in South Dakota that earns between $17,420 and $69,680 a year is eligible for these tax benefits. To find out more, use the calculator.

You can enroll in a new healthcare plan on the marketplace during open enrollment or renew your current one. Additionally, if you relocate or change your job situation, you might be eligible for a special enrollment period.


Health Insurance in South Dakota Medicaid Plans

Medicaid is the least expensive choice for South Dakota people who qualify because of free coverage. Since South Dakota has not extended Medicaid, only those who satisfy the necessary state requirements would be qualified for this coverage. This typically means you must have a very low income, a disability, a pregnancy, or low-income children to qualify.


Health Insurance in South Dakota Medicare Plans

If a resident of South Dakota is 65 years of age or older and has a qualifying sickness or handicap, they may be eligible for Medicare, a federal healthcare program. Certain features of Medicare have related expenses, unlike Medicaid. Nevertheless, Medicare plans are typically inexpensive, particularly when compared to commercial insurance coverage.

Medicare can be divided into three categories:

  • Part A: It is also known as hospital insurance. This section pays for some home health care services, hospice care, hospital stays, and care in skilled nursing facilities.
  • Part B: Part B is a type of medical insurance that pays for some doctor’s services, outpatient treatment, critical medical equipment, and preventative services. Your income determines the Part B monthly premium.
  • Your prescription drug coverage is provided through Part D, which also covers immunizations. Your strategy will determine the costs.

Make sure to read the policy carefully before enrolling in benefits because the coverages provided by Medicare may have some restrictions.



The most cost-effective option for you will rely on your unique demands and traits; our study is based on estimates. Based on this NewHealthInsurance study, which is just a suggestion, no single plan has a guarantee to be the most affordable for you in South Dakota.


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