If you’re looking for health insurance in South Dakota, you’ll find plenty of options. You’ll also find that your rates and coverage are dependent on several factors, including your age, general health, and household size. But, for most residents of your state, premiums start at $488 a month with dental add-ons starting at around $42 a month and vision plans at just $15. On average, residents can expect to spend around $600 a month for a full-coverage health insurance plan. But there are some residents who may even qualify for a free plan!
South Dakota Health Insurance Options
South Dakota has many affordable options for health insurance. We’ve highlighted two of the more popular insurance companies offering plans in the state:
Avera Health Plans
Avera health insurance is a non-profit health insurance carrier in South Dakota that offers individuals and families comprehensive health insurance, including catastrophic, Bronze (high and low deductible), Silver, and Gold plans.
Sanford Health Plans
Sanford Health, one of the largest healthcare systems in the country, is committed to providing integrated health-care delivery, genomic medicine, senior care and services, and affordable insurance, as well as offering global clinics and engaging in medical research. Their organization, headquartered in Sioux Falls, South Dakota, includes 46 hospitals, 1,500 physicians, and more than 200 Good Samaritan Society senior care locations across 26 states and ten countries.
Health Insurance Marketplace in South Dakota
If you’re looking for health insurance in South Dakota, the health insurance Marketplace is a great place to start. Every year during the Open Enrollment Period (OEP) you can purchase Marketplace health insurance, which was created by the Affordable Care Act, offers certain consumer protections, guarantees coverage for pre-existing conditions, and includes coverage for what are known as the “10 essential health benefits”:
- Ambulatory patient services (outpatient care)
- Emergency services
- Pregnancy, maternity, and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
The ACA-compliant plans offered on the Marketplace are divided into different types, known as metal tiers: Bronze, Silver, and Gold. These tiers do not signal a difference in quality of care, though. The tiers differ in your out-of-pocket costs versus what your plan covers.
It’s important to remember that the Marketplace only offers the plans of participating providers. So unfortunately, while the Marketplace is a great tool, you may not be able to compare every plan available to you.
Whether you want a Marketplace plan, or a plan from a private insurer, an EZ agent can help. We work with all carriers in your state in order to compare all options available.
South Dakota Short Term Health Insurance Guidelines
If you’ve missed the health insurance Open Enrollment Period (OEP), or if you need health insurance for a short amount of time, short-term plans are a great option. It’s important to note, though, that these policies tend to only cover the basics, and you can be denied one of these plans if you have a pre-existing condition.
There are some rules around short-term plans, both at the federal and the state level. Some states choose to have their own guidelines separate from federal guidelines, or to not offer short-term plans at all. South Dakota recently changed their guidelines to align with federal guidelines. Prior to 2020, the state only allowed 6-month terms for short-term plans and did not allow renewals, but now plan terms start at 364 days, with the option to renew up to 3 times for up to 36 months of coverage.
South Dakota Health Insurance Resources
You can find good health insurance by using the resources available to you. One of these resources is actually your employer, so talk to them about your group health plan options. While small business employers in South Dakota are not required to offer health insurance to their employers, many employers provide health insurance to their employees as part of their benefit package. These plans are generally less expensive than individual plans, because your employer receives discounts for purchasing group policies.
The federally run Health Insurance Marketplace is also a fantastic resource. South Dakota is one of the states that turned down funding to establish their own exchange, so you can use this resource to compare the plans that are available to you.
You can also use the Marketplace to see if you are eligible for a government-funded program. Medicare covers medical expenses for people over the age of 65 and adults with certain disabilities. Medicaid provides low-income families with affordable or, in many cases, free health insurance programs.
Your best resource, though, is an insurance agent. An EZ agent can help you weigh all of your options, both on and off the Marketplace. They can ensure that your insurance covers all of your medical needs and fits your budget.
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How to Get the Most Savings
South Dakota has the highest per capita healthcare spending of any of the 50 states, with an average annual healthcare cost for an individual of $11,736. But there are steps you can take to lower the cost of your health insurance.
The best place to begin is with your health. The obesity rate in South Dakota is 33%, and if you’re in this group, you could end up paying more for your health insurance. But maintaining a healthy BMI will allow you to get the cheapest health insurance rates.
Another factor that influences the cost of health insurance is tobacco use. 17% of people in South Dakota are smokers. And smokers may pay up to 50% more for health insurance than nonsmokers, so consider quitting to lower your premiums, as well as your healthcare costs in general. And since smoking can cause so many health complications you can improve your health by quitting as well.
There is a simpler way to save, though! Working with a trained agent is the quickest way to ensure you get the best deals. EZ’s professionals will find all the plans available to you that fit your budget, as well as any local discounts you might be eligible for. Working with an EZ agent can save you hundreds of dollars a year, and our services are completely free!
South Dakota Health Insurance FAQS
Does South Dakota require you to have health insurance?
There is no longer a tax penalty on a federal level for not having health insurance. Additionally, South Dakota is not one of the states that has chosen to adopt a health insurance mandate.
What is the cheapest health insurance in South Dakota?
The cheapest health plan will be a Bronze plan, which can start as low as $448 a month. Remember, though, health insurance plan prices can vary depending on age, zip code, gender, and other factors.
How much does health insurance cost in South Dakota?
The average monthly premium for health insurance in South Dakota is $600, or $7,220 per year, with plans as low as $448 a month to as high as $1,800. But do not let these numbers scare you. More than half of uninsured people in South Dakota qualify for a $0 Bronze plan and don’t even know it.
Which insurance companies offer plans in South Dakota?
The top 2 insurers in South Dakota are Avera Health Plans and Sanford Health Plans.
How to Enroll in Health Insurance in South Dakota
There are several methods for enrolling in a health insurance plan in your state. If your employer offers a group plan, you can enroll through them. Or you can buy an individual policy directly from the insurance company of your choice. But keep in mind the company’s website is limited to offering only their plans. Enrolling through the federal Health Insurance Marketplace is another option. Residents can browse plans from participating companies on the exchange.
Regardless of how you want to sign up for health insurance, you should work with an agent. EZ’s agents are available to assist you throughout the enrollment process. They can quickly compare every plan and carrier option!
If you still have questions, feel free to give us a call at 877-670-3557. When you call, you will be directly connected to a local insurance agent who can answer all of your questions and help you find the health insurance plan that works best for you.