The Cheapest South Dakota Health Insurance for Individuals and Families

In South Dakota, how much coverage you need usually determines the cost of health insurance on the private market. South Dakota has a total of four tiers of plans in its marketplace, each with different out-of-pocket maximums and deductibles. Among these four tiers, the Silver plans usually afford the best balance of premiums and coverage, costing $614 per month on average. Sanford Health Plan offers the most affordable Silver plan in South Dakota — the Sanford TRUE $4,750 — at an average cost of $473 per month.

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Last Updated: 8/20/2021
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If you cannot get health insurance through your employer or a government program like Medicaid or Medicare, you will have to purchase a private insurance plan through the South Dakota insurance exchange.

It can be quite challenging to find a plan on the marketplace that presents the best balance between sufficient coverage and low monthly premiums. More affordable plans also tend to have higher out-of-pocket maxes and deductibles. While you would have to pay less per month, these plans would also cover less in terms of medical expenses.

To help you find the right plan for your needs, MoneyGeek identified the best health insurance in South Dakota through the insurance exchange based on age, coverage level and other important factors.

The Cheapest Health Insurance in South Dakota by Metal Tier

The cost of health insurance in South Dakota depends on the insurance tier you choose. The metal tier system enables you to lower your premiums by choosing higher deductibles and out-of-pocket expenses. You can also opt for a plan with higher premiums for more extensive coverage.

In South Dakota, the four currently available health insurance metal tiers are Catastrophic, Expanded Bronze, Silver and Gold. Plans named after more precious metals cost more per month but have lower deductibles and out-of-pocket expenses. For each tier, the average monthly premiums in South Dakota are:

  • Catastrophic: $302 per month
  • Expanded Bronze: $448 per month
  • Silver: $614 per month
  • Gold: $668 per month

If you are relatively healthy, with a lower probability of needing expensive medical coverage, you can save on monthly premiums by choosing a lower-tier plan like Expanded Bronze. However, if you expect frequent medical expenses, it can make sense to pay higher monthly premiums to keep deductibles and uncovered expenses to a minimum.

In the table below, you can see the plans with the lowest monthly premiums for each metal tier. Within a particular tier, however, premiums, deductibles and out-of-pocket costs can vary greatly in the South Dakota insurance marketplace.

If you are a low-income individual, you can see if your profile is eligible for cost-sharing reductions (CSR) that apply to Silver plans. CSRs can lower your deductible and premiums and get you more coverage for your money.

The premiums displayed in the table above are for a 40-year-old male sample profile for all plan types available in South Dakota. These rates are for PPO or HMO plans, with HMO being the most common in the state.

Cheapest Health Insurance in South Dakota by Metal Tier

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  • Metal Tier
    Plan
    Company
    Monthly Cost
    OOP Max
  • Catastrophic
    Sanford TRUE $8,550
    Sanford Health Plan
    $235
    $8,550
  • Expanded Bronze
    Sanford TRUE $7,000
    Sanford Health Plan
    $347
    $8,400
  • Silver
    Sanford TRUE $4,750
    Sanford Health Plan
    $473
    $8,150
  • Gold
    Sanford TRUE $1,750
    Sanford Health Plan
    $502
    $6,250

The Cheapest Health Insurance in South Dakota by Age and Metal Tier

An analysis of the South Dakota insurance marketplace shows that age can have a significant role in deciding health insurance premiums. For example, a 26-year-old purchasing a Silver plan (across all HMO and PPO plans) pays an average of $492 per month, while a 60-year-old would pay about $1,304

Health Insurance Costs in South Dakota by Age and Metal Tier

Health insurance premiums increase as you advance in age. Choosing a lower-premium option like an Expanded Bronze plan might cost less per month but would also involve higher out-of-pocket costs if you have high medical expenses.

As you look at the available data, please remember that sample ages do not account for how your income can affect premiums. For instance, older South Dakota residents might pay less for a plan in the insurance exchange due to tax premiums and other relevant regulations. Until you apply for a plan, you will not know your exact quote.

The table below shows the cost variance for different metal-tier plans based on your age. To learn more in detail about these tiers and choose the right one for your situation, take a look at our detailed guide on South Dakota health insurance options.

Cheapest Health Insurance in South Dakota by Age And Metal Tier

Sort by Metal Tier:

Silver

Sort by Age:

40 years

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  • Plan
    Company
    Monthly Rate
  • Catastrophic
    HMO
    Sanford Health Plan
    $168
  • Catastrophic
    HMO
    Avera Health Plans
    $181
  • Catastrophic
    PPO
    Sanford Health Plan
    $234
  • Catastrophic
    PPO
    Avera Health Plans
    $238
  • Expanded Bronze
    HMO
    Sanford Health Plan
    $248
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The Cheapest Health Insurance in South Dakota by County

Health insurance costs in South Dakota can vary based on where you live in the state. South Dakota is divided into different rating areas, and health insurance companies have different rates for different regions.

Overall, South Dakota has 66 counties, split into four distinct rating areas. In Minnehaha County, the most populous county in South Dakota, the cheapest Silver plan on average is Sanford TRUE $4,750 offered by Sanford Health Plan for $473 per month.

Use the table below to see a list of the cheapest plans in your county for each metal tier.

The average premiums are for a sample 40-year-old male in South Dakota purchasing a health insurance plan in that county.

Cheapest Health Insurance Plans in South Dakota by County

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Aurora

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  • Metal Tier
    Company
    Cheapest Plan
    Monthly Premium
  • Harding
    Catastrophic
    Avera Health Plans
    Avera 8550
    $399
  • Butte
    Catastrophic
    Avera Health Plans
    Avera 8550
    $399
  • Perkins
    Catastrophic
    Avera Health Plans
    Avera 8550
    $399
  • Ziebach
    Catastrophic
    Avera Health Plans
    Avera 8550
    $399
  • Haakon
    Catastrophic
    Avera Health Plans
    Avera 8550
    $399

The Cheapest Health Insurance in South Dakota With High Out-of-Pocket Maxes

For younger people with low medical costs, it can make sense to opt for a plan with lower premiums and higher out-of-pocket maximums. If you choose to do this, remember that you would have to pay more out of pocket in case of high medical costs or unexpected medical emergencies.

The most affordable insurance plan with a high out-of-pocket expense in South Dakota is the Sanford TRUE $8,550 plan from Sanford Health Plan. This costs an average of $188 per month for a 26-year-old.

For this guide, MoneyGeek defined a high out-of-pocket max plan as one with maximum out-of-pocket expenses of $8,250 or higher per year.

Sanford Health Plan

When it comes to the best health insurance in South Dakota, Sanford Health Plan offers the most affordable option for a plan with a high out-of-pocket maximum. Since this plan is in the Catastrophic tier, you are only eligible if you are under 30 or qualify for an affordability or hardship exemption.

The Cheapest Health Insurance in South Dakota With Low Out-of-Pocket Maximums

For people anticipating high medical costs, a plan with higher premiums and lower out-of-pocket maximum expenses can make a lot of sense. While you pay more every month, recurring medical expenses like prescription drugs and doctor’s visits will help you reach your out-of-pocket max limit more quickly. Once you reach that limit, the insurance company will start covering your medical costs.

In South Dakota, the most affordable option for a plan with a low out-of-pocket max is the Avera 4500 HSA Eligible HDHP by Avera Health Plans. With this plan, the average 40-year-old male can expect to pay around $697 per month in premiums.

Usually, MoneyGeek considers a plan to be a low out-of-pocket maximum plan if it has out-of-pocket costs below $4,250. While the Avera 4500 HSA Eligible HDHP plan has a slightly higher max out-of-pocket expense of $4,500 per year, it features the lowest out-of-pocket max in the state and the cheapest average premiums.

Avera Health Plans

The Avera 4500 HSA Eligible HDHP is a Silver-tier plan, which means that it can provide a good balance between reasonable monthly premiums and a low out-of-pocket maximum while also covering more of your medical costs once you reach the spending limit.

Cheapest HMO/PPO Health Insurance Plan in South Dakota

Your healthcare needs and preferences can go a long way in helping you choose the type of plan to purchase. In South Dakota, most plans are of the Health Maintenance Organization (HMO) variety. Apart from this, the state also offers Preferred Provider Organization (PPO) plans.

HMO plans are usually more affordable than other types but require you to stay within your provider network to have services covered. PPO plans are usually more expensive but have a wider network, and you do not need a referral to see a specialist.

MoneyGeek found that the most affordable Silver-tier plans for each plan type are:

  • Cheapest HMO Silver Plan: The Sanford TRUE $4,750 plan offered by Sanford Health Plan. The average 40-year-old male will pay $473 per month.
  • Cheapest PPO Silver Plan: The Avera 3000 plan offered by Avera Health Plans. The average 40-year-old will pay $646 per month.

Cheapest Plan in South Dakota With an HSA

For individuals in good health who do not make frequent doctor visits, a Health Savings Account (HSA) might be a good option. These plans are less expensive and let you make your own pre-tax contributions to use for medical expenses. If you do not use this money on medical expenses, you can roll it over into savings.

In South Dakota, MoneyGeek found that the most affordable healthcare plans with an HSA option in each available tier are:

  • Expanded Bronze: The Sanford TRUE $6,900 HSA/HDHP offered by Sanford Health Plan. It costs an average of $348 per year for a 40-year-old male.
  • Silver: The Avera 4500 HSA Eligible HDHP offered by Avera Health Plans. It costs an average of $697 per year for a 40-year-old male.

It is important to remember that HSAs tend to have higher deductibles. Your savings might take a hit if you have an unexpected medical expense.

What to Know About Health Insurance in South Dakota

The sample rates used by MoneyGeek in this analysis are based on private plan data from the South Dakota insurance marketplace. If you apply for a plan on the health insurance exchange, you might be able to find an even cheaper one, depending on your circumstances. Low-income residents or seniors in South Dakota may be eligible for Medicaid or Medicare, which are usually much cheaper than marketplace plans.

Private Health Insurance on the South Dakota Marketplace

Private health insurance plans in the South Dakota marketplace are divided into several metal tiers. Catastrophic and Expanded Bronze plans have the highest out-of-pocket costs and the lowest premiums. Silver and Gold plans, on the other hand, have higher premiums and lower total costs.

Tiered health insurance plans, while all conforming to state and federal health insurance requirements, have their own pros and cons:

  • Catastrophic: Catastrophic plans offer the lowest possible benefits, with less coverage, high out-of-pocket costs and high deductibles. These plans are only available to people who are under 30 or living under conditions of financial hardship. While Catastrophic plans don’t offer much in the way of coverage, the cost is extremely low, and it can help you avoid incurring hundreds of thousands of dollars in medical debt after a medical emergency.
  • Expanded Bronze: The Expanded Bronze plan covers more than the Catastrophic plan and has lower out-of-pocket costs.
  • Silver: Silver plans are in between Catastrophic coverage and Gold coverage. They have lower maximum out-of-pocket costs than Catastrophic and Extended Bronze policies, but their monthly premiums are usually higher.
  • Gold: Gold plans have significantly lower deductibles and out-of-pocket costs than any of the plans mentioned above but can be significantly more expensive than the lower-tier options. However, if you know you will need major medical coverage in the near future, you may save money overall by choosing a Gold plan.

You might qualify for even cheaper plans or increased coverage options based on your income level.

You can get premium tax credits if your income falls between 100% and 400% of the federal poverty level. In South Dakota, a two-person household making between $17,420 and $69,680 per year would qualify for these tax credits. Use the HealthCare.gov calculator to learn more.

Open enrollment is when you can renew your existing plan or enroll in a new healthcare plan through the marketplace. This typically falls between November and December, although the dates have now been expanded due to COVID-19. You might also qualify for a special enrollment period after moving or changing your employment status.

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If your income is between 138% and 250% of the federal poverty level, you would be eligible for cost-sharing reductions when purchasing a Silver plan. This can lower your deductibles, out-of-pocket maximums and copayments and coinsurance. If you qualify for these deductions, you might even be able to buy a Gold plan for Silver plan prices. In South Dakota, a two-person household making between $24,040 and $43,550 per year would be eligible.

Medicaid in South Dakota

Since Medicaid is free, it is the cheapest option for eligible residents of South Dakota. Since South Dakota has not expanded Medicaid, you would only be eligible for this coverage if you meet the requisite state guidelines. Usually, this means you must have a very low-income family, disabilities, a pregnancy or low-income children to be eligible.

Medicare in South Dakota

Residents of South Dakota who are 65 and above might qualify for Medicare, a federal healthcare program, if they have a qualifying illness or disability. Unlike Medicaid, certain aspects of Medicare have associated costs. However, Medicare plans are usually affordable, especially when compared with private insurance policies.

Medicare can be broken down into three parts:

  • Part A: This portion is often called hospital insurance, which covers hospital stays, hospice care, care in a skilled nursing facility and some home health care services.
  • Part B: Part B is medical insurance covering some doctors’ services, outpatient care, important medical supplies and preventive services. The monthly premium for Part B depends on your income.
  • Part D: This is your prescription drug coverage, which includes prescription drugs and vaccines. The costs vary depending on your plan.

The coverages offered through Medicare can have some limitations, so ensure that you review the policy before signing up for benefits.

Methodology

MoneyGeek's research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in South Dakota for you

MoneyGeek collected plans and premiums for health insurance in South Dakota from the Health Insurance Exchange Public Use Files (Exchange PUFs) for all available metal tiers and across several age groups. 

Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.

About the Author


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Mark Fitzpatrick is a senior content manager with MoneyGeek specializing in insurance. Mark has years of experience analyzing the insurance market and creating original research and content. He graduated from Boston College with a Bachelor of Arts and Johns Hopkins University with a Master of Arts.