Updated: May 22, 2024
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Best Health InsuranceSouth DakotaBest Health Insurance in South Dakota
Why Trust MoneyGeek? We downloaded plan data for South Dakota directly from the Centers for Medicare & Medicaid Services (CMS). MoneyGeek’s scoring methodology balances costs, claims approval and plan types to find the best providers in the state.
Plan data was updated with the CMS exchange data released in October 2023 for the 2024 enrollment period.
Avera Health Plans has a MoneyGeek score of 56 out of 100, making it the best health insurance in South Dakota. It has the lowest out-of-pocket costs and better than average performance in managing denials.
In South Dakota, we examined 19 Silver health plans that included different types like EPO, HMO and PPO for this analysis.
Low out-of-pocket maximum costs
Diverse plan options available
Tends to deny more claims than average
MoneyGeek's top pick for the best health insurance in South Dakota is Avera Health Plans. The provider offers a total of five Silver plans.
Avera Health Plans provides both HMO and PPO Silver plans. The PPO plans tend to have more out-of-network coverage, which can offer more flexibility.
It offers an average plan rate of $658, and the average maximum out-of-pocket cost for these plans is $7,150.
Avera Health Plans has a 3.1% denial rate, which is lower than most of the competition.
Plan Recommendations
MoneyGeek recommends the following Silver plans:
Wellmark of South Dakota offers the best health insurance in South Dakota for low out-of-pocket costs, with a MoneyGeek score of 62 out of 100. The provider offers the cheapest plan options and denies fewer claims compared to others.
For this analysis, there were two Gold EPO plans, seven Gold HMO plans and seven Gold PPO plans evaluated in South Dakota.
Excels in not denying claims
Offers competitive premium rates
Variety in plan types available
High maximum out-of-pocket costs
MoneyGeek's top pick for the best health insurance in South Dakota for low out-of-pocket costs is Wellmark of South Dakota. It offers two Gold EPO plans, a type of plan that lets you choose from a network of doctors and hospitals. The company also offers an average plan rate of $666, and the average maximum out-of-pocket cost for these plans is $8,600.
Wellmark of South Dakota has a denial rate of 0%, which is a lower denial rate than most of the competition.
Plan Recommendations
MoneyGeek recommends the following Gold and Platinum plans:
Sanford Health Plan offers the best cheap health insurance in South Dakota, earning a score of 67 out of 100.
The provider offers the cheapest plan options, has lower out-of-pocket expenses than many others and denies fewer claims than most providers.
For our study, we looked at a total of 19 Silver plans in South Dakota. This included two Silver EPO plans, eight Silver HMO plans and nine Silver PPO plans. MoneyGeek focused on plans with lower monthly premiums, but remember that usually, plans with lower premiums have higher out-of-pocket costs.
Affordable premium rates
Diverse plan options available
High frequency of claim denials
MoneyGeek's top pick for the best cheap health insurance in South Dakota is Sanford Health Plan. It offers eight different Silver plans.
Sanford Health Plan provides both HMO and PPO Silver plans. PPO plans usually give you more choices for out-of-network doctors.
It offers an average plan rate of $619, and the average maximum out-of-pocket cost for these plans is $8,588.
Sanford Health Plan has a prescription drug denial rate of 5%, which is lower than most of the competition.
Plan Recommendations
MoneyGeek recommends the following cheap Silver plans:
Wellmark of South Dakota provides the best health insurance in South Dakota for young adults, with a MoneyGeek score of 73 out of 100. It secures positions with lower out-of-pocket costs and fewer denials compared to most other providers.
We evaluated three Expanded Bronze EPO plans, 10 Expanded Bronze HMO plans, eight Expanded Bronze PPO plans, one Catastrophic HMO plan and two Catastrophic PPO plans for young adults under the age of 30.
Exceptionally low claim denial rate
Lowest maximum out-of-pocket costs
Does not offer different types of plans
Wellmark of South Dakota is MoneyGeek's top choice for the best health insurance for young adults in South Dakota. This insurer provides three Expanded Bronze plans and doesn't offer a Catastrophic plan.
Wellmark of South Dakota provides EPO plans. EPO plans often allow you to use doctors and hospitals within their network without a referral.
The company offers an average plan rate of $358, and the average maximum out-of-pocket cost for these plans is $8,633.
Wellmark of South Dakota has a denial rate of 0%, which is lower than most of the competition.
Plan Recommendations
MoneyGeek recommends the following plans for young adults:
Health insurance companies have different kinds of plans. The best providers for all plan categories in South Dakota are:
MoneyGeek's recommendations only include Silver plans. Silver plans are good because they help you balance what you pay every month with what you pay when you go to the doctor. This makes Silver plans a good choice for people who see the doctor sometimes but don’t want to pay a lot every month.
In South Dakota, there are a total of 19 Silver plans available. There are two Silver EPO plans, eight Silver HMO plans and nine Silver PPO plans. These options help people in South Dakota find the right plan for their health care needs.
MoneyGeek's top pick for the best health insurance in South Dakota for Silver PPO plans is Avera Health Plans. It offers five Silver PPO plans. The insurer offers an average plan rate of $762, and the average maximum out-of-pocket cost for these plans is $7,825. The company has a denial rate of 3.1%, which means it denies fewer claims than average.
PPO plans give you the freedom to choose your doctors and you don't need a referral to see specialists. They are quite popular but can cost more than other plans. They are a good choice if you want more choices and don't mind paying a bit more.
Plan Recommendations
We suggest the following Silver PPO plans from Avera Health Plans:
MoneyGeek's top pick for the best health insurance in South Dakota for Silver EPO plans is Wellmark of South Dakota. It offers two different plans. The insurer offers an average plan rate of $666, and the average maximum out-of-pocket cost for these plans is $8,900. The provider denies 0% of claims, which is better than most.
Silver EPO plans have some advantages and disadvantages. You may not need a referral to see a specialist, but you must stay in the network unless it's an emergency. They are popular plans because they provide benefits similar to HMOs.
Plan Recommendations
We suggest the following Silver EPO plans from Wellmark of South Dakota:
MoneyGeek's top pick for the best health insurance in South Dakota for Silver HMO plans is Sanford Health Plan. It offers an average plan rate of $484, and the average maximum out-of-pocket cost for these plans is $8,588. The provider has a denial rate of about 4.7%, which is lower than the median, so it denies fewer claims than average.
HMO plans can be good because they often cost less each month compared to other types. But, if you have an HMO, you need to stay in the network, except for emergencies. If you want to see a specialist, you also need to get a referral from your main doctor. These plans are worth considering if you want to pay less each month and if the doctors in the network are right for you.
Plan Recommendations
We suggest the following Silver HMO plans from Sanford Health Plan:
Everest Reinsurance Company tops our list of best short-term health insurance companies in South Dakota, with a MoneyGeek score of 85 out of 100.
The Affordable Care Act (ACA) requires all health insurance plans to cover certain essential health benefits, such as emergency services, prescription drugs, mental health care and maternity care. Short-term health insurance, however, does not have to include these benefits. Consequently, it is often cheaper than major medical plans that meet ACA requirements. This can leave you vulnerable if you do get sick or injured.
Everest Reinsurance Company offers many plan options, each with a different coverage period, copay and deductible that may help you receive enough coverage without compromising your budget. The company’s coverage of pre-existing conditions or non-hospital prescriptions is not included in its plan, which means you will have to pay out of pocket if you require these services. This may come as a drawback.
The best health insurance providers in South Dakota can provide you with the required coverage and flexibility to meet your budget and health care needs. Following our tips may help you get a health insurance plan that works for you.
Understand when a health insurance plan will cover you
In-network means the doctors and hospitals that your health plan has a deal with. If you go out-of-network, it means you're choosing doctors or hospitals not on the list, which might cost you more money. Some plans let you use out-of-network places but others don't.
PPO plans let you visit doctors outside the list but might charge more. EPO plans usually say you can't go out-of-network or they won't pay for it. PPO plans cost more but are more flexible. EPO plans cost less but give you fewer choices.
In South Dakota, there are nine PPO plans. There are two EPO plans.
Weigh the cost of premiums vs. the cost of care
When you look for health insurance, you need to think about how much you pay each month and how much you might have to pay when you go to the doctor. Some plans might have a big monthly cost, but you won't have to pay as much for doctor visits.
Now, let's say you choose the "Avera $4,000 Medical Deductible with $0 Rx Deductible" plan. This plan has a lower MOOP of $4,000. You might pay $776 each month, which is more than some other plans Avera offers.
Medicaid is a federal-subsidized health insurance program for qualifying residents of South Dakota. Eligible residents may receive this coverage for free. However, they must meet certain guidelines to do so. These guidelines vary depending on your income and conditions.
Medicare is another federal health care program that provides medical insurance for senior citizens aged 65 and above and individuals with disabilities with qualifying medical conditions. Unlike Medicaid, Medicare does not cover all medical expenses, but it does provide coverage for many common health issues.
Medicare is broken down into three parts:
The coverage offered through Medicare can be restrictive, so it's important to know what they are and whether or not you are getting exactly what you need.
The cost and availability of health insurance plans are often concerns for potential customers. Here, we answer some frequently asked questions.
Overall, Avera Health Plans offers the best health insurance in South Dakota for 2024, balancing costs and coverage. However, the best insurer for you may vary based on your income or age.
Compare the benefits and costs of different plans to find the right one for you. Some plans may offer low monthly premiums but minimal coverage. Only you can determine what level of coverage is appropriate for your needs.
Note that, depending on how your health insurance is structured, your network of doctors and hospitals is going to be different. Be sure to check with the insurance company or your benefits administrator to find out what's covered or what isn’t.
About Mark Fitzpatrick
Mark Fitzpatrick has analyzed the property and casualty insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. Currently, he leads P&C insurance content production at MoneyGeek. Fitzpatrick has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.
Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
