Updated: May 15, 2026
Advertising & Editorial Disclosure
Sanford is South Dakota's most affordable health insurance provider, with an average monthly premium of $612.
Avera offers the cheapest rates for children, teens, young adults, adults, seniors and HMO plans. Sanford has the lowest Gold and PPO rates and Wellmark provides the most affordable EPO coverage.
Compare at least three insurers during Open Enrollment to find affordable coverage. Spending 30 minutes comparing plans can save you hundreds annually.
Sanford Health Plan costs $612 monthly, but Avera costs less at every age, from children at $326 through seniors at $1,158, despite averaging $48 more per month overall. Sanford leads only on Catastrophic, Gold-tier and PPO plans.
South Dakota's marketplace has three carriers: Sanford, Avera and Wellmark. The spread between cheapest and most expensive is $124 monthly or $1,488 annually. For most residents under 60 prioritizing Silver-tier premiums, Avera is worth pricing first.
Sanford Health Plan charges $612 monthly for South Dakota's most affordable health insurance, saving residents $39 below the state average with HMO and PPO network options available depending on your location. Avera and Wellmark offer additional marketplace choices. Plan availability differs across South Dakota based on where you live.
| Sanford Health Plan | $612 | $39 | $7,344 | $468 |
| Avera Health Plans | $660 | $9 | $7,920 | $108 |
| Wellmark Of South Dakota, Inc. | $736 | $85 | $8,832 | $1,020 |
* We calculate average monthly rates by taking the rounded average of each provider’s monthly plan rates in South Dakota. We calculate average monthly savings by subtracting the statewide average monthly rate from each provider’s average to show how much cheaper they are than the overall state average. Your actual rates will vary based on age, location and chosen plan.
Your cheapest option depends on age and plan type. Avera wins on Silver-tier rates at every age. Sanford leads on Gold-tier plans and PPO averages. Wellmark is the only EPO option.
Avg. Monthly Rate
Avg. MOOP
Avg. Deductible
Avera wins six of the eight profile categories we analyzed, including every age group from children through seniors. Sanford leads the PPO category at $753 monthly average. The difference in that category is small enough that network fit matters more than price for most shoppers.
A senior on Avera pays $1,158 monthly, more than three times the $326 rate for a child, both on Silver-tier plans from the same carrier. Wellmark is the only carrier offering EPO plans in South Dakota, at $740 monthly for a 40-year-old, $195 above Avera's HMO average of $545. If an EPO network fits your doctors, you're paying for exclusivity, not competition.
| Children | Avera Health Plans | $326 | $3,916 | $5,998 | $3,021 |
| Teens | Avera Health Plans | $389 | $4,673 | $5,998 | $3,021 |
| Young Adults | Avera Health Plans | $437 | $5,241 | $5,998 | $3,021 |
| Adults | Avera Health Plans | $545 | $6,542 | $5,998 | $3,021 |
| HMO | Avera Health Plans | $545 | $6,542 | $5,998 | $3,021 |
| EPO | Wellmark Of South Dakota, Inc. | $740 | $8,880 | $5,325 | $3,007 |
| PPO | Sanford Health Plan | $753 | $9,035 | $5,867 | $2,748 |
| Seniors | Avera Health Plans | $1,158 | $13,892 | $5,998 | $3,021 |
* Rates shown are averages for silver-tier plans, using the following ages for each group: teens age 18, young adults age 26, adults age 40, seniors age 60. For plan type costs, we used average rates for 40-year-olds.
Seniors age 60 pay $1,158 monthly on Avera's Silver-tier plans. If you're approaching 65, Medicare coverage costs less than marketplace plans for most enrollees.
The $280 monthly gap between Sanford's Catastrophic plan ($294) and its Gold-tier plan ($574) is the sharpest split in South Dakota's marketplace. The trade-off: Catastrophic coverage's deductible is $10,600, while the Gold-tier plan's deductible is $1,406.
For a 40-year-old who expects even one major medical event annually, the Gold-tier plan's higher premium likely costs less overall. The Catastrophic plan's math only works if you're genuinely healthy, under 30 or qualify for a hardship exemption and can cover $10,600 out of pocket if something goes wrong.
| Catastrophic | Sanford Health Plan | $294 | $3,528 | $10,600 | $10,600 |
| Expanded Bronze | Avera Health Plans | $432 | $5,185 | $7,025 | $5,375 |
| Silver | Avera Health Plans | $545 | $6,542 | $5,998 | $3,021 |
| Gold | Sanford Health Plan | $574 | $6,882 | $6,450 | $1,406 |
* Rates shown are the provider's average at the given metal tier for 40-year-olds.
Use the table below to compare plans by type, metal level and deductible. The default filter shows PPO Silver plans for a 40-year-old without HSA eligibility.
The cheapest PPO Silver plan for a 40-year-old is Sanford Individual Simplicity Standardized at $722 monthly with a $3,100 deductible. Avera's closest match, Connectplus Standard, costs $749 with the same $3,100 deductible.
If keeping the deductible low matters more than the monthly rate, Sanford Individual Simplicity $3,500 at $765 monthly carries the lowest deductible on this list at $2,214.
| Sanford Health Plan | Sanford Individual Simplicity Standardized $6,000 | $722 | PPO | Silver | $5,657 | $3,100 | 40 | No |
| Avera Health Plans | Connectplus Standard $6000 | $749 | PPO | Silver | $5,657 | $3,100 | 40 | No |
| Avera Health Plans | Connectplus $4500 | $757 | PPO | Silver | $6,143 | $2,864 | 40 | No |
| Sanford Health Plan | Sanford Individual Simplicity $3,500 | $765 | PPO | Silver | $5,971 | $2,214 | 40 | No |
| Avera Health Plans | Connectplus Myweighforward $6000 | $771 | PPO | Silver | $5,657 | $3,100 | 40 | No |
| Sanford Health Plan | Sanford Individual Simplicity $4,750 | $771 | PPO | Silver | $5,971 | $2,929 | 40 | No |
| Avera Health Plans | Connectplus $0 Silver | $822 | PPO | Silver | $6,536 | No Data | 40 | No |
Follow these five steps to identify budget-friendly South Dakota coverage:
In our South Dakota rate data, the gap between the cheapest Expanded Bronze plan and the cheapest Gold-tier plan for a 40-year-old is $142 monthly, or $1,704 annually. If you expect more than $1,704 in out-of-pocket medical costs under a Bronze plan in a year, Gold-tier likely costs less overall.
Your household income and size determine eligibility for 2026 health insurance subsidies. Subsidies apply to incomes between 100% and 400% of the Federal Poverty Level (FPL). Lower incomes receive larger subsidies, with credit amounts decreasing as income rises.
Medicare, Medicaid, Medicare Advantage plans and Medicare Supplement plans cost less than marketplace coverage. Compare eligibility requirements and benefits for each program.
Check which tier your medications fall under for each insurer. Some plans place common prescriptions on lower tiers with smaller copays, potentially saving you hundreds annually.
Open Enrollment runs from November 1 to January 15. You may qualify for Special Enrollment if you've lost your job, divorced or had a child. Compare coverage types, customer ratings, costs and whether your doctors accept the plan.
In South Dakota's three-carrier market, Silver-tier plan rates vary across carriers and plan types. Spending 30 minutes comparing all plans during Open Enrollment is worth it.
South Dakota's marketplace is small enough that pricing all three carriers across at least two metal tiers is worth the 30 minutes it takes. In my analysis, Avera's pricing advantage by age is more consistent than Sanford's overall average suggests.
For most South Dakota residents not specifically seeking Gold-tier coverage or a PPO, Avera is the better starting point. Wellmark's EPO rates are higher on average, but its network may cover providers the other two don't, particularly in parts of the state where Sanford and Avera clinic access is limited. Use MoneyGeek's health insurance calculator to compare your estimated annual costs across metal tiers before Open Enrollment closes.
We answer common questions about affordable health insurance in South Dakota:
Avera is cheaper for most South Dakota residents. It has the lowest Silver-tier rates at every age group, from children at $326 monthly through seniors at $1,158.
Sanford wins on Gold-tier plans at $574 monthly, with a $1,406 deductible versus Avera's Silver-tier average of $3,021. Choose Avera for the lowest Silver-tier premium. Choose Sanford for Gold-tier coverage or a lower deductible on a PPO plan.
HMO plans require you to use in-network providers and get referrals for specialists. Avera's HMO averages $545 monthly for a 40-year-old. PPO plans let you see out-of-network providers at a higher cost, with Sanford's PPO averaging $753 monthly.
EPO plans use in-network restrictions without requiring referrals. Wellmark is South Dakota's only EPO carrier at $740 monthly for a 40-year-old. All three plan types are available through HealthCare.gov during Open Enrollment.
Sanford has the lowest overall average premium at $612 monthly. For Silver-tier plans, Avera offers the cheapest rates, averaging $545 monthly for 40-year-olds.
Cheap plans charge higher deductibles and out-of-pocket costs when you need medical care. You'll pay less monthly but more when using services. Higher-premium plans cost more upfront but reduce what you pay for doctor visits, prescriptions and procedures.
Subsidies reduce monthly premiums through HealthCare.gov, South Dakota's federal marketplace. Enter your household income during enrollment to check eligibility.
You can enroll in South Dakota health insurance during Open Enrollment from November 1 to January 15. However, you may qualify for Special Enrollment throughout the year if you experience a qualifying life event like marriage, job loss or having a baby.
South Dakota offers hundreds of health insurance plans and premiums vary by age. We collected 2026 plan data from HealthCare.gov's CMS marketplace plan files for South Dakota to identify which insurers offer the lowest premiums for different demographics.
Our Analysis Approach
We collected plan data for consumers aged 18, 26, 40, 50 and 60 to cover the full age spectrum from teens through pre-Medicare seniors. We ranked providers by their average monthly premiums for 40-year-olds as our baseline "cheapest overall" category, since this age reflects South Dakota's median health insurance consumer and provides the most relevant comparison for most shoppers.
For age-specific rankings (teens, young adults, adults, seniors), we used the corresponding ages listed above. This approach reveals which insurers offer the best rates for your specific age group, not just generic "cheapest" rankings that may not apply to you.
Important Cost Tradeoff
Bronze and Silver plans (the lowest monthly premiums) charge $3,021 to $10,600 deductibles and $5,998 to $10,600 maximum out-of-pocket costs. You'll save monthly but pay more when you need care. Compare premiums and potential out-of-pocket expenses based on your expected medical usage.
About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident insurance expert. He has spent nearly a decade analyzing the market, first at LendingTree and now at MoneyGeek, where he has produced original research on hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.
He writes about economics and insurance on MoneyGeek so people can make coverage decisions with confidence. His insurance insights have been featured in The Washington Post, The New York Times and NPR, among other media outlets.
Like all MoneyGeek analysts, he draws on independent cost and consumer experience data, and no insurance company partnership influences his recommendations.
Fitzpatrick earned his degrees from Johns Hopkins University (M.A. Economics and International Relations) and Boston College (B.A.). He began his career in financial risk management at State Street. He's also a five-time Jeopardy champion!
