Cheapest South Dakota Health Insurance (2023 Plans)
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In addition to Silver plans, you can choose from other metal tier plans that have different deductibles, premiums and maximum out-of-pocket limits. In South Dakota, Sanford Health Plan offers the cheapest Gold and Catastrophic plans.
If you are looking to balance monthly premiums with quality claims and coverage, MoneyGeek analyzed the best health insurance in South Dakota.
Most Affordable Health Insurance in South Dakota
Cheapest Health Insurance in South Dakota by Metal Tier
The Avera Direct Standard 5800 Silver HMO plan from Avera Health Plans is the cheapest health insurance in South Dakota, at approximately $488 per month.
The cost of health insurance varies depending on the metal tier — more valuable metal tiers have higher premiums but come with increased coverage.
Based on our research, Avera Health Plans and Sanford Health Plan offer the most affordable health insurance in South Dakota. The following plans are the cheapest for their respective metal tier:
- Catastrophic: Sanford TRUE $9,100 ($269 per month)
- Bronze: Avera Direct Standard 9100 ($363 per month)
- Expanded Bronze: Avera Direct 8000 ($369 per month)
- Silver: Avera Direct Standard 5800 ($488 per month)
- Gold: Sanford TRUE - Standardized $2,000 ($522 per month)
Although you’ll pay higher premiums if you opt for more valuable tiers such as Gold and Silver plans, you’ll get lower out-of-pocket costs and more. This may be a worthwhile trade-off if you frequently need medical services.
Health insurance plans are grouped into metal tiers. More valuable metal tiers feature higher monthly costs and lower out-of-pocket expenses.
If you’re young and healthy, you may consider purchasing a less valuable metal tier, like Bronze, to save on monthly premiums. However, if you can afford the added cost and expect to frequently use medical services, we suggest opting for a plan with a more valuable metal tier.
Silver plans feature reasonable monthly premiums and lower deductibles, making them a great choice if you have a low income.
Resource: Learn more about metal tiers
Cheapest Silver Plans in South Dakota
Avera Direct Standard 5800 is the cheapest Silver plan in South Dakota. It has an average cost of $488 per month.
We also found the top three cheapest Silver plans in South Dakota to give you more options:
- Avera Direct Standard 5800 from Avera Health Plans: $488 per month
- Avera Direct 5800 from Avera Health Plans: $515 per month
- Sanford TRUE $3,500 from Sanford Health Plan: $517 per month
Silver plans offer decent premiums and moderate out-of-pocket costs. Due to their balance between price and coverage, they are a popular coverage choice. With a Silver plan, you can also qualify for cost-sharing reductions (CSRs) if your income is less than 250% of the Federal Poverty Level (FPL).
In this section, MoneyGeek also focuses on HMO recommendations because an HMO is the most common plan type in South Dakota. This makes them widely accessible to residents of the state.
Cheapest Gold Plans in South Dakota
In South Dakota, the cheapest Gold health insurance plan is Sanford TRUE - Standardized $2,000, costing approximately $522 per month.
Compare your options by checking the three most affordable Gold plans in South Dakota:
- Sanford TRUE - Standardized $2,000 from Sanford Health Plan: $522 per month
- Sanford TRUE $1,750 from Sanford Health Plan: $527 per month
- Sanford TRUE Enhanced - Diabetes & Asthma/COPD Care Plan $1,250 from Sanford Health Plan: $539 per month
Generally, Gold plans come with lower deductibles and out-of-pocket costs compared to less valuable metal tiers. This lowers the amount you pay before your insurer covers your medical expenses.
Cheapest Bronze Plans in South Dakota
Based on our research, the most affordable Bronze plan in South Dakota is Avera Direct Standard 9100, which costs around $363 per month.
Here are the cheapest Bronze plans in the state:
- Avera Direct Standard 9100 from Avera Health Plans: $363 per month
- Avera Standard 9100 from Avera Health Plans: $513 per month
Although Bronze plans come with low monthly premiums, they also feature high deductible amounts. This means you’ll pay more out of pocket if you get health care services.
Cheapest Expanded Bronze Plans in South Dakota
Avera Direct 8000 is the cheapest Expanded Bronze plan in South Dakota. It costs roughly $369 per month.
To help you find the lowest rates, we also listed the top three most affordable Expanded Bronze plans in South Dakota:
- Avera Direct 8000 from Avera Health Plans: $369 per month
- Avera Direct 6800 from Avera Health Plans: $376 per month
- Sanford TRUE $6,000 from Sanford Health Plan: $388 per month
Expanded Bronze plans are considered to be halfway between Bronze and Silver plans in terms of cost and coverage. They provide benefits before meeting your deductible, including one major service and office visit. However, they also feature copays.
Cheapest Catastrophic Plans in South Dakota
At $215 per month, Sanford TRUE $9,100 from Sanford Health Plans is the cheapest Catastrophic plan in South Dakota.
The following are the top three cheapest Catastrophic plans in South Dakota for a 26-year-old buyer:
- Sanford TRUE $9,100 from Sanford Health Plan: $215 per month
- Avera Direct 9100 from Avera Health Plans: $227 per month
- Sanford Simplicity $9,100 from Sanford Health Plan: $291 per month
Catastrophic plans feature low monthly premiums and very high deductible amounts. While affordable, only individuals under the age of 30 are eligible for these plans because of their lack of coverage.
Cheapest Health Insurance in South Dakota for Those With Low Income
If your income is below 250% of the FPL, you may be eligible for CSRs. CSRs help reduce medical costs for qualified individuals by lowering their deductible and out-of-pocket expenses.
Our research shows that Avera Direct Standard 5800 is the cheapest health insurance plan in South Dakota for low-income people, at approximately $488 per month. Note that its MOOP changes based on your income:
- Income lower than $20,385 per year (less than 150% of FPL): Avera Direct Standard 5800 ($1,700 MOOP)
- Income from $28,386 to $27,180 per year (151% to 200% of FPL): Avera Direct Standard 5800 ($3,000 MOOP)
- Income from $27,181 to $47,565 per year (201% to 250% of FPL): Avera Direct Standard 5800 ($7,200 MOOP)
The income limits above are only for individuals — your income threshold may vary depending on the number of people in your household. Also, CSRs are only available for Silver plans.
Although cost-sharing plans don’t have lower monthly premiums, they feature lower out-of-pocket expenses. This means they cover more of your health care expenses and have lower deductibles, copays and MOOPs compared to other plans.
To illustrate, Avera Direct Standard 5800 costs $488 per month for both standard and low-income plans. However, a standard plan has a MOOP of $8,900, while a low-income plan has a MOOP of $1,700 for those whose annual income is 150% or below of the FPL.
The Cheapest Health Insurance in South Dakota by Plan Type
Health Maintenance Organization (HMO) plans are the most common type of health insurance plan in South Dakota. However, you can also find other kinds of plans, such as Preferred Provider Organization (PPO) and Exclusive Provider Organization (EPO) plans.
If you’re looking for PPOs or EPOs, MoneyGeek’s research shows that these are the cheapest health insurance plans in South Dakota:
- PPO: Avera Standard 5800 from Avera Health Plans ($677 per month)
- EPO: Wellmark Standard Silver EPO from Wellmark of South Dakota, Inc. ($713 per month)
PPOs and EPOs tend to cost more than HMO plans. However, the former offer increased flexibility and may not require referrals for specialist visits.
When shopping for health insurance in South Dakota, you may encounter three types of plans: HMOs, PPOs and EPOs.
- HMO plans tend to be the most affordable but have the least flexibility. Policyholders are required to receive care from providers within their network, except for emergency situations. To see a specialist, you’ll need to secure a referral from a primary care provider.
- PPO plans are more flexible than EPOs and HMOs, but they’re also more expensive. They feature a wider network of specialists and don’t require a referral for specialist visits.
- EPO plans, like HMOs, only cover in-network providers. However, they typically have larger provider networks and may not require referrals for specialist visits.
Cheapest Health Insurance in South Dakota by County
Some types of insurance plans may not be readily available in certain areas of South Dakota. The cheapest plan available and its cost can vary between different counties.
To illustrate, we found the cheapest plans for the fourth-smallest county, Campbell, and the largest county, Minnehaha, in South Dakota:
- Minnehaha County: Avera Direct Standard 5800 ($487 per month)
- Campbell County: Avera Direct Standard 5800 ($489 per month)
The table below lets you view your options in your specific county.
Health Insurance Costs in South Dakota by Age and Metal Tier
Health insurance costs can vary significantly depending on the policyholder's preferred coverage and age.
Generally, you’ll pay more for extensive coverage. To help you understand how cost varies based on metal tier, we listed average insurance prices for a 40-year-old in South Dakota:
- Catastrophic: $653
- Bronze: $876
- Expanded Bronze: $1,463
- Silver: $1,970
- Gold: $2,057
Age also impacts your health insurance cost. Since older people are more likely to require medical services, they are riskier to insure and are charged higher rates. For instance, the average cost of a Silver plan in South Dakota is $1,578, $1,970 and $4,183 for a 26-year-old, 40-year-old and 60-year-old, respectively.
What to Know About South Dakota Health Insurance
MoneyGeek compiled data from private health insurance companies to identify the most affordable options for South Dakota residents. During the open enrollment period, you can review these plans and select one that best aligns with your coverage requirements and preferences.
Additionally, you may want to investigate if you qualify for government-funded health insurance programs such as Medicaid (for low-income people) and Medicare (for older adults or folks with disabilities). They are typically less expensive than standard health insurance plans.
Private Health Insurance in the South Dakota Marketplace
The open enrollment period for private insurance plans is typically from November 1 to January 15. During this time, individuals can purchase health insurance from the marketplace.
It's important to note that December 15, 2023, is the final day to sign up for coverage that starts on January 1, 2024. Enrolling early gives you more time to make changes to your plan before the open enrollment period ends.
If you missed buying a health insurance plan during the open enrollment period, you may still buy private health insurance if you qualify for a special enrollment period.
You may qualify for a special enrollment period if you recently got married, moved, had a baby or lost your job. Typically, individuals have a 60-day window before or after the event to apply for or make changes to their health insurance.
What Are Health Insurance Metal Tiers?
Health insurance plans in South Dakota are categorized into metal tiers: Catastrophic, Bronze, Expanded Bronze, Silver and Gold. The less valuable the metal tier, the lower the monthly premium and the higher the deductible.
- Catastrophic plans tend to have the most affordable premiums but the highest out-of-pocket costs. Nonetheless, they offer protection for worst-case scenarios, so they’re a great choice if you’re looking for the lowest monthly rates. To qualify, you need to be 30 years old or younger or have a hardship exemption.
- Bronze plans have lower premiums and higher deductibles, making them suitable for relatively healthy individuals who infrequently require medical services.
- Expanded Bronze plans provide slightly more benefits than Bronze plans but less than Silver plans.
- Silver plans are the most popular option, with moderate premiums and out-of-pocket costs. These plans feature CSRs, which can further reduce out-of-pocket medical expenses for low-income individuals.
- Gold plans have higher premiums than Silver and Bronze plans, but they also feature lower out-of-pocket costs and more comprehensive coverage. This may be a good option if you need frequent care.
Medicaid in South Dakota
Because Medicaid is free, it’s the most cost-effective choice for qualified South Dakota residents. However, you can only be eligible for this program if you meet the state's specific guidelines. Typically, this requires having a low-income family, disability, pregnancy or low-income children.
Medicare in South Dakota
Medicare is a government-run health insurance program for seniors aged 65 and older, as well as those who have a qualifying illness or disability. Unlike Medicaid, certain aspects of Medicare have associated costs, but it’s generally more affordable than private insurance policies.
Medicare is divided into three parts:
- Part A: covers hospital stays and other inpatient care
- Part B: pays for doctors' services, outpatient care and preventive services
- Part D: covers prescription drugs and vaccines
It's important to review the policy before signing up for benefits, as there may be limitations on the coverages offered through Medicare.
South Dakota Health Insurance Frequently Asked Questions
To help you find a plan that fits your needs and budget, MoneyGeek answered the most frequently asked questions about the cost and availability of health insurance in South Dakota.
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- HealthCare.gov. "Federal poverty level (FPL)." Accessed January 13, 2023.