Best Health Insurance Plans in South Dakota

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People in the Mount Rushmore State have plenty of choices when it comes to health care in their state. According to a study by US News, SD has the 21st best health care in the country. That study looks at access, quality, and good public health.

Health Care Choices in South Dakota

There are several ways for SD residents to access health care in their state:

  1. Employer-provided
    1. From your employer
    2. Through your spouse's employer
    3. Through COBRA
  2. Individual or family plans
    1. Through HealthCare.gov
    2. Directly from a health insurance company
  3. Government-assisted
    1. Medicare
    2. Medicaid

Where do most South Dakota residents get their health insurance coverage?

South Dakota (SD) Health Insurance Sources
Sources Percent
Employer-Provided 49%
Individual or family 10%
Medicaid 15%
Medicare 17%
Other Public Care 2%
Uninsured 8%
Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population

Eight percent of SD residents are uninsured, less than the national average. That’s good news for policyholders. A higher rate of uninsured people raises premiums for insured people.

South Dakota Health Insurance Costs and Rate Factors

SD residents spend an average of $8,933 per year on health care expenditures, more than the national average. What determines your prices in South Dakota State? Prices vary person to person, but depend primarily on these factors:

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Body Mass Index

According to the CDC, a high body mass can lead to several serious health conditions. That’s why insurers analyze your BMI to determine your risk-level. A high body mass results in high health insurance rates.

In 2016, SD had a 31.9 percent obesity rate, the 22nd highest rate in the country. Out of the many state residents who used QuoteWizard to compare health insurance plans, 29 percent of residents have a BMI in the obese range.

Tobacco Use

Smokers will pay more for health care because of the risks from tobacco use. About 18.1 percent of state residents are smokers, the 32nd lowest rate in the country.

Age

Health insurance plans cost up to three times more for older people than for younger people. State residents who used QuoteWizard to shop for health insurance are, on average, 41 years old.

Plan Type

Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. The more health care coverage you want, the more you’ll have to pay in monthly premiums.

How much is health insurance in South Dakota? These are the average prices for each plan type for a middle-aged resident in your state:

South Dakota Martketplace Plan Rates
Bronze Silver Gold
$399 $495 $594
Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier

A gold plan in SD costs about 49 percent more than a bronze plan. That’s because gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent of costs. Silver plans, on the other hand, cover 70 percent of costs.

Some people also qualify for catastrophic plans, the lowest level of coverage available in the marketplace. Catastrophic plans have low monthly premiums, but a yearly deductible of $7,150. Because of that high deductible, it may save you money to invest in a bronze or silver plan if you need to use your insurance. A catastrophic plan exists to prevent medical bankruptcy after a serious health issue. It’s not very useful in paying for preventative health care.

Location

Your zip code also plays a role in your health insurance rates. That’s because every state has different rules, regulations, and providers for health insurance. Even within a state, options vary between counties.

Insurance companies also use community-rating, meaning your rates are partly based on the claims that everyone in your state files. If your area files an unusually high number of claims, your rates could rise.

That means that how health-conscious your state is also plays a role. According to America’s Health Rankings, SD is the 24th healthiest state in the country.

South Dakota Health Insurance Companies

SD residents have few options for health care companies. These providers offer both individual and family plans in your state:

South Dakota Health Insurance Laws

The Affordable Care Act limits what insurance companies can use to determine your policy prices.

There’s a limit to how much you’ll pay out-of-pocket for marketplace plans. In 2018, the out-of-pocket maximum is $7,350 for an individual plan and $14,700 for a family plan.

SD state law requires health insurance companies to offer coverage for the following services:

  • Diabetic supplies
  • Minimum maternity stay
  • Dental anesthesia
  • Mental health parity
  • Off-label drug use
  • Inpatient alcoholism treatment

There are additional services that providers need to offer. Find the full list on cms.gov.

Medicare and Medicaid in South Dakota

Medicare and Medicaid are both government-funded health care programs in the US. Medicare covers seniors, whereas Medicaid covers low-income families and children.

Medicare

Medicare offers coverage to seniors 65 and older. There are several coverage options within the program, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for a Medicare Savings Program:

  • Single person with a monthly income lower than $1,357 and savings less than $7,280.
  • Couple with a monthly income lower than $1,822 and savings less than $10,930.

Medicaid

Medicaid aids low-income families. These are the state’s Medicaid financial requirements:

South Dakota Medicaid Financial Requirements
Household Size Maximum Yearly Income
1 $16,040
2 $21,599
3 $27,159
4 $32,718
5 $38,277
6 $43,837
7 $49,396
8 $54,956

South Dakota Division of Insurance

Website:
Homepage
Insurance Commissioner:
Larry D. Deiter
Insurance Hotline:
(605) 773 – 3563
Office Hours:
Monday - Friday
8:00 am to 4:00 pm
File a Consumer Insurance Complaint
Complaint Page

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