Updated: November 22, 2024
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Choosing a different metal tier impacts your health insurance costs. In South Dakota, Sanford Health Plan offers the most affordable plans across all categories available in the state, including Catastrophic, Expanded Bronze, Silver and Gold tiers.
If you want to balance monthly premiums with quality claims and coverage, MoneyGeek also analyzed the best health insurance in South Dakota.
CheapestHealth InsuranceSouth DakotaMost Affordable Health Insurance in South Dakota
Why Trust MoneyGeek? We downloaded plan data for South Dakota directly from the Centers for Medicare and Medicaid Services (CMS).
Plan data was updated with the CMS exchange data released in October, the latest available data for the 2024 enrollment period.
Health insurance costs are influenced by the metal tier selected, with higher-tier plans generally offering lower deductibles and out-of-pocket expenses in exchange for higher monthly premiums.
The most cost-effective Silver plan in South Dakota is the Sanford Individual TRUE Standardized $5,900 from Sanford Health Plan, priced at $455 monthly. Silver plans are popular because they balance monthly costs with comprehensive coverage. For individuals seeking lower monthly premiums, Expanded Bronze plans could be a more suitable option.
The most affordable health insurance plans in South Dakota for each metal tier are:
Eligibility for Catastrophic plans is limited to people under 30 or individuals with a qualifying hardship exemption.
For more information on affordable plans for a broad range of budgets and health care needs, explore cheap health insurance.
| Catastrophic | Sanford Individual TRUE $9,450 | Sanford Health Plan | $265 | $9,450 |
| Expanded Bronze | Sanford Individual TRUE Standardized $7,500 | Sanford Health Plan | $366 | $9,400 |
| Silver | Sanford Individual TRUE Standardized $5,900 | Sanford Health Plan | $455 | $9,100 |
| Gold | Sanford Individual TRUE $1,750 | Sanford Health Plan | $523 | $8,450 |
Health insurance plans are categorized into metal tiers that indicate the level of cost-sharing between the insurer and the individual. Catastrophic, Expanded Bronze, Silver and Gold tiers are available through South Dakota's insurance marketplace. These tiers represent a range of coverage options and associated costs. Plans for more valuable metals, like Gold, typically come with the highest monthly premiums but have lower out-of-pocket expenses when accessing health care services. These plans are preferable for people anticipating frequent medical care. On the other hand, Expanded Bronze and Catastrophic plans have the lowest monthly premiums but the highest out-of-pocket costs, suiting those who are relatively healthy and wish to minimize their monthly expenses.
For individuals below 250% of the Federal Poverty Level, Silver plans offer cost-sharing reductions (CSRs). CSRs decrease the amount you pay for deductibles, copayments and co-insurance, making comprehensive health care more affordable for lower-income individuals.
The most affordable Silver plan in South Dakota is the Sanford Individual TRUE Standardized $5,900 offered by *Sanford Health Plan at a monthly cost of $455. If you’re searching for cost-effective Silver plans in South Dakota, the three cheapest by monthly premium are:
Silver plans are well-suited for individuals who anticipate needing moderate health care services, as they balance monthly premium costs and out-of-pocket expenses when care is needed. For those with lower incomes, CSRs can significantly lower the amount you pay for deductibles, copayments and co-insurance with a Silver plan.
| Sanford Health Plan | $455 | $9,100 | Sanford Individual TRUE Standardized $5,900 |
| Sanford Health Plan | $483 | $9,100 | Sanford Individual TRUE $4,750 |
| Sanford Health Plan | $492 | $9,100 | Sanford Individual TRUE $3,500 |
| Sanford Health Plan | $508 | $7,050 | Sanford Individual TRUE Enhanced $3,700 HSA Qualified |
| Avera Health Plans | $526 | $9,100 | Avera Direct $6000 Medical Deductible with $2000 Rx Deductible |
| Avera Health Plans | $529 | $9,100 | Avera Direct Standard $5900 |
| Avera Health Plans | $579 | $9,000 | Avera Direct $4000 Medical Deductible with $0 Rx Deductible |
| Avera Health Plans | $584 | $9,100 | Avera Direct $5000 Medical Deductible with $0 Rx Deductible |
| Sanford Health Plan | $645 | $9,100 | Sanford Individual Simplicity Standardized $5,900 |
| Wellmark of South Dakota, Inc. | $661 | $9,100 | Wellmark Standard Silver EPO |
| Wellmark of South Dakota, Inc. | $671 | $8,700 | Wellmark Silver Traditional EPO |
| Sanford Health Plan | $684 | $9,100 | Sanford Individual Simplicity $4,750 |
| Sanford Health Plan | $696 | $9,100 | Sanford Individual Simplicity $3,500 |
| Avera Health Plans | $706 | $9,100 | Avera Standard $5900 |
| Sanford Health Plan | $722 | $7,050 | Sanford Individual Simplicity Enhanced Care Plan $3,700 HSA Qualified |
| Avera Health Plans | $744 | $8,000 | Avera $5800 |
| Avera Health Plans | $752 | $5,200 | Avera $5200 HSA Eligilble HDHP |
| Avera Health Plans | $776 | $9,000 | Avera $4000 Medical Deductible with $0 Rx Deductible |
| Avera Health Plans | $1,030 | $5,200 | Avera $5200 HSA Eigible HDHP |
The most affordable Gold plan in South Dakota is the Sanford Individual TRUE $1,750 offered by Sanford Health Plan for $523 monthly. The three cheapest Gold plans available in South Dakota are:
Gold plans provide a higher level of coverage with a lower out-of-pocket maximum than lower-tier plans, making them ideal for individuals who expect to need frequent or high-cost health care services. Customers who prefer predictable costs and can afford a slightly higher premium typically benefit most from Gold plans.
| Sanford Health Plan | $523 | $8,450 | Sanford Individual TRUE $1,750 |
| Sanford Health Plan | $540 | $8,700 | Sanford Individual TRUE Standardized $1,500 |
| Sanford Health Plan | $552 | $8,450 | Sanford Individual TRUE $2,800 |
| Avera Health Plans | $564 | $8,000 | Avera Direct $3000 Medical Deductible with $0 Rx Deductible |
| Sanford Health Plan | $569 | $5,500 | Sanford Individual TRUE Enhanced Care Plan $1,250 |
| Avera Health Plans | $578 | $8,700 | Avera Direct Standard $1500 |
| Avera Health Plans | $588 | $7,500 | Avera Direct $2200 Medical Deductible with $0 Rx Deductible |
| Wellmark of South Dakota, Inc. | $657 | $8,700 | Wellmark Standard Gold EPO |
| Wellmark of South Dakota, Inc. | $675 | $8,500 | Wellmark Gold Traditional EPO |
| Avera Health Plans | $754 | $8,700 | Avera $2000 Medical Deductible with $0 Rx Deductible |
| Sanford Health Plan | $764 | $8,450 | Sanford Individual Simplicity $1,750 |
| Sanford Health Plan | $767 | $8,700 | Sanford Individual Simplicity Standardized $1,500 |
| Sanford Health Plan | $772 | $8,450 | Sanford Individual Simplicity $2,800 |
| Avera Health Plans | $776 | $8,700 | Avera Standard $1500 |
| Avera Health Plans | $802 | $7,500 | Avera $1800 Medical Deductible with $0 Rx Deductible |
| Sanford Health Plan | $811 | $5,500 | Sanford Individual Simplicity Enhanced Care Plan $1,250 |
The most affordable plan in the Expanded Bronze tier in South Dakota is the Sanford Individual TRUE Standardized $7,500 plan by Sanford Health Plan, with a monthly cost of $366. The three cheapest Expanded Bronze plans in the state are:
Expanded Bronze plans are ideal for individuals who want lower monthly premiums while still having coverage. These plans typically have higher deductibles and out-of-pocket maximums, meaning they're best suited for those who don't anticipate needing frequent medical care.
| Sanford Health Plan | $366 | $9,400 | Sanford Individual TRUE Standardized $7,500 |
| Sanford Health Plan | $377 | $9,400 | Sanford Individual TRUE $7,000 |
| Sanford Health Plan | $379 | $9,450 | Sanford Individual TRUE $6,000 |
| Sanford Health Plan | $394 | $7,100 | Sanford Individual TRUE $7,100 HSA Qualified |
| Avera Health Plans | $409 | $9,450 | Avera Direct $8000 Medical Deductible with $1000 Rx Deductible |
| Avera Health Plans | $415 | $9,400 | Avera Direct Standard $7500 |
| Avera Health Plans | $444 | $7,500 | Avera Direct $7500 HSA Eligible HDHP |
| Wellmark of South Dakota, Inc. | $497 | $7,500 | Wellmark Bronze HDHP EPO |
| Wellmark of South Dakota, Inc. | $500 | $9,400 | Wellmark Standard Bronze EPO |
| Wellmark of South Dakota, Inc. | $507 | $9,000 | Wellmark Bronze Traditional EPO |
| Sanford Health Plan | $519 | $9,400 | Sanford Individual Simplicity Standardized $7,500 |
| Sanford Health Plan | $539 | $9,450 | Sanford Individual Simplicity $6,000 |
| Sanford Health Plan | $541 | $9,100 | Sanford Individual Simplicity $7,000 |
| Avera Health Plans | $545 | $7,500 | Avera $7500 HSA Eligible HDHP |
| Sanford Health Plan | $554 | $7,100 | Sanford Individual Simplicity $7,100 HSA Qualified |
| Avera Health Plans | $554 | $9,400 | Avera Standard $7500 |
| Avera Health Plans | $572 | $9,100 | Avera $6800 Medical Deductible with $50 Rx Deductible |
| Avera Health Plans | $747 | $7,500 | Avera $7500 HSA Eigible HDHP |
The most affordable Catastrophic plan in South Dakota is the Sanford Individual TRUE $9,450 offered by Sanford Health Plan for $212 monthly. The three cheapest plans in the state for this tier are:
Catastrophic plans are only available to people who are under the age of 30 or have a hardship exemption. Plans in this tier tend to have low monthly premiums but high out-of-pocket costs for medical care, so they're best suited to those wanting a safety net for major medical events but not expecting to need much medical care otherwise.
| Sanford Health Plan | $212 | $9,450 | Sanford Individual TRUE $9,450 |
| Sanford Health Plan | $298 | $9,450 | Sanford Individual Simplicity $9,450 |
| Avera Health Plans | $331 | $9,450 | Avera $9450 |
Cost-sharing reductions (CSRs) are discounts that lower the amount you pay for health care services if you enroll in a Silver plan. People making up to 250% below the Federal Poverty Level qualify for CSRs, which lower deductibles, copayments and maximum out-of-pocket (MOOP) expenses.
The following illustrates the potential savings available through CSR: take a Silver plan with a maximum out-of-pocket (MOOP) of $7,200. With a high level of CSR (94% AV Level), that MOOP would be just $1,800 — a significant decrease.
The most popular plan type in South Dakota is the Health Maintenance Organization (HMO) plan. Other plan types available in the state are Exclusive Provider Organization (EPO) and Preferred Provider Organizations (PPO) plans.
The most affordable options for each plan type in South Dakota are:
| Sanford Health Plan | $455 | $9,100 | Sanford Individual TRUE Standardized $5,900 |
| Sanford Health Plan | $483 | $9,100 | Sanford Individual TRUE $4,750 |
| Sanford Health Plan | $492 | $9,100 | Sanford Individual TRUE $3,500 |
| Sanford Health Plan | $508 | $7,050 | Sanford Individual TRUE Enhanced $3,700 HSA Qualified |
| Avera Health Plans | $526 | $9,100 | Avera Direct $6000 Medical Deductible with $2000 Rx Deductible |
| Avera Health Plans | $529 | $9,100 | Avera Direct Standard $5900 |
| Avera Health Plans | $579 | $9,000 | Avera Direct $4000 Medical Deductible with $0 Rx Deductible |
| Avera Health Plans | $584 | $9,100 | Avera Direct $5000 Medical Deductible with $0 Rx Deductible |
The most common plan type in South Dakota is the HMO plan, but EPO and PPO plans are also available. Here's a breakdown of the differences between each of these plans:
Health Maintenance Organization (HMO): HMO plans generally require members to select a primary care physician and get referrals to see specialists. This can help in coordinating care and may lead to building a long-term relationship with a primary care physician. However, getting care out-of-network can result in higher costs or no coverage at all, except in emergencies.
Exclusive Provider Organization (EPO): An EPO plan combines some of the flexibility of PPO plans with the cost savings of HMO plans. They typically don't require referrals for specialists but require that you use the plan’s network of providers. The disadvantage is that, similar to an HMO, services received out-of-network are usually not covered unless it’s an emergency.
Preferred Provider Organization (PPO): PPO plans offer more flexibility when selecting a health care provider or hospital than HMOs or EPOs. They often provide coverage for services both inside and outside the provider network without a referral, which can be convenient. However, PPOs usually have higher premiums than HMOs and EPOs, and there may be higher cost-sharing for out-of-network care.
Health insurance rates and the availability of certain plans vary by county. Comparing the most affordable plans in South Dakota's largest and smallest counties by population shows this variation:
The following table shows all available plans in each county in South Dakota so you can get a better sense of your coverage options.
| Sanford Health Plan | $444 | $9,100 | Sanford Individual TRUE Standardized $5,900 |
| Sanford Health Plan | $472 | $9,100 | Sanford Individual TRUE $4,750 |
In South Dakota, health insurance rates increase with age for the same metal tier. For example, a Silver plan for an 18-year-old costs $458 monthly, while a 60-year-old pays $1,362 for the same coverage — that's a difference of $904.
Metal tiers show different coverage levels and prices. For example, 40-year-olds typically pay $487 monthly for Expanded Bronze plans but $669 for Gold plans, showing a $182 increase between the tiers for the same age.
The chart below demonstrates how monthly premiums vary by tier and age, using South Dakota rates from 2023.
There are a variety of options for health insurance coverage in South Dakota, including private insurance available on the marketplace in Catastrophic, Expanded Bronze, Silver and Gold tiers, as well as Medicaid and Medicare for those who qualify. Learning more about each can help you decide which is right for you.
In South Dakota, the open enrollment period for private health insurance typically runs from November 1 to December 15 each year. During this time, residents can browse, compare and purchase health insurance plans through the state's Health Insurance Marketplace. If you miss this deadline, you'll have to wait until the next open enrollment period to get coverage unless you qualify for a Special Enrollment Period (SEP). SEPs are triggered by life events like marriage, childbirth or loss of other coverage and allow you to enroll outside the standard open enrollment dates.
Medicaid is a joint federal and state program that provides health care coverage to eligible low-income individuals and families. In South Dakota, eligibility for Medicaid is determined based on income and family size. It's also determined based on requirements for specific coverage groups, including pregnant, elderly and disabled individuals. Income thresholds vary and are calculated as a percentage of the Federal Poverty Level. In addition to financial criteria, applicants must be South Dakota residents and U.S. citizens or qualified non-citizens. Children may also be eligible for the Children's Health Insurance Program (CHIP) if their family income is too high for Medicaid but too low to afford private insurance.
Medicare is a federal health care program primarily for individuals aged 65 or older, though some younger individuals with disabilities or specific diseases are also eligible for coverage. Medicare Part A covers hospital insurance, including inpatient hospital stays and some home health care services. Part B provides medical insurance covering physician visits, outpatient care and preventive services. Part C — also known as Medicare Advantage — offers an alternative way to receive Medicare benefits through private insurance companies. Part D adds prescription drug coverage. Additionally, Medicare Supplement Insurance — also known as Medigap — can help cover out-of-pocket costs not covered by Original Medicare.
If you're seeking additional coverage, MoneyGeek found the best Medicare Advantage Plans in South Dakota and the best Medicare Supplement plans in South Dakota.
You may have questions about cost and availability when looking for health insurance. MoneyGeek responded to frequently asked questions about cheap private health insurance in South Dakota to help you learn more.
The cheapest silver plan in South Dakota is the Sanford Individual TRUE Standardized $5,900 offered by Sanford Health Plan ($455 monthly), while the cheapest gold plan in South Dakota is the Sanford Individual TRUE $1,750, also provided by Sanford Health Plan ($523 monthly).
Although you'll pay a lower monthly premium for a cheap health insurance plan, you may pay higher out-of-pocket costs when accessing health care services. More expensive plans cover more comprehensive services and considerably lower your out-of-pocket maximums.
About Mark Fitzpatrick
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He 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.
