Health Insurance Companies South Dakota Guide

If you're looking for health insurance in South Dakota, you have several options to consider. Blue Cross Blue Shield of South Dakota is one of the largest health insurance companies in the state.

Blue Cross Blue Shield of South Dakota offers a range of insurance plans, including individual and family plans, as well as group plans for employers. These plans cover medical expenses, hospital stays, and prescription medications.

Avera Health Plan is another popular option in South Dakota. It offers a variety of health insurance plans that cater to different needs and budgets.

South Dakota has several health insurance companies offering plans in the state. Two of the more popular options are Avera Health Plans and Sanford Health Plans, both of which provide comprehensive health insurance coverage.

Avera health insurance is a non-profit carrier that offers individuals and families a range of plans, including catastrophic, Bronze, Silver, and Gold options. Sanford Health, one of the largest healthcare systems in the country, also offers affordable insurance plans in addition to its healthcare services.

Three insurers offer health plans through the South Dakota exchange/Marketplace for 2025, with plan availability varying from one area to another.

Avera Health Plans offer comprehensive health insurance to individuals and families in South Dakota.

Their plans include catastrophic, Bronze (high and low deductible), Silver, and Gold options, making them a suitable choice for those seeking a range of coverage levels.

Three insurers offer health plans through the South Dakota exchange/Marketplace for 2025, and Avera is one of them, providing residents with access to their plans.

Plan availability varies from one area to another, but residents in much of western and north-eastern South Dakota have access to plans offered by Avera.

Sanford is one of the largest healthcare systems in the country. It's headquartered in Sioux Falls, South Dakota. Sanford Health includes 46 hospitals across 26 states and ten countries. They have a vast network of medical professionals, with over 1,500 physicians on staff.

You can enroll in a South Dakota Marketplace plan by visiting HealthCare.gov, where you'll find an online platform to shop, compare, and choose the best health plans.

To make the process easier, you can also work with an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity.

If you need help or have questions, you can call HealthCare.gov's contact center at 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24/7, but it's closed on holidays.

Dental coverage is a smart addition to your health coverage in South Dakota, and there are options available to improve your smile.

Avera Health Plans offers comprehensive health insurance in South Dakota, including catastrophic, Bronze, Silver, and Gold plans, making it a great option for individuals and families.

If you're self-employed or without insurance from your employer, you have more insurance options than you think in South Dakota, including Affordable Care Act insurance, also known as Obamacare.

UnitedHealthcare Nexus ACO Plans offer different levels of coverage depending on whether a referral is required. UnitedHealthcare NexusACO R plans provide network-only coverage for care providers, while NexusACO RB and RP plans require a referral to see a network specialist.

You'll need to select a primary care provider (PCP) within the network to receive preventive care, treat chronic conditions, and manage medications. Members can change their PCP once a month, and changes submitted by the 31st will be effective on the first day of the following month.

Here's a breakdown of the different Nexus ACO plans:

Network coverageLower coverageNexusACO RP

Network coverageLower coverage or out-of-network specialist

Keep in mind that out-of-pocket costs will be higher if you choose a non-network physician, and it's your responsibility to obtain prior approvals and submit claims.

Three insurers offer health plans through the South Dakota exchange/Marketplace for 2025. This is a significant number, offering residents a range of options to choose from.

Plan availability varies from one area to another, with residents in much of south-eastern South Dakota having access to two insurers' plans in the Marketplace, while residents in much of the western and north-eastern portion of the state have access to plans offered by all three insurers.

Avera Health Plans is a non-profit health insurance carrier in South Dakota that offers individuals and families comprehensive health insurance, including catastrophic, Bronze (high and low deductible), Silver, and Gold plans.

You can enroll in an ACA Marketplace plan in South Dakota by visiting HealthCare.gov to access South Dakota's health insurance Marketplace, or by purchasing individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity.

A record high of 52,974 people enrolled in private health coverage through the South Dakota exchange during the open enrollment period for 2024 coverage. This is a testament to the importance of having access to affordable health insurance options.

The enrollment spike in 2024 was also due to the "unwinding" of the pandemic-era Medicaid continuous coverage rule, which allowed nearly 8,000 South Dakota residents to transition from Medicaid to a Marketplace plan during the unwinding process.

If you're looking for Medicare coverage in South Dakota, you're in the right place. Our guide can help you learn about Medicare, Medicare Advantage, and Medigap coverage available in the state.

Medicare coverage is a vital part of many people's health insurance plans in South Dakota. You can use our guide to learn about your options.

Medicare and Medigap coverage are regulated by the state of South Dakota, so it's essential to understand the state's regulations. In South Dakota, Medicare supplement (Medigap) regulations are in place to protect consumers.

To learn more about Medicare coverage and enrollment in South Dakota, you can check out our guide for specific information. It's a great resource to have if you're looking for help navigating the Medicare system.

The Marketplace is a great place to start when looking for health insurance in South Dakota. Every year during the Open Enrollment Period, you can purchase Marketplace health insurance, which offers consumer protections, guarantees coverage for pre-existing conditions, and includes coverage for the 10 essential health benefits.

These benefits include outpatient care, emergency services, hospitalization, and more. You can find a list of the essential health benefits in the Marketplace.

The ACA-compliant plans offered on the Marketplace are divided into different types, known as metal tiers: Bronze, Silver, and Gold. These tiers do not signal a difference in quality of care, though.

Over half of the uninsured in South Dakota who qualify for Marketplace insurance coverage could get a Bronze plan for FREE. That's a great option to consider.

Here's a brief overview of the average rate changes for 2025 for the insurers that offer health insurance through South Dakota's Marketplace:

A record high of 52,974 people enrolled in private health coverage through the South Dakota exchange during the open enrollment period for 2024 coverage. That's a significant number of people who have access to health insurance through the Marketplace.

Your employer is a great resource when it comes to health insurance, especially if they offer group health plans as part of their benefit package. These plans are often less expensive than individual plans because your employer receives discounts for purchasing group policies.

You can also use the federally run Health Insurance Marketplace to compare plans and see if you're eligible for a government-funded program like Medicare or Medicaid. Medicare covers medical expenses for people over 65 and adults with certain disabilities.

Small business employers in South Dakota aren't required to offer health insurance, but many still do. The Marketplace is a good resource to explore these options.

If you're a South Dakota resident looking for health insurance, you have several options to choose from, including Blue Cross and Blue Shield of South Dakota, Sanford Health Plan, and Avera Health Plans.

Blue Cross and Blue Shield of South Dakota offers a range of plans, including individual and family plans, as well as plans for small businesses.

Sanford Health Plan is available to residents in western South Dakota, with plans that include access to Sanford Health's network of providers.

Avera Health Plans offers plans that include access to Avera Health's network of providers, with options for individual and family plans, as well as plans for small businesses.

You can find more information and compare plans on the South Dakota Department of Insurance website.

Short term and special plans can be a decent option if you've missed the health insurance Open Enrollment Period or need coverage for a short time.

If you have a pre-existing condition, you can be denied a short-term plan.

These policies tend to only cover the basics.

South Dakota recently changed its guidelines to align with federal guidelines.

Prior to 2020, the state only allowed 6-month terms for short-term plans and did not allow renewals.

Now, plan terms start at 364 days, with the option to renew up to 3 times for up to 36 months of coverage.