South Dakota Health Insurance – All You Need to Know

In the state of South Dakota, multiple health insurance programs are being run by the Government which makes it possible for the locals to buy cheaper health insurance programs for themselves. Currently, there are two main insurers in South Dakota that provide insurance coverage i.e. Sanford Health Plan and Avera Health Plans Inc.

In 2021, the average installment for insurance plans in South Dakota is $561 every month. The current average premium amount increased by 1% from the previous year. This makes it $5 more costly for an average adult.

After conducting an extensive research, we discovered that the most inexpensive Silver health insurance plan is Sanford Simplicity. This plan is available in most of South Dakota’s counties and costs $4,750. Another very affordable Silver health insurance plan, available in 25% in South Dakota, is the Avera 3000 health policy. 

Low-Priced Health Insurance Plans in Terms of Metal Tier

While compiling this article, we went through all of the health insurance policies available in South Dakota and selected the cheapest option with regards to the metal tier. By classifying health policies in this manner, it can assist you while comparing the different benefits and costs among different levels. For instance, the most affordable Silver health plan is Sanford TRUE $4,750. Its deductible cost is $4,750 and the monthly installment is $473. On the other hand, the cheapest health plan of the Gold tier is Sanford TRUE $1,750. Although it is $29 more expensive every month, its deductible price is lower i.e. $1,750.

In South Dakota, habitants have the option to select from four available tiers: Gold, Silver, Expanded Bronze, and Catastrophic. The benefits and costs of all these plans are different. Generally, the monthly installment depends on how high is the metal tier. Another major factor in this regard that influences the monthly installment rate is age. No matter what metal tier you have chosen, the monthly health premium increases with the age.

While choosing the best one from all health insurance plans in South Dakota, you must consider your living area, health care requirements, and financial situation. If you are someone who is browsing through the state marketplace of health insurance, then there are few general guidelines that you should keep in mind.

Mostly, the upper metal tiers policies (i.e. Gold and Silver) comprise more costly monthly premiums while facilitating much lower expenses that are out of pocket, like copays, coinsurance, and deductibles. If you are suffering from a chronic medical condition or think that you might get sick in the future, then these health insurance plans in South Dakota are best suited for you.

Contrarily, healthy and young people who don’t have pre-existing medical expenses should choose a lower metal tier, such as Catastrophic and Expanded Bronze, to save money.

Gold Plans

In South Dakota, the uppermost metal tier is Gold. Typically, the coverage of Gold health insurance plans covers most of the out-of-pocket expenses, meaning that co-pays, co-insurance, and lower deductibles will be paid by you.

Generally, these policies prove to be more cost-effective in case you expect great medical expenses in the future, or you are already prescribed to costly medical expenses. Around 80% of the total medical expenses are covered by these plans while you have to pay the remaining expenses yourself. Out of all health insurance Gold plans in South Dakota, the cheapest one is the Sanford TRUE $1,750.

Silver Plans

If your income is low or you can only afford average medical expenses, then Silver health insurance plans in South Dakota are best for you. By choosing a Silver metal tier health insurance plan, you can easily balance both benefits and costs.

For instance, the deductible fee of the Sandford TRUE $4,750 Silver health insurance plan is $4,750. Meaning, that $4,750 will be paid by you for the medical expenses before the beginning of your plan. The deductible fee of $4,750 is greater than the deductible fee of Sanford TRUE $1,750 Gold health insurance plan. However, it is much lower as compared to the deductible rate of Sanford TRUE $7,000 Expanded Bronze insurance plan.

Although, Silver health insurance plans in South Dakota can still prove to be quite expensive if you are unqualified for the installment tax credits. Nowadays, the subsidies of cost-sharing reduction (CSR) are not paid by the government but by the insurers.

If your household is financially unstable, then after buying a Silver health insurance plan you might become qualified for the CSR subsidies. This way, those expenses will be further lowered that are out of your pocket. Typically, Silver health insurance plans provide 70% coverage of your total medical expenses, while the rest are paid by yourself. However, if you are qualified to attain CSR subsidies, then you can avail such a Silver health insurance plan that provides 94% coverage of your total health care expenses.

In South Dakota, Sanford TRUE $4,750 is the most affordable Silver health insurance policy.

Catastrophic and Bronze Plans

The monthly rates of catastrophic plans are the lowest which makes them best for healthy and young people. But, only those people can purchase them who are not more than 30 years old. Also, you can’t utilize installment tax credits for reducing the expenses. Moreover, these health insurance plans provide the least amount of coverage. That is why they are recommended only if you are financially capable of covering a great portion of the health care costs in an emergency.

In the case of Bronze health insurance plans, anyone can purchase them. The monthly premiums of Bronze plans are significantly cheaper than other health insurance plans of upper metal tiers along with great out-of-pocket expenses and reduced coverage. So, for getting Bronze health care in a specific year, you must pay additional out-of-pocket expenses before the coverage even begins. Averagely, a Bronze health insurance plan provides 60% coverage of total health expenses, while the remaining 40% is paid by you. Expanded Bronze health insurance plans provide 65% coverage while 35% is paid by you.

While looking through all health insurance plans in South Dakota, the most affordable Expanded Bronze health insurance plan is the Sanford TRUE $7,000.

Companies of Health Insurance in South Dakota

Health Insurance Companies

Currently, only two companies are offering health insurance plans in the state of South Dakota. They are Sanford Health Plan and Avera Health Plans Inc. From the previous few years, both of the insurance companies have been doing this job and it is not expected that any other company will match their level in future as well. Both of these insurance companies have allowed access to all counties. However, the health plan rates on a monthly basis are different for different counties.

Most Affordable Health Insurance Plan for Each County

It can be difficult to find the best health insurance policy for your household, as the offered plans and monthly premiums are subject to change depending upon your region. To make your experience less challenging, we decided to compare each health insurance plan’s rate in South Dakota and discover which County offers the most affordable Silver health insurance plan. We found out that Brown County offered the cheapest Silver health insurance plan i.e. Sanford TRUE $4,750.

Average Health Insurance Cost by Size of Household in South Dakota

While choosing a perfect family health insurance plan, you must keep in mind that the monthly installment will be influenced by the number of family members requiring coverage and their respective ages as well. If your health plan also includes children, then a flat coverage rate will be paid for each child until they reach the age of 15. After that, the rate will keep on increasing with their age.

Consider a family of three persons consisting of a child and two adults. The average health insurance expense on a monthly basis for that family will be $1,712 on a Silver health insurance plan. The monthly installment will further increase by $395 if another child is added in the plan.

Changes in Health Insurance Rates in South Dakota

For a middle-aged person in South Dakota, the average monthly expense of health plans has elevated by $5 or 1% since 2020. Across all metal tiers, the amounts of premium have also changed. The largest cost hike was experienced by the Silver health insurance policies, with a 3% increase in monthly rates. The highest decrease in average price was experienced by the Expanded Bronze health policies. This means that in South Dakota, a 40 years old individual would pay 3% or $14 less each month.

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