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South Dakota Health InsuranceIndividuals and Families

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South Dakota Health Insurance
How to find an affordable plan.

Residents of South Dakota looking for health insurance should explore all options before enrolling in a plan. Only by understanding what each plan covers, and more importantly, does not cover will you be able to make an informed health care decision. Everyone knows they need health insurance, but where to you start? The first step is to understand how health insurance in South Dakota works. What is the difference between an HMO and a PPO? What is a deductible? What are co-payments? Understanding this industry terminology will allow you to more effectively evaluate plans once you are provided with quotes. Health Insurance Online helps with the process, from education to enrollment. Before selecting a plan you may first want to understand your options. Do you qualify for any government sponsored plans? Are there any groups or organizations that you are a member of that may offer group health insurance plans. Does your employer offer health insurance? If so, does that plan meet your needs? Don’t assume that just because a plan is made available at work that it is your best option. You may be able to find an affordable health insurance plan that better meets your needs in the open market. Look for value when selecting a plan. Value does not mean simply that a plan is cheap. Value means that a plan provides the services you are likely to need at an affordable price. Your willingness to take on risk is also an important factor. Are you prepared to pay thousands of dollars in out of pocket expenses in any given year? If not, you may be better off paying more in monthly premiums for a plan that limits out of pocket expenses. Remember that health insurance is “insurance.” It should first be used as a tool to insure against financial disaster should an unexpected illness occur in your family.

Leading South Dakota Health Insurance Companies

Assurant of South Dakota: For well over 100 years, Assurant Health has been providing its customers in South Dakota with affordable health insurance plans that offer high value and complete coverage.

Avera of South Dakota: Avera Health Plans give members exceptional service and choices in health insurance plans.

Blue Cross and Blue Shield of South Dakota: For nearly a century now, Wellmark Blue Cross and Blue Shield has been providing affordable health insurance coverage to residents all over South Dakota.

Celtic of South Dakota: For over twenty-five years now, Celtic has been offering its clients in South Dakota exceptionally affordable and complete health insurance coverage.

South Dakota Individual Health Insurance Options

Below are various individual health insurance options available to residents of South Dakota:

  • HMO - Typically consumers with HMO plans are less likely to have significant out of pocket expenses throughout the year. Monthly premiums often cover most, or all, medical expenses. This is achieved by routing all services through a primary care physician. With some exceptions, your primary care physician must refer you to specialists if specialized care is required. Flexibility is replaced with cost control.
  • PPO - An alternative to HMOs, PPOs offer consumers greater flexibility and choice. Doctors can be selected within a “network” of participating providers, and typically no referrals are required. This flexibility comes at a cost however. Out of pocket expenses throughout the year are typically higher than with an HMO.
  • POS - Point of Service plans combine elements of both HMOs and PPOs. For in network services they most closely resemble an HMO. Out of network services are still reimbursed, but at a lower percentage.
  • CDHP - Consumer Directed Health Plans have grown in popularity recently as they attempt to return control to the consumer. A high deductible insurance component provides protection against catastrophic events, while a flexible spending account is used to cover routine expenses. Incentives are provided to the consumer to limit costs such as rolling over balances from one year to the next.

Government Health Insurance Programs in South Dakota

Within the South Dakota Department of Social services, the Division of Medical Services provides assistance to eligible residents who qualify Medicaid, the joint federal and state need based program. The Division of Medical Services also manages the Health Insurance Program (CHIP) that provides health insurance coverage to uninsured children who qualify. Adults and children who are unable to obtain health insurance coverage, and do not qualify for other programs, may be eligible to participate in the South Dakota Risk Pool.

Health Insurance Exchanges in South Dakota

To learn more about the benefits of the Health Insurance Exchange in your state, click here

Resources and Information

South Dakota Medicare Plans

Seniors age 65 and older are eligible for a variety of Medicare plans in Ohio.  Medicare plan options include Medigap and Medicare Advantage policies:

South Dakota Doctor Directory

Doctors practicing medicine in the State of South Dakota are licensed by the state. Doctors accept different forms of health insurance which you can verify before setting an appointment.

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