Health Plan RadarIn this article we rank South Dakota Medicare Advantage plans based on our evaluation of government 5-star quality scores.
Read more →Medica Advantage Select (PPO)
by Medica
2026 Medicare Advantage plan available in South Dakota
Plan ID H8889-018-0
Additional coverage:
RxHearingVisionDental
Medicare Advantage PPO 3.5 Overall
Monthly plan premium $80 / mo
Annual deductible $0 / yr
Max out-of-pocket · in-network $5,000 / yr
Drug deductible $355 / yr
3.5 Overall Government Star Rating 2026 · out of 5 stars
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Plan Overview
Medica Advantage Select (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in South Dakota and offered by the health insurance company Medica. This plan's network type is PPO, which determines the in-network doctors who accept the plan and whether a referral is needed.
Plan Name Medica Advantage Select (PPO)
Insurance Carrier Medica
Plan Type Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type PPO
Cost Summary
Medica Advantage Select (PPO) has a monthly premium cost of $80 per month, with an annual deductible of $0 and a maximum out-of-pocket cost sharing of $5,000. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.
Monthly Premium $80 / mo
Health portion of premium $80
Drug portion of premium $0
Annual Deductible $0 / yr
Max Out-of-Pocket · in-network $5,000 / yr
Primary doctor visit $0 copay
Specialist visit $50 copay
ER visit $130 copay
Ambulance $375 copay
Additional Benefits and Coverage
Medica Advantage Select (PPO) is a Medicare Advantage plan which includes Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Medica Advantage Select (PPO) includes coverage for hearing, vision, dental.
Part D Prescription Drug Coverage Yes
Dental Yes
Vision Yes
Hearing Yes
Nationwide Coverage No
Other benefits
Fitness benefit Limited coverage
Over-the-counter drug benefits Limited coverage
In-home support services Not covered
Home & bathroom safety devices Not covered
Meals for short duration Not covered
Annual physical exams Limited coverage
Telehealth Limited coverage
Medical Benefits
Doctor Services
Primary doctor visit In-network: $0 copay
Out-of-network: $20 copay
Out-of-network: $20 copay
Specialist visit In-network: $50 copay
Out-of-network: $60 copay
Out-of-network: $60 copay
Tests, labs & imaging
Diagnostic tests & procedures In-network: $0-$90 copay
Out-of-network: $0-$90 copay
Out-of-network: $0-$90 copay
Lab services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI) In-network: $0-$90 copay
Out-of-network: $0-$90 copay
Out-of-network: $0-$90 copay
Outpatient x-rays In-network: $25 copay
Out-of-network: $25 copay
Out-of-network: $25 copay
Emergency care $130 copay
Urgent care $0-$45 copay
Hospital Services
Inpatient hospital coverage In-network:
Tier 1
$450 per stay
Out-of-network:
$550 per stay
Tier 1
$450 per stay
Out-of-network:
$550 per stay
Outpatient hospital coverage In-network: $0-$450 copay
Out-of-network: $0-$500 copay
Out-of-network: $0-$500 copay
Skilled nursing facility
Skilled nursing facility In-network:
Tier 1
$0 per day for days 1-20
$218 per day for days 21-44
$0 per day for days 45-100
Out-of-network:
$100 per day for days 1-20
$218 per day for days 21-35
$0 per day for days 36-100
$0 per stay
Tier 1
$0 per day for days 1-20
$218 per day for days 21-44
$0 per day for days 45-100
Out-of-network:
$100 per day for days 1-20
$218 per day for days 21-35
$0 per day for days 36-100
$0 per stay
Preventive services
Preventive services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance In-network: $375 copay
Out-of-network: $375 copay
Out-of-network: $375 copay
Therapy services
Occupational therapy visit In-network: $50 copay
Out-of-network: $55 copay
Out-of-network: $55 copay
Physical therapy & speech & language therapy visit In-network: $50 copay
Out-of-network: $60 copay
Out-of-network: $60 copay
Mental health services
Outpatient group therapy with a psychiatrist In-network: $20 copay
Out-of-network: $40 copay
Out-of-network: $40 copay
Outpatient individual therapy with a psychiatrist In-network: $30 copay
Out-of-network: $40 copay
Out-of-network: $40 copay
Outpatient group therapy visit In-network: $20 copay
Out-of-network: $40 copay
Out-of-network: $40 copay
Outpatient individual therapy visit In-network: $30 copay
Out-of-network: $40 copay
Out-of-network: $40 copay
Opioid treatment services
Opioid treatment services Covered
Other services
Durable medical equipment (like wheelchairs & oxygen) In-network: 0%-20% coinsurance
Out-of-network: 0%-30% coinsurance
Out-of-network: 0%-30% coinsurance
Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 30% coinsurance
Out-of-network: 30% coinsurance
Diabetes supplies In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Prescription drugs (Part D benefits)
Drug tier standard retail · 1-month supply Initial coverage Catastrophic
Preferred Generic $0.00 copay $0 copay
Generic $7.00 copay $0 copay
Preferred Brand 20% coinsurance $0 copay
Non-Preferred Drug 50% coinsurance $0 copay
Specialty Tier 29% coinsurance $0 copay
Part B drugs
Chemotherapy drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Other Part B drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Medicare star rating
Each year the federal government rates Medicare Advantage and Part D plans on a 5-star system covering quality of care, chronic-condition management, member experience, and customer service. For 2026, Medica Advantage Select (PPO) earned an overall rating of 3.5 stars — the same as South Dakota's state average of 3.5 stars.
Rating category This plan State average
Overall star rating ★ 3.5 3.5
Health plan quality
Summary rating of health plan quality ★ 3.5 3.5
Staying healthy: screenings, tests & vaccines ★ 4.0 3.5
Managing chronic (long-term) conditions ★ 3.0 2.9
Member experience with health plan ★ 4.0 4.0
Member complaints & changes in performance ★ 4.0 3.9
Health plan customer service ★ 3.0 3.0
Drug plan quality
Summary rating of drug plan quality ★ 3.5 3.6
Drug plan customer service ★ 4.0 4.7
Member complaints & changes in performance ★ 4.0 3.9
Member experience with the drug plan ★ 3.0 3.5
Drug safety & accuracy of drug pricing ★ 4.0 3.9
Extra Benefits
Hearing
Hearing exam In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Hearing aids - prescription In-network: $549-$1299 copay
Out-of-network: $549-$1299 copay
Out-of-network: $549-$1299 copay
Hearing aids - over the counter In-network: $499.5 copay
Out-of-network: $499.5 copay
Out-of-network: $499.5 copay
Preventive dental
Oral exam In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Cleaning In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Dental x-rays In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Comprehensive dental
Restorative services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Endodontics In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Periodontics In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, fixed In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Maxillofacial prosthetics In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Implant services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Oral and maxillofacial surgery In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Orthodontics Not covered
Adjunctive general services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Vision
Routine eye exam In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Contact lenses In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Eyeglass frames (only) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Upgrades In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
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