Health Insurance Plans in South Dakota
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| Plan Name | On or Off Exchange | Plan eligible for subsidy? | Metal Level | Deductible (individual/family) | Out-of-pocket Max (individual/family) | |
|---|---|---|---|---|---|---|
| Sanford Individual Simplicity Standardized $7,500 by Sanford Health Plan | Both | Bronze | $7,500 / $15,000 | $9,200 / $18,400 | Price & Details | |
| Avera $6000 by Avera Health Plans, Inc. | Both | Bronze | $6,000 / $12,000 | $9,200 / $18,400 | Price & Details | |
| Wellmark Bronze Traditional EPO by Wellmark of South Dakota, Inc. | Both | Bronze | $7,200 / $14,400 | $9,000 / $18,000 | Price & Details | |
| Wellmark Bronze Traditional EPO by Wellmark of South Dakota, Inc. | Both | Bronze | $7,200 / $14,400 | $9,000 / $18,000 | Price & Details | |
| Avera $6000 by Avera Health Plans, Inc. | Both | Bronze | $6,000 / $12,000 | $9,200 / $18,400 | Price & Details | |
| Avera Standard $7500 by Avera Health Plans, Inc. | Both | Bronze | $7,500 / $15,000 | $9,200 / $18,400 | Price & Details | |
| Avera $7500 HSA Eligible HDHP by Avera Health Plans, Inc. | Both | Bronze | $7,500 / $15,000 | $7,500 / $15,000 | Price & Details | |
| Sanford Individual TRUE Standardized $7,500 by Sanford Health Plan | Both | Bronze | $7,500 / $15,000 | $9,200 / $18,400 | Price & Details | |
| Wellmark Standard Bronze EPO by Wellmark of South Dakota, Inc. | Both | Bronze | $7,500 / $15,000 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual Simplicity $6,000 by Sanford Health Plan | Both | Bronze | $6,000 / $12,000 | $9,200 / $18,400 | Price & Details | |
| Wellmark Bronze HDHP EPO HSA Qualified by Wellmark of South Dakota, Inc. | Both | Bronze | $8,050 / $16,100 | $8,050 / $16,100 | Price & Details | |
| Avera Direct Standard $7500 by Avera Health Plans, Inc. | Both | Bronze | $7,500 / $15,000 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual TRUE $7,100 HSA Qualified by Sanford Health Plan | Both | Bronze | $7,100 / $14,200 | $7,100 / $14,200 | Price & Details | |
| Avera Standard $7500 by Avera Health Plans, Inc. | Both | Bronze | $7,500 / $15,000 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual Simplicity $7,100 HSA Qualified by Sanford Health Plan | Both | Bronze | $7,100 / $14,200 | $7,100 / $14,200 | Price & Details | |
| Avera Direct $6000 by Avera Health Plans, Inc. | Both | Bronze | $6,000 / $12,000 | $9,200 / $18,400 | Price & Details | |
| Avera Direct $7500 HSA Eligible HDHP by Avera Health Plans, Inc. | Both | Bronze | $7,500 / $15,000 | $7,500 / $15,000 | Price & Details | |
| Avera $7500 HSA Eligible HDHP by Avera Health Plans, Inc. | Both | Bronze | $7,500 / $15,000 | $7,500 / $15,000 | Price & Details | |
| Sanford Individual TRUE $6,000 by Sanford Health Plan | Both | Bronze | $6,000 / $12,000 | $9,200 / $18,400 | Price & Details | |
| Wellmark Bronze HDHP EPO HSA Qualified by Wellmark of South Dakota, Inc. | Both | Bronze | $8,050 / $16,100 | $8,050 / $16,100 | Price & Details | |
| Wellmark Standard Bronze EPO by Wellmark of South Dakota, Inc. | Both | Bronze | $7,500 / $15,000 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual Simplicity $4,750 by Sanford Health Plan | Both | Silver | $4,750 / $9,500 | $9,100 / $18,200 | Price & Details | |
| Avera $4000 by Avera Health Plans, Inc. | Both | Silver | $4,000 / $8,000 | $9,200 / $18,400 | Price & Details | |
| Wellmark Silver Traditional EPO by Wellmark of South Dakota, Inc. | Both | Silver | $5,000 / $10,000 | $7,800 / $15,600 | Price & Details | |
| Wellmark Standard Silver EPO by Wellmark of South Dakota, Inc. | Both | Silver | $5,000 / $10,000 | $8,000 / $16,000 | Price & Details | |
| Wellmark Silver Traditional EPO by Wellmark of South Dakota, Inc. | Both | Silver | $5,000 / $10,000 | $7,800 / $15,600 | Price & Details | |
| Wellmark Standard Silver EPO by Wellmark of South Dakota, Inc. | Both | Silver | $5,000 / $10,000 | $8,000 / $16,000 | Price & Details | |
| Avera $4000 by Avera Health Plans, Inc. | Both | Silver | $4,000 / $8,000 | $9,200 / $18,400 | Price & Details | |
| Avera Standard $5000 by Avera Health Plans, Inc. | Both | Silver | $5,000 / $10,000 | $8,000 / $16,000 | Price & Details | |
| Sanford Individual TRUE $3,500 by Sanford Health Plan | Both | Silver | $3,500 / $7,000 | $9,100 / $18,200 | Price & Details | |
| Sanford Individual TRUE $4,750 by Sanford Health Plan | Both | Silver | $4,750 / $9,500 | $9,100 / $18,200 | Price & Details | |
| Avera Direct $4500 by Avera Health Plans, Inc. | Both | Silver | $4,500 / $9,000 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual TRUE Standardized $5,000 by Sanford Health Plan | Both | Silver | $5,000 / $10,000 | $8,000 / $16,000 | Price & Details | |
| Avera Direct Standard $5000 by Avera Health Plans, Inc. | Both | Silver | $5,000 / $10,000 | $8,000 / $16,000 | Price & Details | |
| Avera Direct MyWeighForward $4000 by Avera Health Plans, Inc. | Both | Silver | $4,000 / $8,000 | $9,200 / $18,400 | Price & Details | |
| Avera Standard $5000 by Avera Health Plans, Inc. | Both | Silver | $5,000 / $10,000 | $8,000 / $16,000 | Price & Details | |
| Avera $4500 by Avera Health Plans, Inc. | Both | Silver | $4,500 / $9,000 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual Simplicity Standardized $5,000 by Sanford Health Plan | Both | Silver | $5,000 / $10,000 | $8,000 / $16,000 | Price & Details | |
| Sanford Individual Simplicity $3,500 by Sanford Health Plan | Both | Silver | $3,500 / $7,000 | $9,100 / $18,200 | Price & Details | |
| Avera $4500 by Avera Health Plans, Inc. | Both | Silver | $4,500 / $9,000 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual Simplicity $1,750 by Sanford Health Plan | Both | Gold | $1,750 / $3,500 | $8,900 / $17,800 | Price & Details | |
| Avera $2000 by Avera Health Plans, Inc. | Both | Gold | $2,000 / $4,000 | $8,200 / $16,400 | Price & Details | |
| Sanford Individual Simplicity Standardized $1,500 by Sanford Health Plan | Both | Gold | $1,500 / $3,000 | $7,800 / $15,600 | Price & Details | |
| Avera Standard $1500 by Avera Health Plans, Inc. | Both | Gold | $1,500 / $3,000 | $7,800 / $15,600 | Price & Details | |
| Wellmark Gold Traditional EPO by Wellmark of South Dakota, Inc. | Both | Gold | $1,500 / $3,000 | $7,700 / $15,400 | Price & Details | |
| Avera $1800 by Avera Health Plans, Inc. | Both | Gold | $1,800 / $3,600 | $8,000 / $16,000 | Price & Details | |
| Wellmark Standard Gold EPO by Wellmark of South Dakota, Inc. | Both | Gold | $1,500 / $3,000 | $7,800 / $15,600 | Price & Details | |
| Wellmark Gold Traditional EPO by Wellmark of South Dakota, Inc. | Both | Gold | $1,500 / $3,000 | $7,700 / $15,400 | Price & Details | |
| Avera $2000 by Avera Health Plans, Inc. | Both | Gold | $2,000 / $4,000 | $8,200 / $16,400 | Price & Details | |
| Avera Standard $1500 by Avera Health Plans, Inc. | Both | Gold | $1,500 / $3,000 | $7,800 / $15,600 | Price & Details | |
| Avera $1800 by Avera Health Plans, Inc. | Both | Gold | $1,800 / $3,600 | $8,000 / $16,000 | Price & Details | |
| Sanford Individual TRUE $1,750 by Sanford Health Plan | Both | Gold | $1,750 / $3,500 | $9,000 / $18,000 | Price & Details | |
| Sanford Individual TRUE Standardized $1,500 by Sanford Health Plan | Both | Gold | $1,500 / $3,000 | $7,800 / $15,600 | Price & Details | |
| Avera Direct Standard $1500 by Avera Health Plans, Inc. | Both | Gold | $1,500 / $3,000 | $7,800 / $15,600 | Price & Details | |
| Avera Direct $2000 by Avera Health Plans, Inc. | Both | Gold | $2,000 / $4,000 | $8,200 / $16,400 | Price & Details | |
| Avera Direct MyWeighForward $1800 by Avera Health Plans, Inc. | Both | Gold | $1,800 / $3,600 | $8,000 / $16,000 | Price & Details | |
| Wellmark Standard Gold EPO by Wellmark of South Dakota, Inc. | Both | Gold | $1,500 / $3,000 | $7,800 / $15,600 | Price & Details | |
| Sanford Individual Simplicity $9,200 by Sanford Health Plan | Both | Catastrophic | $9,200 / $18,400 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual TRUE $9,200 by Sanford Health Plan | Both | Catastrophic | $9,200 / $18,400 | $9,200 / $18,400 | Price & Details | |
| Avera $9200 by Avera Health Plans, Inc. | Both | Catastrophic | $9,200 / $18,400 | $9,200 / $18,400 | Price & Details | |
| Avera $9200 by Avera Health Plans, Inc. | Both | Catastrophic | $9,200 / $18,400 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual TRUE $3,500x by Sanford Health Plan | Off | Silver | $3,500 / $7,000 | $9,100 / $18,200 | Price & Details | |
| Sanford Individual Simplicity $4,750x by Sanford Health Plan | Off | Silver | $4,750 / $9,500 | $9,100 / $18,200 | Price & Details | |
| Avera Direct MyWeighForward $4000 by Avera Health Plans, Inc. | Off | Silver | $4,000 / $8,000 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual Simplicity $3,500x by Sanford Health Plan | Off | Silver | $3,500 / $7,000 | $9,100 / $18,200 | Price & Details | |
| Avera Direct $4500 by Avera Health Plans, Inc. | Off | Silver | $4,500 / $9,000 | $9,200 / $18,400 | Price & Details | |
| Avera $4000 by Avera Health Plans, Inc. | Off | Silver | $4,000 / $8,000 | $9,200 / $18,400 | Price & Details | |
| Avera $4000 by Avera Health Plans, Inc. | Off | Silver | $4,000 / $8,000 | $9,200 / $18,400 | Price & Details | |
| Sanford Individual TRUE $4,750x by Sanford Health Plan | Off | Silver | $4,750 / $9,500 | $9,100 / $18,200 | Price & Details | |
| Avera $5200 HSA Eligible HDHP by Avera Health Plans, Inc. | Off | Silver | $5,200 / $10,400 | $5,200 / $10,400 | Price & Details | |
| Avera $5200 HSA Eligible HDHP by Avera Health Plans, Inc. | Off | Silver | $5,200 / $10,400 | $5,200 / $10,400 | Price & Details |
Help with Obamacare & Off-Exchange Plans Sign Up
After using a subsidy tax credit, you may be eligible for Obamacare plans as low as $0.
Licensed insurance agents at our trusted partner help people apply for a subsidy and sign up for Obamacare plans available on healthcare.gov or other State exchange marketplaces.
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Learn More About Obamacare and Off-Exchange Plans in South Dakota
What are Obamacare Health Insurance Plans?
Obamacare health insurance plans are plans which are eligible for reduced costs with a subsidy tax credit. Obamacare plans are only offered through the federal government exchange marketplace healthcare.gov or some States have their own exchange marketplace website. Although plans are only offered through the exchange marketplaces, the federal government allows certified brokers, agents, and web brokers to help you enroll in an Obamacare plan and apply for a subsidy.
What are Off-Exchange Health Insurance Plans?
Off-Exchange health insurance plans are plans which are available outside of the federal government exchange marketplaces. Off-Exchange plans existed before Obamacare. For example, if someone did not have access to a health insurance plan through work, they may have purchased an Off-Exchange plan offered on the Individual Market.
You can enroll in an Off-Exchange plan through a broker, agent, web broker, or by contacting the insurance company directly.
What’s the difference between Obamacare plans and Off-Exchange plans?
The main difference between Obamacare plans and Off-Exchange plans is that only Obamacare plans are eligible for a subsidy tax credit to reduce costs.
Otherwise there are not many other differences between Obamacare plans and Off-Exchange plans. Plan design, coverage, and rates are similar and both sets of plans must adhere to federal government regulations. In fact, there are many plans which are available as both Obamacare plans and as Off-Exchange plans.
Can a plan be both an Obamacare and Off-Exchange plan?
Yes, a plan can be available as both an Obamacare and an Off-Exchange plan.
On the other hand, some plans are only offered as Obamacare plans while other plans are only offered as Off-Exchange plans.
Do plans which are both Obamacare and Off-Exchange plans cost the same price?
Yes, by law a plan which is offered as both an Obamacare plan and an Off-Exchange plan must be sold at the same price. In addition, broker, agents, and web brokers are required to sell plans at the same market price. However, keep in mind that only Obamacare plans are eligible for a subsidy to reduce the monthly premium price.
Who is eligible for Obamacare and Off-Exchange plans?
Technically everyone is eligible for Obamacare plans and Off-Exchange plans. The real question is - who is eligible for a subsidy tax credit? - which can only be used to reduce the costs of Obamacare plans. Note that even if you are not eligible for a subsidy tax credit, you are still allowed to purchase an Obamacare plan at the full price.
What is the Obamacare Subsidy (Tax Credit)?
The Obamacare subsidy is really a tax credit, and it is formally known as the Advanced Premium Tax Credit (APTC). Typically people receive a tax credit at the end of the year when filing taxes, but this tax credit can be received “in advance”, during the year, to reduce the monthly premium costs of an Obamacare health insurance plan.
You must complete an official federal government application to learn your subsidy amount. Everyone’s amount will be different. The calculation for the subsidy amount can be quite complicated. It is based on several different factors, but household income is the main factor. We recommend using our tool to estimate your subsidy amount.
Search Obamacare plans and estimate subsidy amount
Who is eligible to receive an Obamacare Subsidy (Tax Credit)
To be eligible for a subsidy to reduce the monthly premium costs of Obamacare plans, you must meet the following requirements.
- Income requirements based on household size and household income. As examples, earn less than $48,240 for an individual and less than $98,400 for a family of four
- Not eligible for other federal government sponsored insurance, such as Medicare or Medicaid
- Do not have access to a health insurance plan from your employer which meet federal government coverage and affordability requirements
- File taxes or be claimed as a spouse or dependent on taxes. Married couples are required to file taxes jointly.
- Not be incarcerated
- Be legally present in the United States
Why should I consider Off-Exchange plans?
Off-Exchange plans may provide you with additional options compared to available Obamacare plans. If you are not eligible for a subsidy, or only eligible for a small subsidy amount, Off-Exchange plans may still be an affordable option for you.
A second reason for considering Off-Exchange plans is that your favorite doctor may only accept a plan which is available as an Off-Exchange plan. We recommend researching provider networks when considering health insurance plans. We provide links to official provider directories, or doctor lookups, on Health Plan Radar.
In addition, some health insurance companies have been leaving the Obamacare plan market, but they may still offer Off-Exchange plans. Your preferred insurance company may still offer plans on the Off-Exchange market.
How do I choose an Obamacare plan or Off-Exchange plan which is best for me and my family?
There are several health insurance concepts you should understand before choosing a plan that’s best for you, including premium price, out-of-pocket costs, deductibles, and plan metal levels. Visit our choosing a plan FAQ page to learn more.
FAQs - Choosing an Obamacare or Off-Exchange Health Insurance Plan