Medicare Advantage in South Dakota

Looking for South Dakota Medicare Advantage Plans? Enter your ZIP below to compare affordable or $0 premium plans in your area.

South Dakota state

Information about Medicare Advantage Plans in South Dakota

Quick links:

20 percent of Medicare beneficiaries in South Dakota were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.1

There are 2 different South Dakota Medicare Advantage plans in 2019.1 Not every plan is available in each county, so it's important to find out which ones are offered where you live.

A licensed insurance agent can help you compare the availability, benefits and costs of Medicare Advantage plans in your area of South Dakota. Read below to learn more about Medicare in your state.

You can also learn more about other types of Medicare plans:

Average costs of Medicare Advantage in South Dakota

The average Medicare Advantage plan premium in South Dakota in 2019 was $99 per month.

In 2019, there were 2 available plans that feature $0 monthly premiums.

  • Average monthly premium cost in 2019 (weighted): $99
  • Average in-network out-of-pocket spending limit: $3,898
  • Average deductible in 2019 (weighted): $36.181

Individual plan premiums, deductibles and out-of-pocket costs may vary greatly depending on where you live and the plan you have.

You can view the 2019 average South Dakota Medicare Advantage plan monthly premiums by county listed below in this guide.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Compare South Dakota Medicare Advantage plan costs

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

If you want to enroll in Medicare Advantage in South Dakota, you must first be enrolled in Medicare Part A and Part B, often referred to as Original Medicare.

To be eligible for Original Medicare at age 65, you must meet the following requirements:

  • You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.

  • You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.

  • You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

You may also be eligible for Medicare benefits under 65 if:

  • You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.

  • You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).

  • You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

It’s important to note that if you have ESRD, you may not qualify for most Medicare Advantage plans. If you have ESRD, you may be able to enroll in a South Dakota Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in South Dakota

The first time you may be able to enroll in a South Dakota Medicare Part C plan is during your Medicare Initial Enrollment Period (IEP).

Medicare Initial Enrollment Period graphic

Your Medicare IEP starts three months before your 65th birthday. It includes the month of your 65th birthday and then continues for another three months after your birthday.

Additional times at which you may sign up for a Medicare Advantage plan include:

Medicare Advantage Open Enrollment Period graphic

Medicare Advantage Open Enrollment Period: January 1 – March 31

If you're already enrolled in a Part C plan, from January 1 to March 31 every year, you may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare.

If you return to Original Medicare during this period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare AEP graphic

Medicare Annual Enrollment Period (AEP): October 15 – December 7

From October 15 to December 7 every year, you may enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another.

You may also drop your existing Medicare Advantage plan and return to Original Medicare.

During AEP, you may also join, switch or drop a Medicare Part D plan. 

Medicare Special Enrollment Periods (SEP)

You may potentially be granted a Medicare Special Enrollment Period (SEP) at any time throughout the year for qualifying circumstances.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Find a South Dakota Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in South Dakota 2019

Each year, the Centers for Medicare & Medicaid Services (CMS) issues Star Ratings for all Medicare Advantage plans using a system of one to five stars.2

In order for a Medicare Advantage plan to be considered a top-rated plan, it must have four or more stars out of five stars.

There weren't any top-rated 2019 Medicare Advantage plans in South Dakota that are rated four stars or higher.

Medicare Star Ratings
Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

Medicare Advantage plans are rated in the following five categories:

  • Preventive care and health maintenance (screenings, tests, vaccines, etc.)
  • Management of chronic conditions
  • Member experiences and ratings of the plan
  • Member complaints, problems receiving services and member retention
  • Customer service

The information for the star ratings is gathered from information that is submitted to Medicare, Medicare’s regular monitoring activities and member surveys.

List of Medicare Advantage Plans Available in South Dakota in 2019

To view a list of plans offered in your area within South Dakota, use our plan comparison tool.

Find a South Dakota Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in South Dakota

Multiple insurance carriers may offer Medicare Advantage plans in South Dakota, depending on where you live.

Private insurance companies offer Medicare Advantage plans that may be unique to the plan area they serve.

Call to speak with a licensed insurance agent who can help you compare the Medicare Advantage plans that are sold by insurance companies in your area.

When you’re shopping for Medicare Advantage plans in South Dakota, you can compare plans from several different carriers by using some of the following information:

  • The Medicare Star Ratings can give you an idea of a plan’s overall quality.

  • Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.

  • Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.

  • You can read through Medicare Advantage plan reviews and testimonials from customers.

South Dakota Medicare Advantage plans by county

The chart below provides some more information about 2019 South Dakota Medicare Advantage plans by county.1

2019 SD Medicare Advantage by County
County Total of County MA Enrollees % of Medicare Beneficiaries Enrolled in MA Average Monthly Premium Number of Plans Available Number of $0 Premium Plans Available % Enrolled in a $0 Premium Plan
Aurora 124 19% $111 1 1 3%
Beadle 846 22% $119 0 0 0%
Bennett 20 4% $90 0 0 6%
Bon Homme 316 19% $81 0 0 24%
Brookings 952 19% $101 0 0 9%
Brown 903 12% $117 0 0 0%
Brule 202 19% $116 0 0 1%
Buffalo Data not available 0% $106 0 0 14%
Butte 650 26% $101 0 0 1%
Campbell 77 19% $110 0 0 1%
Charles Mix 178 9% $124 0 0 1%
Clark 295 33% $117 0 0 1%
Clay 357 16% $81 0 0 29%
Codington 2247 38% $111 0 0 0%
Corson 35 6% $86 0 0 4%
Custer 513 17% $103 0 0 1%
Davison 845 19% $106 0 0 0%
Day 413 26% $130 0 0 1%
Deuel 358 31% $126 0 0 1%
Dewey 21 3% $106 0 0 14%
Douglas 151 19% $119 0 0 1%
Edmunds 83 9% $117 0 0 1%
Fall River 348 13% $105 0 0 2%
Faulk 71 12% $113 0 0 2%
Grant 802 42% $116 0 0 0%
Gregory 177 15% $145 0 0 1%
Haakon 43 9% $85 0 0 3%
Hamlin 364 30% $114 0 0 1%
Hand 78 9% $116 0 0 2%
Hanson 210 13% $113 0 0 2%
Harding 30 12% $89 0 0 5%
Hughes 299 8% $108 0 0 0%
Hutchinson 486 24% $107 0 0 8%
Hyde 18 5% $106 0 0 14%
Jackson 52 10% $83 0 0 2%
Jerauld 80 12% $116 0 0 1%
Jones 27 11% $90 0 0 6%
Kingsbury 235 16% $112 0 0 1%
Lake 498 11% $90 0 0 16%
Lawrence 1586 24% $111 0 0 0%
Lincoln 2162 25% $86 0 0 21%
Lyman 79 11% $124 0 0 1%
Marshall 156 14% $132 0 0 1%
McCook 275 21% $91 0 0 10%
McPherson 65 8% $130 0 0 2%
Meade 1192 20% $109 0 0 0%
Mellette 13 3% $106 0 0 14%
Miner 67 11% $113 0 0 5%
Minnehaha 8704 23% $78 1 1 27%
Moody 280 20% $99 0 0 17%
Pennington 5189 19% $108 0 0 0%
Perkins 105 13% $121 0 0 1%
Potter 63 9% $111 0 0 2%
Roberts 503 22% $127 0 0 1%
Sanborn 79 15% $77 0 0 8%
Spink 218 13% $116 0 0 1%
Stanley 68 9% $83 0 0 2%
Sully 25 7% $89 0 0 5%
Todd 14 1% $106 0 0 14%
Tripp 132 9% $127 0 0 1%
Turner 533 27% $102 0 0 8%
Union 708 20% $44 0 0 57%
Walworth 131 8% $114 0 0 1%
Yankton 1080 21% $85 0 0 18%
Ziebach Data not available 0% $106 0 0 14%

SD Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 South Dakota Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.1

Plan type Percentage of South Dakota enrollees (2019)
Medicare Cost Plan 88.2%
Local PPO 9%
HMO 2.4%
PFFS <1%
Other Plans <1%

The major types of Medicare Advantage plans include:

  • HMO
    Health Maintenance Organization (HMO) usually requires patients to use health care providers and pharmacies that are part of the plan’s network (except in the case of emergencies) while also typically requiring a referral from a primary care doctor in order to see a specialist.

  • PPO
    Medicare Advantage beneficiaries in a Preferred Provider Organization (PPO) are able to see providers outside of their plan’s network, often at a higher cost.

    Beneficiaries in this type of plan typically pay less out of pocket if they choose to receive medical services from providers within their plan’s network.

    PPO plans typically do not require patients to acquire a referral before visiting with a specialist.

  • PFFS
    A Private Fee-For-Service (PFFS) plan determines how much it will pay to health care providers and how much the patient will pay when care is received.

    With a PFFS plan, you can typically receive care from any doctor, hospital or health care provider that accepts your plan’s terms. Not all providers will accept these terms, however.

  • SNP
    A Special Needs Plan (SNP) is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics.

    Typically, you must receive care from health care providers and hospitals within your SNP network, except for in cases when you need emergency or urgent care and when someone who has End-Stage Renal Disease (ESRD) needs out-of-area kidney dialysis.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 South Dakota Medicare Advantage plans that are available where you live.

Local health insurance resources in South Dakota

  • The Senior Health Information & Insurance Education program helps South Dakota’s seniors better understand their Medicare benefits.

    The free counseling is provided by a team of trained volunteers with the mission of helping people make better use of their insurance.

    The program may be contacted at 800-536-8197 or 605-333-3314 (Eastern South Dakota); 877-331-4834 or 605-224-3212 (Central South Dakota); 877-286-9072 or 605-342-8635 (Western South Dakota).     

  • You can also explore more information about the insurance industry in South Dakota by visiting the state’s Division of Insurance website.

  • South Dakota Prescription Drug Assistance Programs
    The state of South Dakota has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 MedicareAdvantage.com's internal analysis of CMS Medicare Advantage landscape source files, accessed May 2019. Data retrieved from www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.

Includes 2019 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown.

2 Every year, Medicare evaluates plans based on a 5-star rating system.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC is a licensed and certified representative of A Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any plan depends on contract renewal.

TZ Insurance Solutions LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult www.medicare.gov.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year.

Medicare has neither reviewed nor endorsed this information.

Last Updated: 7/1/2019