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South Dakota Health Insurance

Choosing the right South Dakota health insurance plan can be challenging for many consumers. You will likely need to consider a number of SD health insurance plans before you find the right one for you and your family. The best choice as far as health insurance in South Dakota may not be the cheapest one. Instead, you need to weigh out the benefits each plan offers against the cost of coverage.

South Dakota Health Insurance: Indemnity Plans

The SD health insurance plan you choose will either be an indemnity plan, which is also described as a fee-for-service plan, or a managed care plan.

Choosing an indemnity plan will likely mean that you have more choices as far as health insurance providers are concerned. Health care providers include primary care physicians, specialists, and hospitals. To receive benefits under an indemnity plan, you will be required to pay the fee first and seek reimbursement from your insurance company after the fact.

This type of health insurance plan allows enrollees to visit any doctor or hospital they choose. You will likely need to pay an annual deductible before the insurance company will pay any benefits under the plan. After you have paid the deductible, the insurance company will reimburse you for a certain percentage of your health insurance costs.

If your insurance company pays 80% of the claim and you are responsible for the additional 20%, then your portion of the insurance cost is referred to as coinsurance. Your plan may not cover expenses related to preventive care, such as checkups and immunizations. It will cover hospital expenses and doctor visits relating to an injury or illness. Prescriptions and laboratory tests will also be covered under this type of plan.

South Dakota Health Insurance: Managed Care Plans

Under a managed care plan, doctors, hospitals, and other health care professionals enter into an agreement with the insurance company to offer services to subscribers. In return for a large pool of potential patients, the doctors and hospitals agree to provide services at a lower rate than they would normally charge. Each party benefits from this arrangement.

Generally speaking, if you sign up for a managed care plan, you will have less paperwork to deal with. Your out-of-pocket expenses may be lower, as well.

South Dakota Health Insurance: Types Of Managed Care Plans

If you are interested in a managed care plan, you have a choice between an HMO, PPO, or a POS plan.

  1. An HMO (Health Management Organization) plan provides enrollees with a list of doctors and hospitals that have agreed to be part of the plan's network of service providers. You only have health insurance coverage when you consult a doctor or seek treatment at a hospital that is part of your network. Going outside of your network means that you will be solely responsible for the cost of your health care services.

  2. A PPO (Preferred Provider Organization) plan also has a network of health care providers. If you choose to visit a member of your network, you will pay a certain amount toward the cost of your services. Your copayment is calculated based on the reduced rates the insurance company has been able to negotiate with the network members. Going outside the network means that you will need to make a higher copayment as well as pay the difference between the actual cost of the services rendered and what your insurance plan covers.

  3. A POS (Point of Service) plan is offered by some HMOs. It is similar to an indemnity plan. Primary care physicians who are making referrals generally send their patients to other doctors who are part of the POS provider network. If you decide to sign up for a POS, you can decide to see a doctor outside of the network and still receive some benefits under the plan.

South Dakota Individual Health Insurance

Everything else being equal a South Dakota individual health insurance plan will be much cheaper then a South Dakota group health insurance plan. The reason that this is the case is because the underwriting standards are much more strict on the individual side. If you have pre-existing conditions and are unable to get individual health insurance coverage and do not have any time remaining on a South Dakota COBRA health insurance plan then a South Dakota HIPAA health insurance plan may be your best choice for coverage.

South Dakota Children’s Health Insurance

Children in South Dakota who need health insurance coverage have a no cost or low cost option from the State in the South Dakota Children’s Health Insurance Program (CHIP). Ask your SD health insurance broker for more specifics about the plan.

South Dakota Health Insurance Companies

Here is a breakdown of some of the best South Dakota medical insurance companies:



Golden Rule


Wellmark Blue Cross and Blue Shield

If you are unsure about the licensing status of a South Dakota health insurance company or agent then be sure and check them out at the South Dakota Division of Insurance.

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You can discover more valuable information about South Dakota health insurance right now!

The SD health insurance quote tool at the top of this page will help you find the facts you need to choose a plan that is right for you.

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