Health insurance

Best Ways To Get Affordable Health Insurance in South Dakota

There are 855,400 Total South Dakota Residents, 8% of which are Uninsured South Dakota Residents. In South Dakota, the average premium for 2022 health plans is $671 per month, representing a 24% increase over the past year.

However, costs will be different among the wide selection of health plans. Understanding the relationship between health coverage and cost can help you choose the right health insurance for you. 

Residents of South Dakota are required to have health insurance under the Affordable Care Act (also known as Obamacare).

By Law, Employers are not required to provide health plans to their employees in South Dakota. Nonetheless, most employees do receive this benefit from their companies.

If you’re looking for individual or family health insurance in South Dakota – you might be seeking Affordable Care Act insurance, what’s often called Obamacare.

What Is The A.C.A

The Affordable Care Act (ACA) is a 2010 federal law. This health reform made profound changes to health insurance. It is often called “Obamacare” since it was enacted during the administration of former President Barack Obama.

Residents can purchase cheap health insurance in South Dakota on the federally run state insurance exchange. South Dakota at the moment has two insurers that provide coverage for the state: Avera Health Plans Inc. and Sanford.

ACA is intended to lower health insurance costs. It starts from the premise that the cost of insurance should be shared between the government, employers and individuals. It also seeks to prevent restrictive practices in the health industry.

How Does The ACA (Affordable Care Act) Work?

The main objective of Obamacare is to reduce medical costs in the US To this end, it included the obligation to purchase health insurance, subsidies for health insurance premiums, and new regulations for the health insurance industry.

Who Benefits From Obamacare Subsidies?

Obamacare subsidizes premium costs to help lower-income people pay for their insurance. It also makes payments to health providers to keep deductibles relatively low.

Insurance Regulations

The ACA added a significant number of requirements for health insurance. Prohibits insurance companies from:

  • cancel policies when the holder becomes ill;
  • deny coverage to individuals with pre-existing conditions;
  • offer different premiums to people of the same age and geographic group.

Individual mandate

Initially, the ACA contemplated a fine for those who did not buy an individual health insurance plan, which was known as the “individual mandate”. The reason for forcing everyone to buy a health plan was to make the premiums of young and healthy people help cover the health costs of older and poorer people. In 2017 the fine was eliminated.

Rights granted by the ACA

Obamacare has made changes to the United States health system, and grants the following rights:

Allow children to be covered by their parent’s health plan until they turn 26.

Allow people to compare plans and sign up for coverage through state health insurance centres. This is known as the “health insurance marketplace.” It is facilitated by the federal government. The enrollment period to buy health insurance is from November 1 to December 15 of each year.

Make those earning up to 133% of the federal poverty level eligible for Medicaid. This is known as the expansion of Medicaid. Not available in Alabama, North Carolina, South Carolina, Florida, Georgia, Kansas, Mississippi, Tennessee, or Texas.

Make subsidies to purchase health insurance available to those with incomes up to four times the federal poverty level. These subsidies are delivered through tax credits.

Minimum standards for health insurance policies. All insurance plans must cover certain essential benefits and include health coverage for pregnancy, mental health and preventive care.

Rights for those with health insurance

If you already have insurance, Obamacare protects you in the following ways:

Insurers must give you a  summary of the benefits.

Insurers cannot cancel a plan in response to illness.

Certain preventive health services must be covered at no cost. 

You can choose any doctor within the plan’s network and you can use any emergency services outside of your plan’s network. Before requesting medical attention, it is important to verify that the professional of your choice is within the insurance network. 

How To Choose The Right Health Plan For My Needs?

Obamacare is intended to make health care more affordable for everyone. Visit the  Health Insurance Marketplace to see if you qualify for free or low-cost coverage.

There are at the moment four different tiers available to purchase in South Dakota: Catastrophic, Expanded Bronze, Silver and Gold. These plans differ in the affordability and benefits that they each provide. In general, the higher the metal tier, the higher the monthly premium. Contrastingly, those who are young and healthy or don’t expect to have many medical costs may wish to choose a plan in a lower tier, such as Expanded Bronze and Catastrophic, to save money. 

Age is also another important factor that will affect your monthly premium: As you grow older, your monthly health insurance costs will increase regardless of the metal tier. 

Bronze plans typically charge the lowest premiums but pay less money when you get health services. Platinum plans, on the other hand, charge higher premiums but will pay more money when you receive a health service.

For example, you may have to pay $600 per month for a platinum plan and $200 for a bronze plan. Although the platinum plan is more expensive, you will most likely have to pay less money each time you use a health service. So if you have appendicitis and you get a $30,000 hospital bill, the platinum plan will likely cover a larger portion of that bill.

Cheapest Health Insurance By Metal Tier

We researched all of the policies available in the state and identified the lowest-cost health insurance options by metal tier to help you compare the different costs and benefits among the levels. For example, the Sanford TRUE $4,750 is the cheapest Silver plan, which has a monthly premium of $460 and a deductible of $4,750. However, the cheapest Gold plan, the Sanford TRUE $1,750, costs $10 more per month but has a much lower deductible of $1,750.

In the table below, we list the cheapest health insurance plans by metal tier for South Dakota, along with the deductible, out-of-pocket maximum and monthly cost for a 40-year-old.

Metal tierCheapest PlanMonthly CostDeductibleMaximum out of pocket
CatastrophicSanford TRUE $8700$224$8700$8700
Expanded bronzeSanford TRUE $7000$330$7000$8700
SilverSanford TRUE $4750$460$4750$8700
GoldSanford TRUE $1750$470$1750$6750

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