Find 2020 Medicare Plans in South Dakota - SD Medicare Insurance Overview

Medicare Insurance in South Dakota

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South Dakota Medicare Insurance

South Dakota Medical Insurance Stats

Medicare in South Dakota

Medicare offers healthcare coverage to South Dakota residents age 65 or older, or to those South Dakota residents that suffer from certain medical disabilities. In 2016, 147,000 people are enrolled in Medicare in South Dakota, accounting for 17.3% of the population in South Dakota. In 2009 an average of approximately $8,148 was spent per Medicare enrollee in South Dakota, about 21.39% lower than the national average of $10,365. Between 2015 to 2030 the senior population in South Dakota is expected to increase by an estimated 44.61% according to calculations based off of the 2000 Census. Therefore the number of individuals enrolled in Medicare in the state is also projected to grow.

Local Medicare Resources

Medicare beneficiaries, their families, and their caregivers that reside in South Dakota can receive free, one-on-one, and unbiased counseling from a program called Senior Health Information and Insurance Education (SHINE). Another program called the South Dakota Senior Medicare Patrol (SMP) aims to educate and empower individuals to recognize, prevent, and report instances of possible healthcare billing errors, abuse, fraud, and/or waste.

Types of Medicare Coverage

When you are eligible for Medicare you may sign up for Original Medicare (Part A & Part B), which cover hospital services and medical services, respectively, or you may enroll in a Medicare Advantage Plan (Medicare Part C). If you sign up for Original Medicare you also have the option to purchase a separate or stand alone prescription drug plan (Part D). Medicare Advantage and Medicare Part D insurance plans are sold by private insurance companies that have a contract with Medicare. Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. For most Medicare beneficiaries, Part A is already paid through paycheck deductions during their working years (or their spouse's) but most Medicare beneficiaries pay premiums for Part B unless they qualify for financial assistance. Many Medicare beneficiaries will elect to enroll in a Medicare Advantage plan that includes prescription drug coverage (MAPD) or purchase a stand alone prescription drug plan to go with their Original Medicare coverage. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Most Medicare Advantage plans also include additional health benefits such as vision, dental, or hearing coverage and you have the option to purchase a Medicare Advantage plan with prescription drug coverage (MAPD) in almost all states.

South Dakota 2017 Medicare Advantage Plans at a glance

Using CMS data HealthPocket found that:

  • The average total monthly premium for a 2017 Medicare Advantage plan in South Dakota is $111.68, 78.75% greater than the national average of $62.48. 8.78% of 2017 Medicare Part C insurance plans in South Dakota have a $0 monthly premium.
  • The maximum possible annual drug deductible in any 2017 Medicare Advantage plan with a drug component is $399, but in South Dakota the average annual drug deductible for Medicare Part C insurance plans with drug components is $157.43. 40.58% of 2017 Medicare Part C insurance plans with a drug component in South Dakota have a $0 annual drug deductible.
  • All 2017 Medicare Part C insurance plans without a drug component in South Dakota have a $0 monthly premium.
  • The average medical out-of-pocket limit for 2017 Medicare Part C insurance plans in South Dakota is $4247.86. 48.08% of 2017 Medicare Advantage plans in South Dakota had a medical out-of-pocket limit of $3,400 or less.

To assist seniors in choosing Medicare plans, CMS assigns star ratings to Medicare Part C and Part D plans each year based on preventive care, chronic condition management, customer service, member satisfaction, and drug pricing. Ratings range from 1 star (a poor plan) to 5 stars (an excellent plan).

  • The average overall CMS star rating assigned to Medicare Part C insurance plans in South Dakota was 4.4 stars in 2017.
  • Among South Dakota's 2017 Medicare Advantage plans with CMS star ratings:
    • 85.74% earned a score of 4 or 4.5 stars
    • 14.26% earned a score of 3 or 3.5 stars

Sources:

Data on Medicare eligibility, enrollment, and spending by state from Kaiser Family Foundation

There are 16 Medicare insurance providers that offer affordable and comprehensive Medicare insurance in South Dakota. Of these, the companies that offer the largest variety of plans to choose from are Humana, Universal American, and Anthem BCBS. In South Dakota,Medica has the largest selection of Medicare Advantage plans while Humana offers the most Medicare Part D plans. The following are all medicare insurance providers in South Dakota:

Humana

11 Plans

Medical Associates Health Plan, Inc.

3 Plans

Aetna

3 Plans

Mutual of Omaha Rx

2 Plans

MII Life Insurance, Incorporated

2 Plans

Clear Spring Health

2 Plans

Lasso Healthcare

1 Plans

EnvisionInsurance

1 Plans

Lasso Healthcare (MSA)
TYPE:MSACOST:from $0CMS Rating:Not Rated
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Humana Gold Choice H8145-155 (PFFS)
TYPE:PFFSCOST:from $0CMS Rating:Not Rated
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HumanaChoice H5216-086 (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
Aetna Medicare Premier Advantra (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
Humana Gold Plus H0028-011 (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
AARP Medicare Advantage Choice (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
Aetna Medicare Elite Advantra (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
Aetna Medicare Prime (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
Humana Walmart Value Rx Plan (PDP)
TYPE:PDPCOST:from $13CMS Rating:Not Rated
Select
WellCare Wellness Rx (PDP)
TYPE:PDPCOST:from $13CMS Rating:Not Rated
Select
Medica Prime Solution Premier w/Rx (Cost)
TYPE:CostCOST:from $239CMS Rating:Not Rated
Select
HealthPartners Sanford Ultimate (Cost)
TYPE:CostCOST:from $159CMS Rating:Not Rated
Select
Kearney Community Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Omaha Community Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Central Iowa Health Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Medica Prime Solution Premier w/Rx (Cost)
TYPE:CostCOST:from $239CMS Rating:Not Rated
Select
HealthPartners Sanford Ultimate (Cost)
TYPE:CostCOST:from $159CMS Rating:Not Rated
Select
Kearney Community Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Omaha Community Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Central Iowa Health Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Medica Prime Solution Premier w/Rx (Cost)
TYPE:CostCOST:from $239CMS Rating:Not Rated
Select
HealthPartners Sanford Ultimate (Cost)
TYPE:CostCOST:from $159CMS Rating:Not Rated
Select
Kearney Community Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Omaha Community Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Central Iowa Health Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Medica Prime Solution Premier w/Rx (Cost)
TYPE:CostCOST:from $239CMS Rating:Not Rated
Select
HealthPartners Sanford Ultimate (Cost)
TYPE:CostCOST:from $159CMS Rating:Not Rated
Select
Kearney Community Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Omaha Community Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select
Central Iowa Health Senior Plan (Cost)
TYPE:CostCOST:from $145CMS Rating:Not Rated
Select

The following are the most popular medicare doctors in South Dakota based on the provider utilization and payment data published by the U.S. Department of Health & Human Services.

NameSpecialtyLocation
OphthalmologyRAPID CITY, SD
DermatologyRAPID CITY, SD
OphthalmologySIOUX FALLS, SD
OphthalmologySIOUX FALLS, SD
OphthalmologyDAKOTA DUNES, SD
OphthalmologySIOUX FALLS, SD
OphthalmologyYANKTON, SD
DermatologyRAPID CITY, SD
OphthalmologyABERDEEN, SD
Internal MedicineSIOUX FALLS, SD

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