Many South Dakota residents replace their Original Medicare plan with a private Medicare Advantage (Part C) plan for better coverage and benefits. South Dakota has 37,763 Medicare Advantage (MA) beneficiaries and a 23.95% participation rate.

Keep reading for important information regarding Medicare Advantage plans, including coverage, plan options, and costs.

How Medicare Advantage Plans Work in South Dakota

What is a Medicare Advantage plan? Instead of using Original Medicare from the federal government, you can replace it with a Medicare Advantage plan from a private carrier. Each carrier has different benefits, so it’s important to explore each plan’s benefits, services, and coverage before enrolling.

Many MA plans provide additional benefits that Original Medicare doesn’t cover. South Dakota offers up to 50 MA plans, though the exact number available to you depends on your zip code.

Medicare Advantage Plans Offers in South Dakota

Unlike Medigap plans, the government doesn’t standardize MA plans. The table below lists various MA plan options based on one zip code in South Dakota. Your exact rates may vary slightly based on your actual zip code.

Next, we’ll explain various South Dakota Medicare Advantage plans. We’ll discuss zero-dollar premium plans, zero-dollar drug deductibles, 5-star plans, and Part B Reduction plans.

Medicare Advantage Plans with a Zero-Dollar Premium in South Dakota

Many South Dakota residents enroll in zero-dollar premium MA plans. No monthly premium may sound great, but there’s a catch: higher deductibles and out-of-pocket costs.

Humana offers a zero-dollar premium MA plan for South Dakota residents. The plan is a Health Maintenance Organization (HMO), so your healthcare will come primarily from in-network providers. Humana’s HMO MA plan has a Maximum Out-of-Pocket (MOOP) cost of $3,850.

Another zero-dollar premium MA plan is from Aetna. As a Local Preferred Provider Organization (PPO) plan, it offers the flexibility of choosing in-network or out-of-network providers. This plan gets a 4-star rating and has a MOOP cost of $6,700.

In addition to its HMO MA plan, Humana offers a Local PPO plan for South Dakota beneficiaries. The plan earned a 4-star rating, has no monthly premium, and features a MOOP cost of $4,400.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Humana $0 $3,850 HMO 4
Aetna $0 $6,700 LOCAL PPO 4
Medica $0 $4,500 1876 COST 4
Sanford Health $0 $5,000 LOCAL PPO N/A
Humana $0 $4,400 LOCAL PPO 4

Medicare Advantage Plans with a Zero-Dollar Drug Deductible in South Dakota

Aetna offers a popular South Dakota MA plan with a zero-dollar drug deductible. The Local PPO plan has a 4-star rating and zero-dollar premium, although its MOOP cost is $4,400.

Another zero-dollar drug deductible MA plan comes from UnitedHealthcare. There’s no monthly premium for this Local PPO plan, and you can choose your own providers. However, it has a MOOP cost of $3,900.

Wellmark offers two zero-dollar drug deductible MA plans for South Dakota residents. One has a $19 premium and a MOOP cost of $4,200, and the second has a $69 monthly premium with a MOOP cost of $3,900.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
UnitedHealthcare $0 $3,900 LOCAL PPO 4
Aetna $0 $4,400 LOCAL PPO 4
Aetna $0 $5,400 LOCAL PPO 4
Wellmark $19 $4,200 LOCAL PPO N/A
Wellmark $69 $3,900 LOCAL PPO N/A

Medicare Advantage Plans with a 5-Star Rating in South Dakota

Certain regions of South Dakota have 5-star plans available for enrollment. If you’re in one of those areas, you may be eligible for a Special Enrollment Period (SEP). The SEP allows you to change your policy or apply for Medicare outside the standard enrollment period.

One of the best 5-star MA plans in South Dakota is from HealthPartners. The monthly premium for this 5-star plan is $39.70, with a MOOP cost of $3,400.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
HealthPartners $39.70 $3,400 1876 COST 5

Medicare Advantage Plans with a Part B Reduction in South Dakota

Residents of specific South Dakota zip codes can enroll in a MA plan with a Part B reduction. In a Part B Reduction plan, your carrier pays some or all of your Part B premium, from 10 cents to full coverage. Unfortunately, Part B give-back plans aren’t available in every zip code.

Humana offers a zero-dollar premium MA Part B Reduction plan for eligible South Dakota residents. It has a $55 reduction benefit and a MOOP cost of $4,900.

Aetna is another carrier for MA Part B Reduction plans in South Dakota. You won’t pay a monthly premium, but the MOOP cost is $6,700. The program provides a $25 Part B reduction benefit.

UnitedHealthcare also has a South Dakota MA Part B Reduction plan. The zero-dollar premium plan offers a $30 reduction benefit and a MOOP cost of $6,700.

PLAN PREMIUM MOOP PART B REDUCTION STAR RATINGS
Aetna $0 $6,700 $25 4
Humana $0 $4,900 $55 4
UnitedHealthcare $0 $6,700 $30 4

Ancillary/DVH

Medicare Advantage plans differ from Supplemental plans like Medigap. Both Medigap and Medicare Advantage plans provide additional benefits. However, MA plans usually have ancillary insurance coverage with services that Original Medicare doesn’t cover.

The most common services include dental, vision, hearing, and prescription drug coverage.

FAQs

Does South Dakota have Medicare Advantage plans?

Yes. South Dakota has many private carriers offering up to 50 MA plans for eligible beneficiaries. Your zip code will determine your enrollment options.

What are the four types of Medicare Advantage plans in South Dakota?

The four types of South Dakota MA plans include:

What is the difference between Original Medicare and Medicare Advantage in South Dakota?

The federal government issues Original Medicare, which includes Part A and Part B coverage. South Dakota Medicare Advantage plans are from private carriers and combine Part A, Part B, and additional coverage benefits in one plan.

Can I switch from the Medicare Advantage plan back to Original Medicare in South Dakota?

Yes. South Dakota residents may switch from a Medicare Advantage plan to Original Medicare during the Annual Enrollment Period (October 15 to December 7) or MA Open Enrollment Period (January 1 to March 31).

Can I simultaneously have a Medicare Advantage and a Medicare Supplement in South Dakota?

No. Medicare Advantage plans and Medicare Supplement plans are different, and South Dakota residents may not enroll in both simultaneously.

How to Get Help Enrolling in a South Dakota Medicare Advantage Plan

If you’re unsure which Medicare Advantage plan suits your needs best, we can help. We work with an extensive carrier network at Medigap, and our services are always free.

It’s our job to find you the right MA plan with the benefits and coverage you need. Better yet, our services are completely free to you.

Call us today or fill out our online rate form to receive the best rates now regarding Medicare Advantage plans in South Dakota.

Written By:
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Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
Reviewed By:
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Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.