South Dakota Family Benefits From $0 Monthly Premium

A $0 health insurance premium payment may seem like a white whale, but for Britt Jones it’s real life.

She and her family recently moved to the West River area. Through the process of changing insurance plans they found an individual and family plan through Avera Health Plans and applied for premium tax credits on the Marketplace. The family benefited from tax credits in the past; their last payment in Sioux Falls was $195 a month.

She didn’t expect that her payment would decrease by $195.

“I don’t know that I’ve ever had a $0 premium cost per month,” Jones said. "It’s very exciting because we just purchased a new home and we’ve been thinking of ways to cut costs, and $195 is a lot I can put towards something else in our budget.”

Premium Savings Without Losing Coverage

Other comparable plans in her area would have been $350 a month. Premium tax credits are available to people who enroll in a plan through the Federal Marketplace and meet certain income guidelines. In South Dakota, 95% of Marketplace enrollees save from advance premium tax credits. Enrollees can also apply for cost share reductions, which reduce out-of-pocket costs as long as you use a covered health care service and have a silver plan.

The Joneses chose a Standard 7500 plan, which offers access to local health care providers in their area. Added benefits include coverage of virtual urgent and behavioral health care visits, and fitness center discounts. She was also able to add dental and vision insurance for herself and her husband for the first time in years.

“I definitely want to have insurance, but we don’t have anyone in our family who has regular doctor visits,” she said. “It’s more for if the kids are sick and they need to go to the doctor.”

Changes to Premium Tax Credits in 2026

As the Joneses consider plans for 2026, savings may be more limited. Congress has not extended the enhanced premium tax credits that were introduced during the COVID-19 pandemic. Premium tax credits will still be offered to qualifying health insurance buyers, but the amount of premium assistance will revert to pre-COVID lower levels. This means most enrollees will see increases in premiums.

If you find yourself eligible for less savings as you choose a plan for 2026, Avera Health Plans experts suggest looking at other options.

“If you had a Silver plan and can’t afford the higher premium, you can look into a Bronze plan or a plan with a higher deductible,” said Kate Serenbetz, Individual Product Manager for Avera Health Plans.

Learn more about changes to health insurance open enrollment in 2026.