Health Plans

If you live in South Dakota and don’t have health insurance through an employer, you can still have coverage with an individual or family plan.

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The Affordable Care Act (ACA)-regulated plans are available through private insurance companies like Avera Health Plans or on the Federal Marketplace (Healthcare.gov).

Cost Considerations

  • You won’t be fined if you don’t have health insurance, but it’s an important investment.
  • Health care without health insurance could cripple your finances.
  • ACA-regulated plans offer key benefits and savings potential according to your yearly income.

2022 Plan Options

You have various plan options to fit your coverage needs and budget. For individual and family health coverage effective Jan. 1, 2022 and after, select the plan documents below to read the Summary of Benefits and Coverage. This will help you identify what works best with your budget. You can also view summaries of:

Gold Plans

Gold Plans

Gold plans have the best coverage. They feature lower deductibles and lower out-of-pocket expenses when you go to the doctor. The richer coverage offered by Gold plans results in higher monthly premiums.

On-Exchange Plans

These plans are sold on Healthcare.gov – and you may qualify for financial assistance through tax credits (discounted monthly premiums.)

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Silver Plans

Silver Plans

On-Exchange Plans

Silver plans sold on Healthcare.gov offer the most opportunity to save through cost share reductions. You may qualify for cost share reductions (discounted co-pays, coinsurance and deductibles), offered only on Silver plans, and tax credits (discounted monthly premiums), which are applicable to all ACA plans.

Off-Exchange Plans

These plans are not sold on Healthcare.gov, meaning they do not qualify for extra savings. They are only available for direct purchase through Avera Health Plans.

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Bronze Plans

Bronze Plans

Bronze plans feature higher deductibles, which will result in more out-of-pocket costs for you when you go the doctor, however these plans have lower monthly premiums.

On-Exchange Plans

These plans are sold on Healthcare.gov – and you may qualify for financial assistance including tax credits that discount your monthly premium.

Off-Exchange Plans

These plans are not sold on Healthcare.gov, meaning they do not qualify for extra savings. They are only available for direct purchase through Avera Health Plans.

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Catastrophic Plans

Catastrophic Plans

To qualify for these plans, you must be under the age of 30 before Jan. 1, 2022 or qualify for a federal hardship exemption.

On-Exchange Plans

These plans are sold on Healthcare.gov – and you may qualify for financial assistance through tax credits that lower your monthly premium.

Off-Exchange Plans

No Catastrophic plans are available for direct purchase through Avera Health Plans.

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Search for a Provider, Hospital or Clinic

See if your health care providers or locations are included in our wide Midwest network.

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Dental & Vision Plans

  • Our plans include pediatric dental and vision coverage.
  • For adult vision, you’ll want to research other providers.
  • For adult dental, we’ve partnered with two coverage providers to give you choice in oral care needs.

Dental Plans

Pharmacy Coverage

  • Prescriptions are covered in your individual or family plan.
  • Coverage varies by prescription and plan.
  • Check out our prescription coverage options for your specific medications.

Learn More

How to Choose and Sign Up

Costs, discounts, coverage, visits, prescriptions, providers and more – there are many factors to consider.

CHOOSING A PLAN

How to Enroll

Get Started

Get a Quote

Still have questions? Our local team is happy to help make sure you have the right plan for your health care needs and budget.

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You can also call our sales team toll-free at 855-692-8372.

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