South Dakota is nicknamed as the Mount Rushmore State, Coyote State and the Sunshine State. This state is filled with fertile prairies, rolling hills, craggy mountains, and has some of the most beautiful national parks, and scenic drives. The state ranks 17th in terms of area and is the fifth least densely populated pf the 50 states. The state is right in the middle of the pack as far as health is concerned and so the residents as well as the government of this state need to do more to improve upon it. Among the several measures, availing the right health insurance plan is also a vital step to improve the state’s health ranking. To provide its residents with the right platform to purchase health insurance, South Dakota Health Insurance Exchange operates through a federally-run health insurance exchange, known as the Health Insurance Marketplace and the residents enroll through HealthCare.gov. South Dakota residents also access information about all the available health insurance plans through the Exchange. Open enrollment for the 2020 health plan has ended and only residents with the qualifying events can still enroll or make changes in their 2020 coverage. In South Dakota’s exchange enrollment grew in each year from 2014 to 2018 and in the year 2018 the state witnesses the highest enrollment but for the first time in 2019, the enrollment dropped, as only 29,069 people signed up for private plans through the state’s exchange. However, enrollment increased again for 2020 coverage, as 29,330 people enrolled during the open enrollment period.
Highlights & Updates of South Dakota Health Insurance
- South Dakota exchange operates through federally run exchange so applicants enroll through HealthCare.gov.
- Open enrollment for health plans effective from January 2020 health plans has ended and now only residents with qualifying events can enroll or make changes to their coverage.
- The open enrollment period, for health plans effective in 2021, will start from November 1, 2020.
- In South Dakota short-term health plans are available for initial plan terms of only six months and it can’t be renewed.
- Almost 29,330 people enrolled during the open enrollment period for the 2020 coverage.
- With mostly Republican lawmakers, state mostly opposed to the ACA.
Individuals and Family Health Insurance Plans in South Dakota
Individuals residing in South Dakota are not only responsible for their health but also of their family and to ensure the well-being of themselves and their families, they need to have proper health insurance plan that cover them for their every healthcare need and also financially protect them. So all the individuals residing in South Dakota who are self-employed, unemployed, or a student and do not receive health benefit package from their employer or don’t qualify for a government plan should enroll in the individual and family health insurance plan available in the state. Each and every individual and family plan available in the state differs in terms of cost and benefits, therefore residents are advised to carefully shop for the right health plan taking the help and assistance or expert, who will guide them choose plan that perfectly cater to their healthcare needs. Some of the individual and family plans available in the state include:
PPO Plans – PPO or Preferred Provider Organization are the most flexible type of health insurance plan that allow individuals the flexibility to choose healthcare provider of their choice. However, if they choose an in-service provider they will save on their insurance costs. In the PPO plans individuals do not need to obtain a referral to visit a specialist and they also do not require to see a in-network healthcare provider to use their plan benefits. Members of the PPO plans probably have to pay an annual deductible to pay before their insurance carrier starts covering their medical bills. Insured also have a co-payment of around $10 to $30 for certain medical services or they need to cover a certain percentage of the total costs of their medical bills.
HMO Plans – HMO or Health Maintenance Organization plans offer extensive range of healthcare services through a network of healthcare providers who agree to render medical services to members at a pre-negotiated price. With HMO plans insured are likely to receive quite a broader range of preventive healthcare services than they would receive through any other plan. Members of the HMO plan are provided a list of medical service providers that accept their insurance and they are allowed to visit in-network service providers. If the members visit outside-the-network healthcare provider then they will be responsible for the 100% of their health care costs. Members will require a referral from their primary care provider before visiting a specialist.
Point of Service – POS or Point of Service plan come with the combine qualities of HMO and PPO plans and the benefits usually depend on whether the member receive medical care in or out of the insurance company’s network of providers. Members of POS plan are also required to select a primary care physician just like a HMO plan who will manage their health and will also provide referral for visiting a specialist. In this plan too, members can receive health care from non-network providers but with a higher out-of-pocket costs just like a PPO plan. Members of the POS plan are also responsible to pay coinsurance, co-payments and an annual deductible. This plan is ideal for individuals who prefer to coordinate their healthcare through a primary care physician and if their preferred doctor is included in the in-network providers.
HDHP with HSA – Individuals eligible for the High Deductible Health Plan have the option to enroll in a Health Savings Account, in which they can save fund to pay for covered medical, dental, and vision expenses with pre-tax dollars. South Dakota residents using the amount saved in the account can pay for qualified medical expenses as well as save for retirement on a tax-deferred basis. High-deductible HSA-compatible health insurance plan usually has a lower premium compared to a plan with a lower deductible and the money saved in this account accrue interest or gains on a tax-free basis. Health Savings Account not only allows individuals to lower their taxable income but they also protect themselves from the impact of unexpected medical expenses.
Short-term Health Insurance in South Dakotas
According to South Dakota’s law short term plans cannot last more than six months and even renewals of these plans are not permitted. Despite of new federal regulations allowing longer short-term plans, South Dakota has impose stricter guidelines with six month limits on short-term plans and this rule will continue unless the state enacts legislation to change it. In spite of the state restrictions on this plan, residents prefer this plan due to its affordability and its benefits that are generally related to emergency care. Thus, individuals who do not require regular medical care like frequent visits to the doctor or expensive prescriptions prefer this plan, as its provide coverage at quite an affordable price. Though short term plans do not have many benefits like the major medical health plan but still they cover for emergency care at reasonable price. In South Dakota around six insurance carriers are offering short-term plans in the state.
Individuals looking for affordable dental plan in South Dakota to save on dental care can shop for dental plans that are categorized as either Indemnity or managed care plans.
Indemnity dental plans – Indemnity plans in South Dakota offer a broader selection of dental care providers from which the insured can choose their preferred dentist. In an indemnity plan, the insurance companies pay for the covered services only when it receives a bill for the services offered. This means that the insured have to pay for the dental care up front and then later on obtain reimbursement from the insurance company.
Managed Care Plans – Managed care dental plans in South Dakota maintain a network of dental care providers, who agree to render dental care services to members at a pre-negotiated rate. The dentist usually submit the claim to the insurance carrier on behalf of the insured. People having managed care dental plans have less paper work and lower out-of-pocket costs with this plan.
Vision Insurance Plan in South Dakota
Vision Insurance plans in South Dakota is a must for all its residents who wish to provide all essential protection for maintaining healthy eyes. Vision care cost is not generally covered under health plans, so individuals and families looking for eye coverage need to obtain a vision insurance plan in South Dakota just like any other states of the U.S. Vision plans not only provides coverage for routine vision care but also allow insured receive discounts on vision expenses like glasses or even for LASIK. Beside, vision insurance either cover or provide discounts on annual eye examinations, eyeglass lenses, and contact lenses.
Insurance Carriers in South Dakota
Health insurance carriers that are offering health plans in the exchange for 2020 in South Dakota are: