Compare 2023 South Dakota Medicare Advantage Plans



South Dakota Medicare Advantage Plans (also known as Part-C) are offered by Medicare approved private insurance companies. There are several types of Medicare Advantage Plans available in SD, depending on your location. Some South Dakota MA plans may include extra benefits such as routine vision, hearing care and prescription drug coverage. Some plans may offer coverage for services like transportation to doctor visits, over-the-counter drugs that Part D doesn’t cover, and many services that promote your health and wellness. If you enroll in a Medicare Advantage Prescription Drug plan, you can get all your benefits in one plan. With any MA plan, you still must pay your monthly Part B premium along with any plan premium. To compare different plans available in South Dakota, click on your county below to see a list of available plans, what benefits it offers, its cost and if there are any limitations.



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Aurora MA Plans
Beadle MA Plans
Bennett MA Plans
Bon Homme MA Plans
Brookings MA Plans
Brown MA Plans
Brule MA Plans
Buffalo MA Plans
Butte MA Plans
Campbell MA Plans
Charles Mix MA Plans
Clark MA Plans
Clay MA Plans
Codington MA Plans
Corson MA Plans
Custer MA Plans
Davison MA Plans
Day MA Plans
Deuel MA Plans
Dewey MA Plans
Douglas MA Plans
Edmunds MA Plans
Fall River MA Plans
Faulk MA Plans
Grant MA Plans
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Haakon MA Plans
Hamlin MA Plans
Hand MA Plans
Hanson MA Plans
Harding MA Plans
Hughes MA Plans
Hutchinson MA Plans
Hyde MA Plans
Jackson MA Plans
Jerauld MA Plans
Jones MA Plans
Kingsbury MA Plans
Lake MA Plans
Lawrence MA Plans
Lincoln MA Plans
Lyman MA Plans
Marshall MA Plans
McCook MA Plans
McPherson MA Plans
Meade MA Plans
Mellette MA Plans
Miner MA Plans
Minnehaha MA Plans
Moody MA Plans
Oglala Lakota MA Plans
Pennington MA Plans
Perkins MA Plans
Potter MA Plans
Roberts MA Plans
Sanborn MA Plans
Spink MA Plans
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Sully MA Plans
Todd MA Plans
Tripp MA Plans
Turner MA Plans
Union MA Plans
Walworth MA Plans
Yankton MA Plans
Ziebach MA Plans
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Giveback Plans in South Dakota

The Medicare Giveback Benefit is a Part B premium rebate provided by some Medicare Advantage plans in South Dakota. If you enroll in a Medicare Advantage plan with this benefit, some or all of your monthly premium will be covered by the plan carrier. The standard Part B monthly premium in 2023 is $164.90. The plan carrier will reduce this cost by “giving back” towards your Part B premium amount. The Part B Giveback will be credited monthly to your Social Security check.


Plan Name Plan ID Provider Name Premium Give Back Amount
AARP Medicare Advantage Patriot (PPO)
H1278-019 UnitedHealthcare $0 $30.00
Aetna Medicare Eagle (PPO)
H1608-061 Aetna Medicare $0 $25.00
Humana Honor (PPO)
H5216-278 Humana $0 $55.00



What is the Best Medicare Advantage Plan in South Dakota

The best Medicare Advantage Plan in South Dakota will be different for each person, due to their specific needs and requirements. A plan that includes your doctors in the plan’s network and your medications on the plan’s formulary is best. You can find MA plans from major carriers like Anthem/Blue Cross Blue Shield, United Healthcare, Humana, Aetna, and Cigna.




Most Popular Plans by Enrollment in South Dakota

Plan Name Plan ID Marketing Name Premium Enrollment
Medica Prime Solution Core (Cost) H2450-034
Medica $86.00 27033
Humana Honor (PPO) H5216-278
Humana $0 15162
Medica Prime Solution Standard (Cost) H2450-044
Medica $0 14705
Medica Prime Solution Premier (Cost) H2450-036
Medica $195.00 11354
Aetna Medicare Premier (PPO) H1608-001
Aetna Medicare $0 11242



Plans by Provider




Medicare Advantage changes in South Dakota, 2023


• 30 Advantage plans are available in 2023, compared to 25 plans in 2022. This represents a 20% change in plan options.

• The average monthly Advantage plan premium changed from $23.04 in 2022 to $16.30 in 2023. This represents a -29.3% change in average premium.

• 100% of people with Original Medicare have access to a Part-C plan.

• $0 is the lowest monthly premium for an Advantage plan.

• 100% of people with Original Medicare will have access to a Part-C plan with a $0 monthly premium.

• Through the CMS Value-Based Insurance Design (VBID) Model, 10 plans will offer Medicare Advantage seniors additional options, including reductions in cost sharing (in some cases to zero) for some benefits, such as eliminated Medicare Part D cost sharing; rewards and incentives programs related to healthy behaviors; and customized, innovative benefits that address social determinants of health, such as food insecurity and social isolation, for seniors who receive low income subsidies (Extra Help) and/or chronically ill seniors.

• In South Dakota, 187,737 seniors are enrolled in Medicare.

With the passing of the Inflation Reduction Act, people with Medicare prescription drug coverage will have a $35 cost-sharing limit on a month’s supply of each covered insulin products. As well as adult vaccines that are recommended by the Advisory Committee on Immunization Practices (ACIP) at no additional cost.



How do I qualify for Medicare Advantage in South Dakota?

You can join a Medicare Advantage Plan in South Dakota if all these apply:
•You're a U.S. citizen or lawfully present in the U.S.
•You have Medicare Part A and Part B.
•You live in the service area of the plan you want to join.



When can I enroll in a Medicare Advantage Plan in South Dakota?

Open enrollment starts October 15 and runs to December 7, 2022. During this time, seniors eligible for Medicare can compare 2023 coverage options on Medicare.gov. The Medicare Plan Finder provides clear easy-to-use information to allow people to compare options for Medicare Advantage Plans in South Dakota, which may change from year to year.

Late September 2022

• The 2023 Medicare & You handbooks are mailed to beneficiaries. Keep the handbook as a reference guide.
• Plan providers begin notifying enrollees about changes to their plans.

October 2022

• Beneficiaries can begin comparing plans starting October 1.
• Beneficiaries should watch their mail for notices from Medicare with information about changes in 2023.
• Star ratings will be available starting October 11.
• Open enrollment begins October 15.

December 2022

• Open enrollment ends December 7.

January 2023

• Medicare plan coverage begins January 1.

January 1 - March 31

The open enrollment period gives you an opportunity to try out an insurance plan. During this period, you can make one switch to a different Advantage Plan, or you can disenroll and return to Original Medicare. If so, you will be able to join a Medicare Prescription Drug Plan. Any changes you make during this period will be effective on the first of the month after the request is received by the provider.

During this period (Jan 1 - March 31) you can't:

• Switch from Original Medicare to a MA Plan.
• Join a Prescription Drug Plan if you're on Original Medicare.
• Switch from one Medicare Prescription Drug Plan to another if you're on Original Medicare.



Can I switch to a South Dakota Part-C Plan anytime?

Medicare provides special enrollment periods. You can make changes to your MA plans and Medicare Part-D coverage when certain events happen, like if you move and need Medicare in Tennessee or lose your insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Regulations about the type of changes and when you can make changes are different for each SEP.



Are some Medicare Advantage Plans free in South Dakota?

You may be surprised to find some Medicare Advantage Plans are offering a $0 premium. Of course, no Medicare Part-C plan is really $0 cost for you. MA plans are offered by private insurance companies. These companies need to make a profit to pay employees. To offer $0 premiums, providers must make up their costs in other ways. Insurance companies do this through copays, deductibles, and coinsurance.



Why consider a Medicare Advantage Plan?

Many Medicare Advantage Plans offer preventive care and disease management programs to help people better manage their health, and healthy patients generally have better health outcome. With a Medicare Advantage Plan, you may have coverage for things like fitness programs and some vision, hearing, and dental services (like routine check-ups) that Original Medicare doesn't cover.

Also, MA plans may offer lower out-of-pocket expenses for you than Original Medicare. There is a limit from Part-C Plans on what you must pay out-of-pocket each year.

Plus plans may offer coverage for services like transportation to doctor visits, over-the-counter drugs, and services that promote your health and wellness.



Which pre-existing conditions are not covered by MA Plans?

You can join any Medicare Advantage Plan in SD even if you have a pre-existing condition.



How Much Does Medicare Advantage Cost in South Dakota?

The average premium for a Medicare Advantage Plan in 2022 was $19 per month, some premiums cost $0, and others cost over $100. In addition to any premiums your plan may charge, you may have to pay a yearly deductible. Cost-sharing in the form of copays, coinsurance, and deductibles varies depending on your provider. What you pay in a Medicare Advantage Plan in South Dakota depends on several factors. In most cases, you will need to use health care providers who participate in the plan’s network. Some plans will not cover all services from providers outside the plan’s network and service area.



What does Medicare Advantage cover?

Medicare Advantage Plans offer both medical (Part-B) and hospital (Part-A) insurance coverage and additional benefits. Depending on the type of plan you choose.

Prescription drug coverage. While this isn’t typically covered under original Medicare, most Medicare Advantage Plans offer additional prescription drug coverage and all MAPD plans offer drug coverage. To find out if your medications are covered, check the plan’s formulary or list of covered prescription drugs.

Dental, hearing, and vision. This includes non-medically necessary coverage, which Original Medicare doesn't always cover. MA plans differ in benefits offered and vary from plan to plan.



How to join a Medicare Advantage Plan

Go to the Medicare Plan Finder and enter your zip code to find and compare plans in your area. You can speak to a licensed Medicare agent at 1-855-778-4180 to help you determine which Medicare Advantage Plan would be best for your health care needs.



How to Choose a Medicare Advantage Plan in South Dakota

Exploring your options could save you a lot of money. When choosing an Advantage Plan, consider the out-of-pocket costs and coverage for your medical needs and prescription drugs, coverage for any current medical issues, and which providers and facilities are included in the plan’s network. You can find out more about the costs and coverage for all the MAPD plans available in South Dakota by selecting your county above.

Which plan fits your budget. How much is the monthly premium? How much is the annual deductible? How much are the copays and coinsurance? What are the plans' maximum out-of-pocket cost?

Check CMS star ratings. CMS created the five-star quality rating system to help seniors compare plans being offered. The star rating is on a scale of 1 to 5, with 5 being best.

Look for your doctors. If you have caregivers and medical facilities you use and prefer, look for plans that include them.

Prescription Drugs. A Medicare Advantage plan that includes your prescription drug coverage is ideal. Look at the plans Drug List (formulary) for coverage of your current medications. Check if your preferred local pharmacy is included in the plan’s pharmacy network or consider using a mail order pharmacy to lower costs.

Other coverage. Part-C Plans offer some additional benefits for dental, hearing, vision, gym memberships and transportation to medical appointments.

Travel coverage. Original Medicare generally doesn’t cover care outside the U.S. You may be able to buy supplemental insurance that offers emergency care when you travel outside of the U.S.

South Dakota Health Insurance Assistance Program (SHIP)

The State Health Insurance Assistance Program (SHIP) is a national program that offers one-on-one counseling and education to seniors. SHIP team members are highly trained and certified to assist people on their Medicare, Medicare Advantage and Medigap and Medicaid benefits. SHIP also assists seniors with low income to apply for benefits, such as Medicaid, Extra Help, (Low Income Subsidy) and Medicare Savings Program which help pay for or reduce healthcare costs.

SHIINE can help you understand Medicare and your benefits. Senior Health Information and Insurance Education (SHIINE) is a federally funded program through the Administration for Community Living (ACL) and administered by the South Dakota Department of Human Services Division of Long Term Services and Support (LTSS). SHIINE is not affiliated with any company that sells or distributes a product or service. We are committed to providing free, confidential and unbiased information to Medicare beneficiaries. SHIINE Regional Coordinators are located in three different regions of the state to assist Medicare beneficiaries, support local volunteer counselors, recruit new volunteers and provide local SHIINE promotion.

Most of the credit for SHIINE success rests with its core of committed volunteer counselors throughout the state. SHIINE has nearly 430 counselors throughout South Dakota. Counselors work with individuals by educating them on Medicare and how to protect their benefits and avoid fraud. They also help spread the word about SHIINE in their communities. SHIINE Volunteer Counselors typically consist of both professionals working in fields related to Medicare (nursing home staff, social workers, pharmacy staff) and retired individuals

Website: http://shiine.net/
Telephone: 1-800-536-8197



What is the Best Medicare Advantage Plans in South Dakota?

The best Medicare Advantage Plan will be different for each person, due to their specific needs and requirements. The most popular plan by enrollment in South Dakota is the Medica Prime Solution Core (Cost) with 27033 seniors enrolled.

How Much Does Medicare Advantage Cost in South Dakota

The average premium for a Medicare Advantage Plan in 2022 was $19 per month, some premiums cost $0, and others cost over $100. In addition to any premiums your plan may charge, you may have to pay a yearly deductible.


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*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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