Health insurance cost in South Dakota
If you're moving to South Dakota without job-based coverage, here's what a Marketplace plan costs before subsidies. South Dakota ranks #35 of 51 for the lowest benchmark premium.
Monthly premium by age
| Age | Benchmark silver | Cheapest bronze |
|---|---|---|
| 21 | $512 | $378 |
| 30 | $582 | $430 |
| 40 | $655 | $484 |
| 50 | $915 | $676 |
| 60 | $1,391 | $1,028 |
| 64 | $1,537 | $1,136 |
Scaled from the age-40 average with the federal default age curve, which lets insurers charge a 64-year-old up to 3× what a 21-year-old pays. Excludes tobacco surcharges.
The South Dakota benchmark rose 6% for 2026, less than the 26% national increase, leaving it 5% above the U.S. average for a 40-year-old.
What is different in South Dakota
- Where to enroll
- HealthCare.gov
- Open enrollment for 2027
- Nov 1 – Jan 15
- Marketplace insurers, 2026
- 3
- Medicaid expansion
- Since Jul 2023
- Penalty if uninsured
- None
- Average paid after credits, 2026
- $211/mo
- Where and when. South Dakota uses HealthCare.gov, the federal marketplace. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027; pick a plan by December 15 for coverage that starts January 1.
- Choice of insurers. 3 insurers sell Marketplace plans in South Dakota for 2026, the same number as in 2025. Not every insurer sells in every county, so your choices depend on where you live. 50,951 people picked a Marketplace plan here for 2026, down 7% from 2025.
- What enrollees paid. Enrollees here paid an average of $211 a month after tax credits for 2026, up 69% from the $125 they paid for 2025 (U.S. average: $178). Before credits, the plans they chose averaged $684.
- Medicaid. South Dakota expanded Medicaid in July 2023, after voters approved it in November 2022. Adults with income up to 138% of the federal poverty level can generally get Medicaid instead of a Marketplace plan.
- Going uninsured. South Dakota doesn't charge a penalty for going without coverage, and the federal penalty ended after 2018. In 2024, 7.9% of residents had no health insurance (U.S.: 8.2%), and 10.1% bought their own coverage.
Subsidies in 2026
The enhanced premium tax credits of 2021–2025 expired, so 2026 follows the original ACA rules: credits are available for household incomes between 100% and 400% of the federal poverty level, and you're expected to pay between about 2.1% and 9.96% of income for the benchmark plan. Above 400% there's no federal credit. Check your price at HealthCare.gov.
Frequently asked questions
How much is health insurance in South Dakota in 2026?
The benchmark silver plan for a 40-year-old averages $655 a month before subsidies, and the cheapest bronze plan $484 (KFF analysis of CMS data). That's up 6% from 2025.
How much does health insurance cost for a 60-year-old in South Dakota?
About $1,391 a month for the benchmark silver plan before subsidies, using the federal default age curve.
Did South Dakota expand Medicaid?
South Dakota expanded Medicaid in July 2023, after voters approved it in November 2022. Adults with income up to 138% of the federal poverty level can generally get Medicaid instead of a Marketplace plan.