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South Dakota · 2026 plan year

Silver health insurance plans in South Dakota (2026)

There are 22 Silver plans on the South Dakota Marketplace from 3 insurers, and they are not interchangeable — premiums run from $401 to $685 a month for the same metal tier. Here is what separates them.

22
Silver plans
3
Insurers
66
Counties covered
$401
Cheapest premium
$6,000
Median deductible
These are benchmark premiums, not your price. Every dollar figure here is the individual rate at age 21 for a non-tobacco user, before any premium tax credit — the standard way plans are compared like for like. What you actually pay depends on your age, county, household and income. Estimate your real cost.

South Dakota Silver premiums rank 18th cheapest of 35.

Averaged across all 22 plans, Silver coverage in South Dakota costs $528 a month before subsidies — 18th lowest of the 35 states with federal-marketplace data. Premiums vary far more by county and age than this single number suggests.

Metal tiers describe roughly what share of covered costs a plan pays, not the quality of its care or network. How the metal tiers actually differ walks through the trade, and how ACA subsidies work explains why the prices below are rarely what anyone pays.

Cost

What a Silver plan costs in South Dakota in 2026

Across all 22 Silver plans in South Dakota, monthly premiums run from $401 to $685, averaging $528. Those are age-21, non-tobacco rates before any subsidy — the basis every figure on this page uses, and rarely what anyone actually pays. Premium tax credits cut that bill for most South Dakota enrollees, often to a fraction of the sticker price.

Deductibles

Silver plan deductibles in South Dakota

Silver deductibles in South Dakota run from $3,500 to $6,000, with a median of $6,000 across the 19 plans with one combined deductible — the amount you pay yourself before the plan starts sharing most costs. The median is the closest thing to a typical plan; the mean sits at $5,263 because the spread is not symmetric. The other 3 set a separate deductible for prescription drugs, so their medical deductible alone would understate what you pay; they are left out of these figures, and the table below shows both deductibles where a plan has two. No single figure is a quote — the table below shows the real deductible on each of the cheapest plans, and the insurer breakdown shows how the range splits by carrier.

Out-of-pocket maximum

Silver out-of-pocket maximums in South Dakota

Individual out-of-pocket maximums on South Dakota Silver plans run from $7,500 to $10,600, with a median of $8,900. That is the ceiling on what a plan can make you pay in a year for covered in-network care — after you reach it, the plan pays 100% of covered services. It is the number that matters most in a bad year, and the top of the range here is set by the federal limit that applies to every Marketplace plan, not by the insurer.

Lowest premiums

The cheapest Silver plans in South Dakota

PlanPremium / mo (age 21, pre-subsidy)DeductibleOut-of-pocket max
DirectConnect Standard $6000Avera Health Plans$401$6,000$8,900
DirectConnect $4500Avera Health Plans$402$4,500$10,150
Sanford Individual TRUE Standardized $6,000Sanford Health Plan$404$6,000$8,900
DirectConnect MyWeighForward $6000Avera Health Plans$418$6,000$8,900
Sanford Individual TRUE $3,500Sanford Health Plan$429$3,500$9,750

Showing 5 of 22. See all South Dakota Silver plans →

Who sells here

Silver plans by insurer

InsurerSilver plansCheapestTier averageDeductible range
Avera Health Plans12$401$537$4,500–$6,000
Sanford Health Plan6$404$482$3,500–$6,000
Wellmark of South Dakota, Inc.4$539$572$5,000–$6,000
Other tiers in South Dakota

How Silver compares to the rest

Bronze
Avg $406 · from $318
21 plans
Silver
Avg $528 · from $401
22 plans · you are here
Gold
Avg $555 · from $437
20 plans

All South DakotaMarketplace plans →

Nearby on price

States with similar Silver premiums

North Carolina
Avg $525
74 Silver plans
Louisiana
Avg $540
36 Silver plans
Mississippi
Avg $543
16 Silver plans
Common questions

South Dakota Silver plans, answered

What are the copays on South Dakota Silver plans?
Copays vary plan by plan rather than by tier — the metal level sets roughly what share of total care costs the plan covers, not the individual amounts. What the tier does bound is the rest of the cost-sharing: across the 22 Silver plans in South Dakota, out-of-pocket maximums run $7,500 to $10,600, and deductibles on the 19 plans with one combined deductible run $3,500 to $6,000. The other 3 set a separate deductible for prescription drugs and are not included in the deductible figures. Open any plan below to see its full cost-sharing schedule, including primary care, specialist and prescription tiers.
Who is eligible for a Silver plan in South Dakota?
Anyone eligible to buy Marketplace coverage in South Dakota can pick a Silver plan — there is no separate test for the tier. What Silver uniquely unlocks is cost-sharing reductions, available if your household income is roughly 100–250% of the federal poverty level. Those reductions apply only to Silver plans, which is why Silver is usually the right choice at those incomes even though its sticker price here ($528 a month on average) is higher than Gold in some states.
What is the deductible on South Dakota Silver plans?
Silver deductibles in South Dakota run from $3,500 to $6,000 across the 19 plans with one combined deductible, with a median of $6,000 — that median is the figure closest to a typical plan. The other 3 set a separate deductible for prescription drugs and are not included in the deductible figures. Out-of-pocket maximums run $7,500 to $10,600. The spread inside a single tier is wide, so two plans at a similar premium can differ by thousands in what you would actually pay during a year with significant care. Deductible is usually a better basis for comparison than premium alone.
Are Silver plans available in my South Dakota county?
Silver plans are sold in 66 South Dakota counties, from 3 insurers. Which specific plans you can buy depends on where you live — a plan offered in a metro county is often not sold in a rural one. Enter your ZIP code to narrow the list to plans actually available to you.
When can I enroll in a Marketplace plan in South Dakota?
South Dakota uses the federal Marketplace, so open enrollment runs November 1 to January 15. Outside that window you need a qualifying life event — losing job-based coverage, moving, marriage, or a birth — to open a special enrollment period. Cheapest Silver premiums in South Dakota start at $401 a month before any subsidy.

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