Wellmark Standard Bronze EPO

Wellmark of South Dakota, Inc. · 2026 plan year

Expanded BronzeHSA eligible

Ind. deductible: $7,500
Family deductible: $15,000
Ind. OOP max: $10,000
Family OOP max: $20,000

Compare with other Expanded Bronze plans in SD

Side by side: deductibles, out-of-pocket limits and copays.

DirectConnect Standard $7500 HSA Eligible HDHPAvera Health Plans · Deductible $7,500 · Out-of-pocket max $10,000
ConnectPlus $7500 HSA Eligible HDHPAvera Health Plans · Deductible $7,500 · Out-of-pocket max $7,500
Sanford Individual Simplicity Standardized $7,500Sanford Health Plan · Deductible $7,500 · Out-of-pocket max $10,000

Compare 4 plans Browse all Expanded Bronze plans in SD

Other cost-sharing reduction variants for this plan:

Limited Cost Sharing Plan Variation Standard Bronze Off Exchange Plan Zero Cost Sharing Plan Variation

More Wellmark of South Dakota, Inc. plans in SD

Wellmark Bronze Traditional EPO Wellmark Bronze HDHP EPO HSA Qualified Wellmark Silver Traditional EPO Wellmark Gold Traditional EPO Wellmark Standard Bronze EPO

Monthly premiums by age

Rating Area 2 — the lowest-priced of the 2 areas this plan covers. Premiums differ by area.

Age	Individual	Individual + tobacco
Under 15	$314	$314
21	$410	$472
30	$465	$535
40	$524	$603
50	$732	$842
60	$1,113	$1,280
64 and over	$1,230	$1,415

Live premium estimate

Benefits & cost sharing

Primary Care

Benefit	In-network
Preventive Care/Screening/Immunization	No charge
Primary Care Visit to Treat an Injury or Illness	$50.00

Specialist

Benefit	In-network
Specialist Visit	$100.00

Hospital

Benefit	In-network
Emergency Room Services	50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	50.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$75.00

Pharmacy

Benefit	In-network
Generic Drugs	$25.00
Non-Preferred Brand Drugs	$100.00 Copay after deductible
Preferred Brand Drugs	$50.00 Copay after deductible
Specialty Drugs	$500.00 Copay after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$50.00

Other

Benefit	In-network
Orthodontia - Child	60.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)	$50.00
Cosmetic Surgery	Not covered
Nutritional Counseling	Not covered
Orthodontia - Adult	Not covered
Basic Dental Care - Adult	Not covered
Basic Dental Care - Child	40.00%
Chemotherapy	50.00% Coinsurance after deductible
Chiropractic Care	$50.00
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	$100.00
Acupuncture	Not covered
Allergy Testing	$100.00
Bariatric Surgery	50.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care	50.00% Coinsurance after deductible
Dental Check-Up for Children	No charge
Diabetes Education	$50.00
Dialysis	50.00% Coinsurance after deductible
Durable Medical Equipment	50.00% Coinsurance after deductible
Emergency Transportation/Ambulance	50.00% Coinsurance after deductible
Eye Glasses for Children	80.00%
Habilitation Services	$50.00
Hearing Aids	Not covered
Home Health Care Services	50.00% Coinsurance after deductible
Hospice Services	50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	50.00% Coinsurance after deductible
Infertility Treatment	$50.00
Infusion Therapy	50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	50.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home Care	Not covered
Major Dental Care - Adult	Not covered
Major Dental Care - Child	60.00%
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	50.00% Coinsurance after deductible
Outpatient Rehabilitation Services	$50.00
Prenatal and Postnatal Care	50.00% Coinsurance after deductible
Private-Duty Nursing	50.00% Coinsurance after deductible
Prosthetic Devices	50.00%
Radiation	50.00% Coinsurance after deductible
Reconstructive Surgery	50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	$50.00
Rehabilitative Speech Therapy	$50.00
Routine Dental Services (Adult)	Not covered
Routine Eye Exam (Adult)	Not covered
Routine Eye Exam for Children	No charge
Routine Foot Care	Not covered
Skilled Nursing Facility	50.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$50.00
Transplant	50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	50.00% Coinsurance after deductible
Weight Loss Programs	Not covered
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	50.00% Coinsurance after deductible