Wellmark Bronze Traditional EPO

Wellmark of South Dakota, Inc. · 2026 plan year

Expanded BronzeHSA eligible

Ind. deductible: $7,200
Family deductible: $14,400
Ind. OOP max: $9,900
Family OOP max: $19,800

Compare with other Expanded Bronze plans in SD

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

Sanford Individual TRUE $7,200 HSA QualifiedSanford Health Plan · Deductible $7,200 · Out-of-pocket max $7,200
Sanford Individual Simplicity $7,200 HSA QualifiedSanford Health Plan · Deductible $7,200 · Out-of-pocket max $7,200
DirectConnect Standard $7500 HSA Eligible HDHPAvera Health Plans · 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	$293	$293
21	$382	$440
30	$434	$499
40	$489	$562
50	$683	$785
60	$1,038	$1,193
64 and over	$1,147	$1,319

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	$80.00

Specialist

Benefit	In-network
Specialist Visit	$150.00

Hospital

Benefit	In-network
Outpatient Surgery Physician/Surgical Services	50.00% Coinsurance after deductible
Emergency Room Services	50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	50.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$80.00

Pharmacy

Benefit	In-network
Generic Drugs	$35.00
Non-Preferred Brand Drugs	50.00% Coinsurance after deductible
Preferred Brand Drugs	50.00% Coinsurance after deductible
Specialty Drugs	50.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$80.00

Other

Benefit	In-network
Outpatient Rehabilitation Services	50.00% Coinsurance after deductible
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	$150.00
Acupuncture	Not covered
Allergy Testing	$150.00
Bariatric Surgery	50.00% Coinsurance after deductible
Basic Dental Care - Adult	Not covered
Basic Dental Care - Child	40.00%
Chemotherapy	50.00% Coinsurance after deductible
Chiropractic Care	$80.00
Cosmetic Surgery	Not covered
Delivery and All Inpatient Services for Maternity Care	50.00% Coinsurance after deductible
Dental Check-Up for Children	No charge
Diabetes Education	$80.00
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% Coinsurance after deductible
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	$80.00
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%
Nutritional Counseling	Not covered
Orthodontia - Adult	Not covered
Orthodontia - Child	60.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)	$80.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	50.00% Coinsurance after deductible
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% Coinsurance after deductible
Rehabilitative Speech Therapy	$80.00
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% Coinsurance after deductible
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