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Best Medicare Advantage Plans South Dakota 2027

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) | Last updated October 8, 2026

South Dakota’s Medicare Advantage market changes for 2027: Wellmark, the Blue company for Iowa and South Dakota, is leaving Medicare Advantage, and the state’s average plan premium is about $56.04 a month, far above the $12 national average.

Choices are widest around Sioux Falls and Rapid City. In rural areas, check the distance to in-network hospitals as carefully as the premium.

✔ Licensed across all 50 states
✔ Built on CMS 2027 data
✔ No-cost plan comparison

Key Highlights

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Wellmark exits Medicare Advantage.

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Average premium about $56.04.

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Check rural hospital access.

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Nationally, the average 2027 Medicare Advantage premium is $12 a month, down from $14.37 (CMS).

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The Annual Enrollment Period is October 15 to December 7, 2026.

Compare plans and enroll online

Medicare Options in South Dakota

Key Takeaway

Which Medicare Advantage plans you can pick depends on your county. Medigap and Part D plans are sold statewide.

Feature HMO PPO
Out-of-network care Not covered except emergencies and urgent care Covered at a higher cost
Referrals for specialists Usually required Usually not required
Premiums Usually lower Usually higher
Out-of-pocket maximum In-network limit In-network limit plus a higher combined limit
Best for Lower costs, local care Flexibility, travel, keeping specific doctors

Benefits South Dakota Plans May Offer

South Dakota Plans May Include

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Hospital and medical coverage matching Original Medicare Part A and B

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Part D prescription drug coverage on most plans

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Routine dental, vision and hearing benefits

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Fitness programs and over-the-counter allowances

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Telehealth visits and care coordination programs

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A yearly out-of-pocket maximum on every plan

Benefits are not offered by every plan. They differ by plan and county and may change for 2027. Review the Evidence of Coverage for each plan before enrolling.

Understanding Medicare Advantage Plans in South Dakota

South Dakota Changes for 2027

Nationally, large insurers are trimming PPOs and pulling plans from some counties for 2027. In South Dakota, read your Annual Notice of Change, and if you received a non-renewal letter, choose a new plan before December 31, 2026.

Insurer Key 2027 Changes
UnitedHealthcare 852 plans (846 last year); about 140 counties lose standard plans; exiting Wyoming; 34 PPOs eliminated
Humana 861 plans, compared with 887; exiting Minnesota and 57 counties; 37 PPOs eliminated; about 600,000 members losing their plans
Aetna (CVS Health) 654 plans (compared with 642); standard plans withdrawn from 123 counties; exiting Maryland and New Hampshire; 20 PPOs eliminated; 29 C-SNPs introduced
HCSC (including HealthSpring) Down from 948 counties to roughly 478; exiting CT, KS, MT, NY, OR, UT and D.C.; 48 PPOs dropped
Centene (Wellcare) Standard plans removed from 344 counties; exiting Hawaii, Oklahoma and Tennessee
Elevance (Anthem) Standard plans removed from 56 counties; exiting South Carolina
Devoted Health Entering CT, MI, NH, NJ and NY; adding 342 counties

Source: company announcements and CMS 2027 landscape data reported by Becker’s on October 1, 2026. For 2027, Wellmark, Blue Cross Blue Shield of North Dakota and Blue Cross Blue Shield of Mississippi are exiting Medicare Advantage as well.

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South Dakota 2027

Wellmark

Leaving Medicare Advantage.

$56.04

Average 2027 South Dakota premium.

$12

National average premium.

Guaranteed issue: when your Medicare Advantage plan exits your area, you can generally purchase certain Medicare Supplement plans with no health questions asked, up until 63 days after that coverage ends.

Medicare Advantage in South Dakota

Medicare Advantage, sometimes called Part C, lets you receive your Medicare benefits through a Medicare-approved private insurer. These plans cover everything Original Medicare Part A and Part B cover, with the exception of hospice care, which Original Medicare continues to pay for. Most also bundle Part D drug coverage, and many may tack on extras like routine dental, vision and hearing benefits.

The trade-off is that Medicare Advantage plans generally rely on doctor and hospital networks and may call for referrals or prior authorization for certain services. Each Medicare Advantage plan sets a yearly out-of-pocket maximum for covered medical care, something Original Medicare lacks. You still pay your Part B premium, along with the plan’s premium if there is one.

Advantages

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Often a low or $0 premium

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A yearly out-of-pocket maximum

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Drug coverage usually included

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Dental, vision and hearing benefits may be included in many plans

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One card and one plan

Tradeoffs

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Networks; except for emergencies, HMOs require in-network care

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Prior authorization and referrals are common

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Copays add up if you use a lot of care

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Plans and networks can change every year

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Moving to Medigap later may involve health questions

What Medicare Advantage plans are available in South Dakota

Medicare Supplement Plans in South Dakota

If Original Medicare is your preference, a Medicare Supplement (Medigap) plan covers some or all of what Medicare leaves unpaid and lets you use any U.S. provider that accepts Medicare. Since benefits are standardized by plan letter, compare what insurers charge for the same letter.

Plan What You Pay Best For
Plan G The Part B deductible; once it’s met, Medicare-approved costs are covered Most complete coverage for new enrollees
Plan N Part B deductible, Part B excess charges, and copays of up to $20 for some office visits and up to $50 for some ER visits Lower premium, accepts small copays
High-Deductible Plan G A yearly deductible, then coverage like Plan G Healthy people who want the lowest premium

Plan letter determines Medigap benefits, which are standardized. Prices differ by insurer, age, ZIP code and tobacco use.

Be aware: once your six-month Medigap Open Enrollment Period has passed, and without a guaranteed issue right, insurers in most states may ask health questions and turn you down or charge you more.

Part D Drug Plans in South Dakota

$700

Maximum 2027 Part D deductible, up from $615.

$2,400

2027 Part D out-of-pocket cap, up from $2,100.

About $36

CMS average standalone Part D premium for 2027, an increase of under $1.

$7

Projected 2027 average for the drug portion of a Medicare Advantage premium, a decrease from $11.32.

If you keep Original Medicare in South Dakota, add a standalone Part D plan. Compare plans with your exact drugs and pharmacies using the 2027 Part D plan finder.

If Your Plan Is Ending

A non-renewal notice should have reached you in early October if your plan won’t be available in your county for 2027. Coverage doesn’t end immediately; it runs through December 31, 2026, which gives you time to decide.

If Your Plan Is Ending

1

Review your non-renewal letter. It verifies that your plan is ending and lays out your choices.

2

Write down your doctors and drugs. Comparing replacement plans requires them.

3

Compare your 2027 plan choices. Look at networks, drug coverage and the out-of-pocket maximum, not only the premium.

4

Pick a plan by December 31 to avoid a gap. If you enroll during Annual Enrollment by December 7, your coverage starts January 1, 2027.

5

Rely on your Special Enrollment Period if necessary. If your plan is ending, you generally have until the end of February 2027 to make a choice.

If you take no action: on January 1, 2027, you go back to Original Medicare, and you will have no drug coverage unless you pick a Part D plan. Being without drug coverage may result in a late enrollment penalty.

Medigap rights: if your Medicare Advantage plan exits your area, you generally get a guaranteed issue right, lasting up to 63 days after your coverage ends, to purchase certain Medicare Supplement plans with no health questions.

How to Compare South Dakota Plans for 2027

How to Compare

1

Review your Annual Notice of Change. It spells out every 2027 change to the plan you have now.

2

Verify your doctors and hospitals. Make sure every provider is in the 2027 network, not only the 2026 network.

3

Review your prescriptions. Verify every drug, the tier it falls on and any step therapy or prior authorization rules.

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Look at the full annual cost. Total up the premium, usual copays and drug costs, and review the out-of-pocket maximum.

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Look at star ratings. Medicare scores plans on quality and service using a 1 to 5 star scale.

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Sign up by December 7. Coverage under your new plan begins January 1, 2027.

2027 Enrollment Dates

Enrollment Period Dates What You Can Do
Annual Enrollment Period October 15 to December 7, 2026 Join, change or drop a Medicare Advantage or Part D plan effective January 1, 2027
Medicare Advantage Open Enrollment January 1 to March 31, 2027 In Medicare Advantage, you can change to another plan or go back to Original Medicare one time
Initial Enrollment Period 7 months around your 65th birthday month Sign up for Medicare and choose your first plan
Special Enrollment Periods Varies Switch plans after events such as a move, a loss of other coverage or your plan exiting your area

Annual Enrollment is when most people make changes. If you like your current plan, no action is needed; it renews on its own. Even so, review your Annual Notice of Change, since networks, premiums, copays and drug lists can all change on January 1.

Special Needs Plans

Special Needs Plans (SNPs) are Medicare Advantage plans designed for particular groups. Their benefits, networks and drug lists are shaped around the members they serve, and many come with care coordinators. In 2027, SNPs are one of the few places large insurers are adding plans, even while cutting PPOs.

Type Who Qualifies What Is Different
Dual Special Needs Plan (D-SNP) People with both Medicare and Medicaid Coordinates both programs; costs are often very low, with extra benefits
Chronic Condition SNP (C-SNP) People who have qualifying conditions like diabetes, heart failure or chronic lung disease Doctors, drugs and programs designed around the condition
Institutional SNP (I-SNP) People who live in a nursing home or need that level of care at home Care delivered where the member lives

Turning 65 in 2027

When you turn 65 in 2027, you get a seven-month Initial Enrollment Period: the three months before your birthday month, the birthday month itself and the three months that follow. If you sign up in the first three months, coverage begins on the first day of your birthday month.

Turning 65 Checklist

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Enroll in Part A and Part B, unless you have qualifying employer coverage and decide to postpone Part B

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Choose between Medicare Advantage and Original Medicare plus Medigap

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Enroll in a drug plan, or a Medicare Advantage plan that includes drugs, to avoid a late Part D penalty

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If you go with Medigap, purchase during your six-month Medigap Open Enrollment Period

Help Paying Medicare Costs

When your income and savings are limited, two programs can greatly lower your Medicare costs:

Medicare Savings Programs

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Run by your state Medicaid office

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May cover your Part B premium, and in some cases deductibles and coinsurance

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Income and asset limits vary by state

Extra Help (Part D)

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Run by Social Security

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Lowers Part D premiums, deductibles and copays

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Those enrolled in a Medicare Savings Program qualify automatically

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

Free Medicare Help in South Dakota

South Dakota’s State Health Insurance Assistance Program, South Dakota’s State Health Insurance Assistance Program (SHIP), offers free, unbiased Medicare counseling. You can also call 1-800-MEDICARE any time or compare plans with a licensed agent at no cost.

Free Help Comparing Plans

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Available any time: Medicare Plan Finder on Medicare.gov

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1-800-MEDICARE (1-800-633-4227), reachable 24 hours a day on all seven days of the week

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Your State Health Insurance Assistance Program (SHIP), which provides free, unbiased counseling

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A licensed agent or insurance broker, who can compare plans across several insurers for free

Gather your Medicare card, a list of your drugs and doses, your doctors and your preferred pharmacies before you call. That way a long conversation becomes a quick one.

Reading Your Annual Notice of Change

Check Every Line

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Your 2027 premium and deductible

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Doctor, specialist and hospital stay copays

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The out-of-pocket maximum

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Updates to your formulary, drug tiers and coverage rules

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Whether your doctors, hospitals and pharmacy stay in network

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Updates to dental, vision, hearing and other extras

The Annual Notice of Change must reach members by September 30. It is the most useful single document you receive each fall, since it spells out exactly how your plan will change on January 1.

Special Enrollment Periods

Outside of the fall and early-year windows, changing plans generally requires a Special Enrollment Period. Typical reasons include:

You May Qualify If

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Your plan is leaving your area or ending

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You move outside your plan’s service area

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You lose employer or union coverage

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Your Medicaid status changes, or you qualify for a Medicare Savings Program or Extra Help

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You want to join a 5-star plan, once a year

Every Special Enrollment Period has a separate time limit, so move as soon as the event occurs.

Bottom Line

The Bottom Line

South Dakota offers Medicare Advantage, Medigap and Part D choices for 2027. Compare plans in your county and enroll during Annual Enrollment, October 15 to December 7, 2026.

Compare plans and enroll online

Frequently Asked Questions

➤ Is Wellmark leaving South Dakota?

Yes, Wellmark is exiting Medicare Advantage for 2027, which affects its South Dakota members. If you have a Wellmark Medicare Advantage plan, it will end after December 31, 2026, and you will need to choose new coverage. You will get a Special Enrollment Period and generally a guaranteed issue right to buy certain Medigap plans.

➤ What is the average premium?

The average Medicare Advantage premium in South Dakota is about $56.04 a month for 2027. That is well above the national average of about $12. Your own premium could be higher or lower depending on the plan and county you live in.

➤ What if my South Dakota Medicare Advantage plan is ending?

Your South Dakota plan keeps covering you until December 31, 2026, and the insurer will send a non-renewal notice. You can enroll in a replacement during Annual Enrollment or a Special Enrollment Period. You generally also gain a guaranteed issue right to buy certain Medigap plans, typically within 63 days after your coverage ends.

➤ When can I change my South Dakota Medicare plan for 2027?

You can change plans during Annual Enrollment, October 15 to December 7, 2026, with new coverage beginning January 1, 2027. If you are enrolled in Medicare Advantage, you get one more change between January 1 and March 31, 2027. Because South Dakota has limited choices in some areas, start comparing early.

➤ What is the best Medicare Advantage plan in South Dakota for 2027?

There is no single best plan, because the right choice depends on your county, doctors, medications and budget. Compare each plan’s premium, out-of-pocket maximum, network and drug costs in Medicare Plan Finder. A licensed agent or your State Health Insurance Assistance Program (SHIP) can help you narrow down the options.

➤ Should South Dakota residents consider Medigap instead of Medicare Advantage?

It may be worth comparing, especially with Medicare Advantage premiums averaging about $56.04 in the state. A Medigap plan paired with a Part D plan lets you see any provider that accepts Medicare, which can help in rural areas. Medigap premiums vary, and outside guaranteed issue periods most insurers can ask health questions.

➤ Are Medicare Advantage plans available in rural South Dakota?

Yes, but options may be more limited in rural counties than in larger cities. Some areas may have only a few plans, and provider networks can be narrower. Enter your ZIP code in Medicare Plan Finder to see exactly which plans serve your county and check that local doctors and hospitals are included.

➤ Can Wellmark Medicare Advantage members buy a Medigap plan?

Yes, if your Wellmark Medicare Advantage plan is ending, you generally have a guaranteed issue right to buy certain Medigap plans. This right usually lasts about 63 days after your coverage ends, and insurers cannot turn you down over health questions during it. You would also need a separate Part D plan for drug coverage.

( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.