Medicare Advantage Plans in South Dakota 2026
Last reviewed: June 2026 · Data sourced from CMS.gov
South Dakota has low Medicare Advantage penetration. Sioux Falls has the most plan options, with Rapid City having some availability as well. Much of the state, including the western Black Hills area and the largely rural eastern corridor, has very limited plan availability.
Plan availability varies by county. Enter your ZIP code to see the exact plans, premiums, and coverage available where you live in South Dakota.
Rural Coverage Note
Parts of South Dakota have limited Medicare Advantage plan availability. If you live in a rural county, you may find fewer plans or smaller provider networks. Comparing your options alongside Medicare Supplement plans is worth doing before you decide.
What to Look for in a South Dakota Medicare Advantage Plan
- ✓ Whether your current doctors and specialists are in-network
- ✓ Drug formulary — does it cover your prescriptions at a reasonable cost?
- ✓ Monthly premium and annual out-of-pocket maximum
- ✓ Extra benefits: dental, vision, hearing, fitness programs
- ✓ Star rating — CMS rates plans from 1 to 5 stars based on quality and member experience
- ✓ HMO vs. PPO — HMOs require referrals and restrict out-of-network care; PPOs are more flexible
2026 Medicare Advantage Costs in South Dakota
| Cost | Typical Range |
|---|---|
| Monthly premium | $0 to $50 (many plans at $0) |
| Annual out-of-pocket maximum | Up to $9,350 in-network (2026 CMS limit) |
| Primary care visit copay | $0 to $20 typical |
| Specialist visit copay | $20 to $50 typical |
| Inpatient hospital stay | $250 to $350/day for first few days (varies by plan) |
| Part B premium (always required) | $202.90/month standard (2026) |
Medicare Advantage vs. Medigap in South Dakota
Medigap is widely used in South Dakota outside Sioux Falls. The state's rural character and limited MA plan market make Medigap the more reliable coverage option for most beneficiaries.