South Dakota · 2025
Sanford Health Plan
Your price depends on you.
Marketplace premiums are personalized based on your age, household size, income, tobacco use, and zip code. Most households qualify for a premium tax credit that lowers the monthly cost — often by a lot.
Share a few details and we'll show you the real monthly price for this plan, including any subsidy you're eligible for.
Get my personalized priceA deductible is the amount you pay for covered services before the plan starts paying. After you meet the deductible, you typically pay only copays or coinsurance until you hit your out-of-pocket maximum.
Combined Medical and Drug EHB Deductible
In-Network · Individual
$1,750
The most you'll have to pay for covered services in a plan year. Once you reach this amount, the plan pays 100% of covered services for the rest of the year. Premiums and out-of-network charges don't count toward this limit.
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total)
In-Network · Individual
$8,700
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total)
In-Network · Family
$17,400
Bronze, Silver, Gold, and Platinum plans balance monthly premiums against out-of-pocket costs. Higher metal levels cost more per month but pay more of your care.
HMO, PPO, EPO, POS, and Indemnity plans differ in how they handle networks and referrals. PPOs and POS plans give you more freedom; HMOs and EPOs trade flexibility for lower costs.
Individual plans are bought directly by consumers. SHOP plans are offered through small employers.
Qualified Health Plans (QHP) meet Affordable Care Act standards and are eligible for premium tax credits.
Indicates whether this is a medical/healthcare plan or a specialized product line (e.g. dental, vision).
If Yes, you can pair this plan with a Health Savings Account to set aside pre-tax money for medical expenses.
Simple Choice (Standardized) plans follow a common cost-sharing template defined by CMS, making it easier to compare plans side by side.
When Yes, your monthly premium is locked in for the plan year and won't change mid-year.
Indicates whether this plan has been certified by the Marketplace to meet the standards required to be offered to consumers.
Whether the plan is currently available for new enrollments or has been suppressed/withdrawn from the Marketplace.
CMS publishes three standardized benefit scenarios so you can compare what different plans would cost in the same situation. Amounts shown are what you would pay.
Having a Baby
Typical uncomplicated pregnancy and delivery.
Managing Diabetes
A year of well-controlled Type 2 diabetes care.
Simple Fracture
Emergency room visit and follow-up for a broken bone.
A sampling of the benefits this plan covers, what they mean, and what you'll pay. The full list of covered services is in the plan's Summary of Benefits.
What this is:
Your Cost
A copay is a flat dollar amount you pay per visit. Coinsurance is a percentage of the cost you pay after meeting your deductible.
Coverage Limit
2 exams per benefit period
The plan only covers this benefit up to the amount shown. Visits beyond the limit are your full responsibility.
What this is:
Your Cost
A copay is a flat dollar amount you pay per visit. Coinsurance is a percentage of the cost you pay after meeting your deductible.
What this is:
Your Cost
A copay is a flat dollar amount you pay per visit. Coinsurance is a percentage of the cost you pay after meeting your deductible.
What this is:
Your Cost
A copay is a flat dollar amount you pay per visit. Coinsurance is a percentage of the cost you pay after meeting your deductible.
What this is:
Your Cost
A copay is a flat dollar amount you pay per visit. Coinsurance is a percentage of the cost you pay after meeting your deductible.
What this is:
Your Cost
A copay is a flat dollar amount you pay per visit. Coinsurance is a percentage of the cost you pay after meeting your deductible.
What this is:
Your Cost
A copay is a flat dollar amount you pay per visit. Coinsurance is a percentage of the cost you pay after meeting your deductible.
What this is:
Your Cost
A copay is a flat dollar amount you pay per visit. Coinsurance is a percentage of the cost you pay after meeting your deductible.
What this is:
Your Cost
A copay is a flat dollar amount you pay per visit. Coinsurance is a percentage of the cost you pay after meeting your deductible.
What this is:
Your Cost
A copay is a flat dollar amount you pay per visit. Coinsurance is a percentage of the cost you pay after meeting your deductible.
CMS combines member experience, clinical quality, and plan efficiency into a single 5-star overall rating. Higher is better.
Measures how well the plan helps members get recommended care — things like preventive screenings, chronic disease management, and behavioral health follow-ups.
Reflects surveyed members' experience with their plan and providers — access to care, customer service, and overall satisfaction.
Measures how efficiently the plan delivers care — use of appropriate services, avoiding unnecessary hospitalizations, and network stability.
A Yes means you have in-network coverage when traveling outside your state. Most Marketplace plans are regional only.
When Yes, you must see a primary care provider first for a referral before the plan covers specialist visits.
Free programs to help members manage specific chronic conditions. They typically include nurse coaching, medication support, and educational resources.
When Yes, you can get a 90-day supply of maintenance medications delivered by mail — usually cheaper than filling three 30-day prescriptions at a retail pharmacy.
The oldest a dependent child can be and still stay on this plan. The ACA generally allows coverage up to age 26.
Indicates whether the plan covers abortion services beyond the narrow exceptions (rape, incest, life of the mother) allowed under the Hyde Amendment.
Whether this plan is currently open to new enrollment. Some plans are shown for informational purposes only.
The insurance company that underwrites and administers this plan. You'll deal with them for ID cards, claims, and customer service.
The state in which the issuer is licensed to sell this product.
Text Telephone number for members who are deaf, hard of hearing, or have a speech disability.
The issuer's website for individual (non-group) members.
The issuer's website for small employer (SHOP) plans.
Most values on this page are placeholder data while we finish wiring up the full plan feed.