South Dakota Medical Insurance– low cost medical & dental insurance quotes « Health Insurance Advisory

Affordable Individual and Self-Employed Medical Insurance- South Dakota

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South Dakota State Flag

Get online medical insurance quotes from top health insurance companies in South Dakota, such as Celtic Health Insurance, Coventry Health Insurance, Medica Insurance, Wellmark Blue Cross and United Healthcare Golden Rule.

We make it easy for you to shop and compare the prices of individual medical insurance plans and health insurance for the self-employed, including High Deductible Health Plans paired with a Health Saving Account in South Dakota. You are sure to find affordable medical insurance for you and your family.

Since the new healthcare law went into effect March 2010, individual major medical insurance plans and employer sponsored group health plans have undergone many positive changes that will benefit you. This includes mandated coverage for preventive care services and expanded eligibility for young adults less than age 26. For a summary of the new healthcare law and timeline, including the latest information regarding new consumer protections, visit our healthcare reform blog.

Other types of health insurance that you can shop and apply for online through this site for South Dakota include:

Individual Dental Insurance

Are you one of 150 million estimated Americans who do not have dental insurance? If so, have you considered an individual dental insurance plan? Full coverage dental insurance helps maintain proper health and financial well-being. Choose from a variety of plans in South Dakota. You can even continue to use your own dentist! Inexpensive dental insurance is perfect for students too. Get a quote and apply online today. It is fast and easy!

Short Term Medical Insurance

Are you between jobs? Want a more affordable alternative to COBRA continuation coverage? Need student medical insurance? If yes, then short term medical insurance may be right for you. These affordable temporary health insurance plans help individuals in South Dakota fill a short term gap in coverage, usually 12 months or less. Short term medical insurance also help individuals maintain continuous health insurance coverage in order to preserve HIPAA eligibility status. This is important because HIPAA eligible individuals are guaranteed the right to purchase individual major medical insurance, regardless of their health status.

Guaranteed Health Insurance

If you are unable to qualify for individual major medical insurance in South Dakota due to a pre existing health condition or cannot afford it, then a guaranteed health insurance plan or mini med is an alternative worth considering. Also referred to as health insurance for pre existing conditions, this type of individual medical insurance is often called the cheapest health insurance. There is generally no medical underwriting so acceptance is usually guaranteed. Since benefit payments made by the guaranteed medical insurance plan are fixed, the coverage is not considered major medical insurance. Additionally, health conditions that existed prior to the effective date of the medical insurance policy are not covered for typically 12 months. Having some form of medical insurance, however, enables individuals to gain access to the healthcare system in South Dakota and typically receive a higher level of care than if they did not have health insurance. Think about it. What is one of the first questions a healthcare provider asks when making an appointment? “Do you have medical insurance?”

Medical Insurance Overseas

Are you traveling from South Dakota to a destination outside the United States or taking a school trip to another country? Medical insurance overseas and international student medical insuranceis designed to provide additional protection should you or a family member require healthcare overseas. Since most individual medical insurance offers limited or no coverage outside the United States, make sure you are adequately protected before you leave South Dakota. Medical insurance overseas and international student medical insurance provides additional benefits, such as emergency air evacuation and travel assistance if you lose your passport or experience flight delays or cancellations due to weather or other causes.

Critical Illness Insurance

Could your nest egg withstand the financial impact of a critical illness? Even though medical insurance covers the cost of medical services and supplies, surgery and hospitalization, there are still many uninsured expenses, such as deductibles, prescription drugs, home healthcare and private nursing, and lost income/ wages. Critical illness protection insurance will pay a lump sum of cash upon the first diagnosis of a critical illness. Critical illness protection works well with a high deductible medical insurance plan because the premium savings can be used to pay for critical illness insurance and the cash benefit can help cover the high deductible.

Prescription Drug Card

Do you not have medical insurance in South Dakota that covers prescription medication? Are you paying for expensive drugs out of your pocket? If yes, then consider a prescription drug card. It can help make the cost of prescription medication more affordable for you and your family. Learn more about how a prescription drug card can help you today!

Free Health Discount Plan

As a thank you to our South Dakota visitors, we offer a free health discount plan (not insurance). You will save 13% to 65% on prescriptions at 50,000 participating pharmacies nationally, including major chains. Also, save 25% to 40% over usual dental charges at 101,000 dental providers nationally, and 10% to 50% off eyewear, contact lenses and corrective surgery at 10,500 optical centers and major vision chains! No personal information required. This free drug discount card is even valid on many prescriptions for your pet! Get your free health discount plan now!

State Facts & Health Statistics South Dakota U.S. Overall
Total Population 795,300 303,343,300
Life Expectancy (years) 78.6 78.0
Median Annual Income $48,416 $49,949
Healthcare Spending per Person $5,327 $5,283
Average Annual % Growth- Healthcare Spending 7.0% 5.5%
Uninsured Population 103,800 49,997,900
Average Daily Cost of Inpatient Hospital Stay $929 $1,782
Adult Smokers* 17.5% 18.3%
Adult Overweight/ Obesity Rate* 64.4% 60.8%
Child Overweight/ Obesity Rate* 28.4% 31.6%
Adults with Diabetes* 7.2% 8.3%
Alzheimer’s Deaths per 100,000 30.2 22.7
Invasive Cancer Rate per 100,000 407.0 461.8
Heart Disease Deaths per 100,000 159.10 190.9

* % of population
Kaiser Family Foundation Reports- state health facts 2005-2010

Medical Insurance South Dakota

  • How competitive is your state's individual medical insurance marketplace?

    A new report by the Kaiser Family Foundation reveals the results of an in depth study into the competitiveness of each state’s individual health insurance marketplace. The results will likely surprise you. This report is important because a “competitive” market is considered healthy and robust with no one insurer dominating the market place. Generally speaking, a more competitive market translates to more affordable medical insurance.

    The greater a health insurance company’s market share, for example, the more leverage it has to negotiate deeper discounts with healthcare providers. If the claims expense of other health insurers is higher, then it is more difficult for these carriers to compete for business (higher cost of doing business means higher premiums are needed to cover the added cost).

    For purposes of this study, two factors were measured to determine the competitiveness of each state’s health insurance market. They were: 1) evaluating how much of the marketplace is controlled by one medical insurance company or health plan, and 2) counting the number of insurance companies that compete in the state that have at least a five percent market share.

    Why these two factors? If one health insurer, for example, controls more than 50% of the individual medical insurance marketplace, then that carrier is able to exert more influence over the market, thereby resulting in a less competitive environment. On the other hand, if there are many medical insurance carriers competing for business in a given market with no one company controlling more than 50% of the marketplace, then that market is considered more competitive.

    “Competitive” does not necessarily mean, however, that medical insurance premiums in the state are low cost and affordable. Although New York, for example, has a very competitive individual medical insurance market (five 5 insurers with more than a five percent market share with no one carrier having more than 34% market penetration), it is one of the least affordable states for medical insurance. Why? Medical insurance premiums are based on the cost of healthcare. If the cost of medical services and supplies are expensive, then so will the cost of insurance. In sharp contrast to New York is Alabama. Considered the least competitive market for individual medical insurance, Alabama has only two insurers with more than a 5% market share, but one carrier has an 86% market share.

    States with the least competitive individual medical insurance marketplace include:

    • Alabama
    • District of Columbia
    • Illinois
    • Indiana
    • Iowa
    • Kentucky
    • Louisiana
    • Maryland
    • Minnesota
    • Nebraska
    • New Hampshire
    • New Jersey
    • North Carolina
    • North Dakota
    • South Dakota
    • Vermont
    • Virginia

    States with the most competitive individual medical insurance marketplace are:

    • Colorado
    • Georgia
    • Missouri
    • New York
    • Oregon
    • Pennsylvania
    • Tennessee
    • Wisconsin

    The three states with the highest number of health insurance companies competing for individual medical insurance business are Colorado, Georgia and Oregon.  Each of these states has seven health insurers that have at least a five percent market share.

    As it relates to the remaining states not mentioned above, the study reported that a single insurer dominated at least 50% of the individual market, resulting in a less competitive climate.

    Regardless of what state you live in, it always pays to shop for an individual medical insurance plan to ensure you secure the highest quality, lowest cost health insurance plan available. Our online health insurance quotes will enable you to run side by side comparisons of health plans from top medical and dental insurance carriers in your state. Get started today!

  • Medical Insurance Options - South Dakota

     South Dakota Medical Insurance– low cost medical & dental insurance quotes

    South Dakota - Find Medical Insurance

    Having adequate, affordable medical insurance is essential because it helps ensure access to quality healthcare and helps pay for the high cost of medical services, supplies, surgery and hospitalization. You and your dependents may be eligible for one or more of the following alternatives in South Dakota:

    Medical insurance for young adults less than age 26 - South Dakota

    Under the new healthcare law, called the Patient Protection and Affordable Care Act (PPACA), effective September 2010, young adults covered their parent’s medical insurance are eligible to remain covered up to age 26. Previously, most young adults “aged off” their parent’s medical insurance when they turned 19 or graduated from college. The young adult is not required to live with their parents to be eligible. They can even be married. Find more details regarding medical coverage for adults less than age 26 by visiting our healthcare reform blog.

    Guaranteed health insurance for children less than age 19 – South Dakota

    Also under PPACA, effective September 2010, medical insurance companies and health plans must provide coverage to children less than age 19, regardless of their health status. Previously, all applicants regardless of age could be denied individual medical insurance or have restrictions put on their medical insurance (Exclusionary Endorsements or Elimination Riders) that exclude pre-existing medical conditions from being covered. For more information regarding guaranteed health insurance for children less than age 19, visit our healthcare reform blog.

    COBRA continuation coverage – South Dakota

    Passed by Congress in 1985, the Consolidated Omnibus Budget Reconciliation Act requires health insurance continuation coverage be offered to employees, their spouses, their former spouses and their dependent children when group health coverage would otherwise be lost due to specific events. Continuation coverage must be made available for 18, 29, or 36 months. Although generally expensive, COBRA can be an excellent alternative for individuals who cannot obtain an individual or self-employed medical insurance policy due to pre-existing health conditions. For COBRA eligibility rules and other details, visit our research center.

    Conversion policy

    For individuals currently covered under an employer (group) health insurance plan that are leaving the employer, it might be possible to convert the job-based health insurance plan to an individual medical insurance policy. This is called “conversion” coverage. It is not the same COBRA continuation coverage because benefits are usually reduced or limited. Contact your employer or employer (group) health insurance carrier for information.

    HIPAA coverage – South Dakota

    The Health Insurance Portability and Accountability Act (HIPAA) guarantees the right to purchase private major medical insurance to “HIPPA eligible individuals,” regardless of their health status. HIPAA also prohibits medical insurance companies from excluding or restricting coverage for pre-existing conditions. This is important because most private health insurance is currently medically underwritten, except for children less than age 19 as explained above. Consequently, individuals 18 and older with medical conditions may not qualify.

    A “HIPAA Eligible Individual” is someone who has/ is:

    1. Had continuous (no break in coverage for 63 days or longer) credible medical insurance coverage for at least eighteen months with the most recent coverage being under a group health plan,
    2. Lost group coverage due to circumstances other than fraud or non-payment of premium (whether you quit your job, were fired or laid off does not matter),
    3. Elected and exhausted COBRA continuation coverage, if eligible (employers less than 20 employees are not subject to COBRA),
    4. Not be eligible for coverage under another group health plan, Medicare or Medicaid, and
    5. Not currently covered under a medical insurance plan

    In South Dakota, “HIPAA eligible individuals” may purchase individual medical insurance directly from South Dakota’s High Risk Pool. The state’s High Risk Pool is required to offer individual medical insurance regardless of a person’s health status. For more details regarding HIPAA visit our research center.

    Medicaid – South Dakota

    Medicaid offers healthcare coverage to certain people with limited income that meet South Dakota’s Medicaid eligibility requirements. Generally, children and parents, pregnant women, people with disabilities, and seniors are included. Medicaid programs are run by states with a mix of state and federal funding. There are certain core rules all states must follow, but some Medicaid rules vary by state.

    Since most states are currently facing severe budget deficits, Medicaid eligibility rules and benefits provided under the program may have recently changed. Please visit South Dakota’s Medicaid program for current information and details.

    State Children’s Health Insurance Plan – South Dakota

    If you are seeking health insurance for your children, President Obama signed the Children’s Health Insurance Bill on February 4, 2009. It enables millions of children to receive health insurance. The eligibility rules for the Children’s Health Insurance Plan are unique because every state has its own program and rules. Generally, uninsured children 18 years old and younger whose families earn up to $44,500 a year (for a family of four) are eligible for free or low-cost health insurance that pays for doctor visits, dental care, prescription medicines and hospitalization.

    Since most states are currently facing severe budget deficits, eligibility rules and benefits provided under South Dakota’s Childrens Health Insurance Plan may have recently changed. Please visit South Dakota’s State Childrens Health Insurance Plan for current information and details.

    Pre-Existing Condition Insurance and High Risk Pool Plans (PCIP) – South Dakota

    The PCIP is a new program offered in every state under the new healthcare law. It can be administered by either states or the Federal government. The PCIP may be able to help you if are unable to qualify for individual major medical insurance. You may qualify if you have been:

    1. Uninsured for at least six months
    2. Have a pre-existing medical condition(s), and
    3. Have been denied coverage (or offered insurance without coverage of the pre-existing condition) by a private health insurance company.

    PCIP covers major-medical and prescription drug expenses. You’re responsible for paying premium, deductible, copayments, and coinsurance amounts. PCIP will not cost you more just because of your health condition. PCIP is not based on income eligibility like Medicaid.

    Visit South Dakota’s Pre-Existing Condition Insurance Plan for details.

    Guaranteed Health Insurance

    Guaranteed Health Insurance, also called Mini-Med, Limited Benefit or Pre-Existing Condition Medical Insurance is another option if you are unable to qualify for individual major medical insurance. Since most Guaranteed Health Insurance Plans are not medically underwritten acceptance is guaranteed.

    While considered supplemental medical insurance, not major medical insurance, these plans typically pay a fixed dollar amount for covered healthcare expenses, such as physician office visits, diagnostic services, lab, x-ray, surgery, inpatient confinement and wellness.

    Individuals purchase Guaranteed Health Insurance because they:

    • Cannot qualify or afford individual major medical insurance
    • Want to save money on healthcare expenses by paying reduced fees (discounts with participating healthcare providers can range from 10 to 25% and eliminate balance billing- owing the healthcare provider the difference between their retail charge and the rate negotiated by the preferred provider network)
    • Want an ID Card to gain access to the healthcare system in the event that unexpected medical care is needed.

  • Regulation of Medical Insurance Premiums - South Dakota

     South Dakota Medical Insurance– low cost medical & dental insurance quotes

    The oversight of individual, self-employed and small employer medical insurance happens at the state level. Since every state has its own unique set of regulations aimed at maintaining low cost medical insurance, the laws governing health insurance contracts vary dramatically. Some states have the authority to disapprove a health insurance company’s premium increase, while others simply review rates but do not have the authority to reject an increase. The laws also differ based on the type of medical insurance policy offered by the health insurance company and how their policy is filed in Tennessee. Some health insurance policies are filed directly with Tennessee, while others are considered “out-of-state” trust or group association arrangements. The former are generally subject to greater regulation thereby giving Tennessee more control and authority over what benefits must be provided and the premiums that can be charged.

    In Tennessee, rates for health insurance policies must generally be filed but can be used immediately without formal “approval” after 30 days. This type of limited oversight often relies on consumer complaints to indicate a problem, so individuals are not always protected against large medical insurance premium increases.

    New medical insurance rate review requirements

    Since medical insurance premiums have doubled during the past 10 years, under the new healthcare law, called the Patient Protection and Affordable Care Act (PPACA), Congress enacted special rate review provisions to help consumers get “better value for their health care dollars.” PPACA requires the U.S. Department of Health & Human Services (HHS) to work in collaboration with state insurance commissioners to review “unreasonable increases in medical insurance premiums.”

    The new healthcare law also requires medical insurance companies and health plans that propose an “unreasonable” rate increase to provide justification for the increase to HHS, and post the justification on their websites. Additionally, in order to promote price transparency, HHS asked the National Association of Insurance Commissioners (NAIC) to develop a standard rate filing disclosure form that all health plans must use when justifying unreasonable rate increases to HHS and South Dakota. The goal is to ensure that regulators and the public can access the data and justifications in a way that allows for “apples-to-apples” comparisons. “Grandfathered” health insurance policies (medical insurance that was effective before March 2010 when the new healthcare law was enacted) are exempt from this new rate review requirement.

    State grants to support review of medical insurance premiums and rate increases

    Lastly, PPACA provides a pool of $250 million in grant funding for state insurance departments to support an enhanced review of medical insurance rates and premium increases. It should be noted that PPACA does not alter South Dakota’s existing regulatory authority over health insurance rates and premium increases.


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