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- 10.1%average approved 2027 increase for full price plans in South Dakota
- 0major carriers announced leaving South Dakota for 2027
- Nov 1when you can start comparing 2027 plans
What is happening in South Dakota
No major carrier has announced it is leaving the South Dakota individual market for 2027.
The bigger change is cost. Carriers in South Dakota filed for an average increase of about 10.1% for 2027 (approved rates) for people who pay full price. Nationally, many carriers point to the same cause: the extra federal subsidies expired at the end of 2025, some healthier people left the marketplace, and the people who stayed cost more to cover on average.
2027 in South Dakota: who is selling and what it costs
Three companies sell marketplace plans in South Dakota, and all three are back for 2027: Avera Health Plans, Sanford Health Plan and Wellmark Blue Cross Blue Shield. In 2026 Avera and Sanford sold in the whole state, while Wellmark sold in 42 of the 66 counties. That left two marketplace choices in the other 24 counties.
The final average increase is about 10.1%, according to ACA Signups. Avera requested about 11.7% and Sanford requested about 11.5% to 11.8%, depending on the product. Averages hide a lot here. Sanford's filed changes ran from a 17.86% decrease to an 18.87% increase, depending on the plan and region. Your own renewal can look very different from the state number, which is why it is worth reading closely.
South Dakota uses HealthCare.gov. Open enrollment runs November 1, 2026 to January 15, 2027. Pick a plan by December 15 for a January 1 start. Voters expanded Medicaid, and it took effect in July 2023. Because of that, adults with income between 100% and 138% of the poverty level now qualify for Medicaid instead of marketplace subsidies. 50,951 South Dakotans picked a plan for 2026, down from a record 54,721 in 2025.
With only three companies, the networks matter as much as the price. Avera and Sanford are both tied to their own hospital systems, so checking that your doctors are in network comes first.
Where carriers are leaving
The exits are real, just not in South Dakota. Cigna is leaving the individual market in all 11 states where it sells. Baylor Scott & White is leaving Texas, CareSource is leaving Indiana, Ohio and West Virginia, Medica is leaving Iowa, Kansas and Oklahoma, and several smaller carriers are leaving other states. If you moved recently or have family elsewhere, the all states overview lists them.
What the price change means for you
If you get a subsidy, the headline increase is not what you pay. Your subsidy is recalculated on your estimated 2027 income, and it usually absorbs much of a price increase. Updating your income estimate matters more than the rate filing.
If you do not get a subsidy, you feel the full increase. This is where it pays to compare more than one kind of coverage. Private major medical plans are priced differently from ACA plans, and for many people who pay full price they can cost less for similar or better coverage. I compare both, side by side, so you can see the real numbers for your household.
The practical point: if you do nothing, most plans renew automatically at the new 2027 price. Automatic renewal does not check whether a different plan now costs less or fits your doctors better. That check takes a few minutes.
The dates that matter
- Fall 2026Renewal notices arrive with your 2027 price. Read it, even if you plan to keep your plan.
- November 1, 2026Open enrollment opens for 2027 coverage. You can compare and choose from this date.
- December 15, 2026Deadline to pick a plan that starts January 1, 2027.
- January 15, 2027Open enrollment closes. After this you generally need a qualifying life event to change plans.
What to do, in order
Read your renewal notice
It shows your 2027 premium and any plan changes. Compare it with what you pay today.
Write down your doctors and your prescriptions
The physicians you want to keep and the exact drugs with dosages. Networks and drug lists change from year to year even when the carrier stays.
Re-estimate your income for 2027
Your subsidy is based on your estimated income for the year ahead. If it changed, your real cost changes with it.
Compare before December 15
Compare on total cost, meaning premium plus deductible plus what you expect to use, and include private options if you pay full price.
Common questions
Is my health insurance company leaving South Dakota in 2027?
Based on the 2027 rate filings, no major carrier has announced an exit from the South Dakota individual market. If you receive a notice that your specific plan is being discontinued, keep it, because it can qualify you for a special enrollment period.
Why is my premium going up for 2027?
Carriers in South Dakota filed for an average increase of about 10.1% (approved). Rising medical costs and the end of the extra federal subsidies after 2025 are the main reasons carriers give. If you get a subsidy, your net cost depends on your 2027 income.
Do I have to use a broker?
No. You can enroll yourself at HealthCare.gov at no cost. A licensed broker also costs you nothing, because brokers are paid by the carriers and the premium is identical either way. A broker can also show you private plans that are not sold on the marketplace.