Key takeaways

  • Medicare is available in South Dakota to eligible U.S. citizens and permanent residents, including those 65 years and older, as well as those younger than 65 with certain chronic conditions or disabilities.
  • In South Dakota, numerous Medicare Advantage plans are offered by private health insurance carriers, with varying costs and coverage options depending on the county and zip code.
  • Part D plans for prescription medications are available alongside Original Medicare, with costs varying by location. Many enrollees may find options with lower premiums than in previous years.

Medicare is a health insurance program for people 65 and older, as well as people of any age who have certain health conditions and disabilities.

It’s made up of four parts:

  • Part A (hospital insurance) and Part B (medical insurance) are known as Original Medicare
  • Part C, also known as Medicare Advantage, is an alternative to Original Medicare
  • Part D, which is prescription drug coverage

You can also purchase a supplemental insurance plan (Medigap) to help cover certain out-of-pocket costs associated with Original Medicare.

Snapshot of Medicare in South Dakota

The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in South Dakota for the 2026 plan year:

  • A total of 201,439 residents of South Dakota were enrolled in Medicare.
  • The average monthly Medicare Advantage plan premium changed from $36.74 in 2025 to $57.85 in 2026.
  • There are 19 Medicare Advantage plans available in South Dakota for 2026, compared with 28 plans in 2025.
  • Around 95.8% of South Dakotaresidents with Medicare have access to buy a Medicare Advantage plan, with 92.45% having access to a $0 premium.
  • In 2026, 11 stand-alone Medicare Part D plans are available in South Dakota, and the lowest monthly premium for a stand-alone Part D plan is $4.70.
  • 15.72% of people with a stand-alone Part D plan get Extra Help.
  • As in most states, 10 different Medigap plans are offered in South Dakota in 2026.

Medicare is more than just one part. Different plans and components cover various aspects of your healthcare.

  • Original Medicare: Original Medicare is managed by the federal government and includes two main parts: Part A (hospital insurance) and (medical insurance). Neither part covers prescription drugs.
  • Medicare Advantage (Part C): Medicare Advantage plans are provided by Medicare-approved private insurance companies and offer the same benefits as Original Medicare. They may also cover benefits like vision, dental, or prescription drugs. Some plans have limited provider networks, so confirm your doctors and facilities are in-network before enrolling.
  • Medicare Part D: Medicare Part D is also offered by Medicare-approved private insurance companies and provides coverage for prescription drugs. If you have Original Medicare, you can purchase a stand-alone Part D plan. If you have a Medicare Advantage plan without prescription drug coverage, you can speak with your insurer to verify if you can purchase a stand-alone Part D plan.
  • Medicare supplement (Medigap): Medigap plans help cover some of the costs associated with Original Medicare coverage, which might include copays and coinsurance. Medigap plans are standardized in most states, and you can choose among 10 plans to supplement Original Medicare. You cannot use Medigap with Medicare Advantage.

For all private Medicare options, availability varies by county, so check Medicare.gov for what’s available in your area.

If you live in South Dakota, you can qualify for Medicare at age 65 if you’re a U.S. citizen or legal resident for at least 5 years. If you’re under 65 years, you may also qualify through disability or by living with end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

When choosing a plan, consider provider networks, costs, and quality ratings. You may be able to join a plan or modify your coverage during one or more of the following enrollment periods:

  • Initial enrollment: Enroll 3 months before to 3 months after the month of your 65th birthday.
  • Open enrollment: Join or change plans from October 15 to December 7.
  • Medicare Advantage open enrollment: Switch Medicare Advantage plans or return to Original Medicare from January 1 to March 31 if you already have Medicare Advantage.
  • Special enrollment period: Enroll after a life change, such as losing job-based coverage.

If you’re eligible for Medicare due to a disability, you’ll be automatically enrolled. If you’re eligible based on age, you’ll need to enroll yourself.

The following resources in South Dakota can help you make the best Medicare decisions for your circumstances:

  • Senior Health Information & Insurance Education: Visit SHIINE to learn more about Medicare, access SHIINE counseling, and get help in your area. 800-536-8197.
  • South Dakota Department of Social Services: Learn more about Medicare, Medicaid, and Long Term Care Support. 605-773-3165.

Carefully consider the Medicare coverage you need in 2026 and whether Original Medicare, an Advantage plan, or a prescription drug (Part D) plan is right for you.

It’s a good idea to make a list of the plans that provide the right drug coverage, fit your budget, and are accepted by your doctor. You can use Medicare’s plan finder to compare these plans and decide which one will give you the best coverage available in South Dakota.