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A Guide to Medicare in South Dakota

September 25, 2023

A Guide to Medicare in South Dakota

In South Dakota, 17.2% of the population is 65 or older. That means many residents may have questions about Medicare and how they can use the coverage to their advantage.

This guide will answer common questions about Medicare and help you understand what coverage options are available so that you can compare plans and choose what’s best for you. We also have licensed agents you can talk to when comparing and choosing your Medicare plan.

Does South Dakota have Medicare?

Medicare is a national program that provides health coverage for older Americans, as well as those with specific health conditions. As a result, Medicare is available in all states, including South Dakota. 

In order to qualify for Medicare, you need to be a U.S. citizen or permanent resident and have lived in the country for at least five years. Also, one of the following needs to be true:

  • You’re age 65 or older
  • You’re under 65 but disabled and receiving disability benefits from Social Security or the Railroad Retirement Board
  • You have end-stage renal disease (ESRD)
  • You have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease

Many people are enrolled in Medicare automatically as soon as they are eligible. However, if you don’t review your coverage, you’ll be stuck with the default options. The default Medicare is called Original Medicare, which includes two parts:

  • Part A covers inpatient hospitalization.
  • Part B covers doctor’s visits, outpatient care, medical equipment, and more. 

If you want to add Medicare Part D, for prescription drug coverage, you’ll need to do that during your initial enrollment period. You won’t get drug coverage automatically. Also, if you want a Medigap plan (Medicare Supplement) to help you cover your Original Medicare costs, you have automatic acceptance during your first enrollment period. After that, you’ll have to qualify.

Another option that many seniors prefer is Medicare Advantage or Medicare Part C. We’ll look at that in more detail now.

Is Medicare Advantage Available in South Dakota?

Medicare Advantage plans are a full replacement for Original Medicare and often include drug coverage and extra benefits. Because Medicare Advantage is sold by private insurance companies and has a limited medical network, the plans differ from state to state. 

There are more than 180,000 people enrolled in Medicare Advantage in South Dakota and more than 1.1 million people who receive Prescription Drug Plan benefits.

Medicare Advantage in South Dakota can give you benefits you can’t get from Original Medicare, including dental and vision coverage, low-cost gym memberships, and more. These benefits can vary based on the provider so it’s important to select a plan that offers the specific coverage that you need.

Before you enroll, it’s important to ensure your medical providers are part of the Advantage plan network. Many Medicare Advantage plans do not provide non-emergency care outside of the network. Learn more about the differences between Original Medicare and Medicare Advantage.

If you travel frequently, you may find that Original Medicare makes more sense for you. However, if you’re usually in your local area and can find a plan with an appropriate medical network, an Advantage plan can help you get more benefits than Original Medicare.

Be sure you compare plans carefully to ensure you get the best option for your money. Some Medicare Advantage plans don’t cost anything above your Part B premium, while others have additional monthly costs. Learn more about Medicare costs, premiums, and deductibles in this guide. 

Learn More About Medicare in South Dakota

We hope this page helped to answer some of your questions about Medicare in South Dakota. However, you may have additional questions or want to talk to someone about how to compare plans for the best benefits. Talking to a licensed insurance agent can help. Contact us today for assistance in choosing the best Medicare plan for your needs!


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