The Best Medicare Supplement (Medigap) Plans in South Dakota
- If you have not yet enrolled in Medicare Supplement Insurance coverage as a Medicare recipient, you may be wondering about these plans. This review provides an overview of Medigap options in South Dakota.
Medicare Part A and B coverage is often referred to as Original Medicare. Medicare covers much of the cost of hospitalization and treatment for eligible participants in this federal health insurance plan. For expenses not covered under Medicare, however, many people seek the added financial help that a Medicare Supplement Insurance (Medigap) plan can provide.
About 72,300 people in the state of South Dakota currently have Medigap insurance plans in place. This represents almost half of those eligible for these supplementary insurance plans. If you are interested in Medigap in South Dakota, continue reading to learn more.
You can find Medicare Supplement plans where you live by comparing plans from several different insurance companies online.
What Are the Best South Dakota Medicare Supplement Plans?
In South Dakota and throughout most of the country, you can select from 10 standardized plans. Each of these plans is referred to by a letter.
|Medicare Supplement Benefits||A||B||C1||D||F1||G||K||L||M||N|
|Part A coinsurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B coinsurance or copayment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plans C and F are not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2. Plans F and G also offer a high deductible plan which has an annual deductible of $2,700 in 2023. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
3. Plan K has an out-of-pocket yearly limit of $6,940 in 2023. Plan L has an out-of-pocket yearly limit of $3,470 in 2023.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.
Although many different insurers may offer Medigap Plan A insurance, policies that bear the same letter will have the same coverage no matter who offers them. This standardized approach to Medigap insurance makes it easy to choose the most affordable plan without worrying about missing out on the coverage you need.
Each Medicare Supplement Insurance plan offered in the state of South Dakota covers both the required coinsurance for Medicare Part A and at least a portion of the copays required for Part B. Medigap plans also provide a full 365-day extension of hospitalization coverage in addition to that offered by Original Medicare.
The Medicare Access and CHIP Reauthorization Act of 2015 included provisions that removed access to Medigap Plans C and F for those who were not eligible for Medicare prior to January 1, 2020. Those who first enrolled in Original Medicare or who turned 65 before that date, however, can still enroll in these Medicare Supplement Insurance plans.
For South Dakota Medicare recipients, the most commonly chosen Medigap plans are Plans F, G and N. Affordability and coverage are among the most important features of these plans. The high-deductible versions of Medigap Plans F and G can feature affordable premiums. Plan N offers affordable copays for emergency room visits and routine medical care in your doctor's office.
How Do I Enroll in a South Dakota Medigap Plan?
The best time to enroll in Medigap coverage is during the initial six months starting with the first day of the month you turn 65 and become eligible for Medicare. During this six-month period, you can choose from among any of the available Medigap plans offered in South Dakota by any company. You cannot be turned down for these plans because of pre-existing conditions. Insurers must also offer you the policy you choose at the same premium rates that they would charge a healthy person. This only applies, however, during your initial six months of eligibility.
After your six-month period of open enrollment eligibility expires, insurers can take pre-existing conditions into account when determining the rates you will pay for your Medigap insurance. They may even decline to cover you at all if your medical conditions are deemed to be too risky. For these reasons, it is essential to obtain Medicare Supplement Insurance during the initial six-month eligibility period. Doing so could guarantee that you can get the plan you want at a rate you can afford.
Even if you do not take advantage of the guaranteed eligibility available to you in the first six months after you turn 65, you may still be able to obtain Medigap insurance on the same preferable terms. Guaranteed issue rights are available if you meet one of the following criteria:
- You have Medicare Advantage, and your plan stops providing service in your area or you move out of the coverage area.
- You chose Medicare Advantage over Medigap or switched from Medigap to Medicare Advantage and want to change back within a year of this decision.
- Your Medigap insurance company goes bankrupt.
These are not the only situations in which you may have guaranteed issue rights for Medigap coverage, but they are the most common ways in which you may be eligible for this preferential status in South Dakota.
You may be required to complete a waiting period of six months before you can receive treatment for pre-existing conditions. This is usually waived, however, if you have maintained insurance coverage for these conditions for six months or more prior to switching to Medicare and Medigap coverage.
AHIP. (Feb. 2023). The Sate of Medicare Supplement Coverage Trends in Enrollment and Demographics. https://www.ahip.org/documents/202301-AHIP_MedicareSuppCvg-v03.pdf.