With Original Medicare, there is no annual out-of-pocket limit, which could leave you owing substantial medical bills. Medicare Supplement plans in South Dakota help pay a variety of healthcare costs under Medicare Parts A and B. Commonly known as Medigap, the right amount of coverage for you depends on your unique situation.
How does Medigap work in South Dakota?
If you have Original Medicare, Medigap plans help pay your out-of-pocket costs. This includes Part A, inpatient care, and Part B, medical services.
There are 10 standard Medicare Supplement plans available in South Dakota (A, B, C, D, F, G, K, L, M, and N). Some insurers also offer high-deductible versions of one or more Medigap plans.
Supplement plans are standardized, meaning that you get the same benefits with Plan A (or D, G, etc.) no matter where you buy it. Costs are not standardized, but Medigap insurers must follow state and federal guidelines when setting premiums.
Unlike Original Medicare, you can be denied Medigap coverage if you don't have a guaranteed issue right – even if you qualify for Medicare. This is because insurance companies use a process called medical underwriting to decide whether to offer you a plan and at what rate. If you smoke, have preexisting health conditions, or are otherwise considered a high-risk enrollee, Medigap insurers may charge you higher premiums or even refuse to sell you a plan.
Who qualifies for Medicare Supplement Insurance in South Dakota?
At the federal level, you qualify for Medicare Supplement Insurance in South Dakota once you enroll in Original Medicare and are at least 65 years old. Most states, including South Dakota, also require Medigap insurers to offer plans to beneficiaries who qualify for Medicare due to a disability and are not yet 65 years old.
South Dakota is also one of the few states to limit how much Medigap insurers can charge under-65 beneficiaries. If you aren't yet 65, you can't be charged more than 75-year-old beneficiaries are.
What does Medigap cover?
Medicare Supplement coverage varies according to the plan you choose, although every Medigap plan pays the Medicare Part A coinsurance and gives you an additional 365 lifetime reserve days for hospital care.
Compare Medigap plan benefits with the following table:
Please note that Medicare Supplement Insurance does not include prescription drug coverage. You get those benefits with a standalone Medicare Part D prescription drug plan.
When is the best time to join a Medicare Supplement plan in South Dakota?
The best time to join a South Dakota Medicare Supplement plan is during your 6-month Medigap Open Enrollment Period (OEP), which starts the day you enroll in Original Medicare.
Your OEP is one of the few times you have guaranteed issue rights. If you're at least 65 years old, your application cannot be rejected AND you can't be charged a higher premium.
If you're under age 65, you're guaranteed a Medigap policy during your OEP but you'll most likely be charged a higher premium. The limits we mention above, though, curtail those extra costs. You receive a second Medigap Open Enrollment Period when you turn 65. At that point, you'll have the same protections as someone who's brand new to Medicare.
Medigap Plan C and Medigap Plan F in South Dakota
Thanks to a change in federal law, Medigap Plan C and Medigap Plan F are not available to people who qualify for Medicare on or after January 1, 2020.
We recommend either Medigap Plan D or Medigap Plan G instead, which offer the same benefits as Plans C and F, minus the Medicare Part B deductible. You also usually pay less for Plans D and G.
Choosing a Medigap plan in South Dakota
The first step is deciding how much coverage you want. We recommend choosing a plan with the most comprehensive benefits you can afford.
Next is cost. The pricing method gives you an idea of what will happen to your Medigap premium over time. Most Medigap insurers use one of three pricing methods:
- Attained-age rated: Premiums start out low but go up as you get older. These policies cost the most over time.
- Community rated: This pricing method does not consider your age. Over time, these plans cost the least.
- Issue-age rated: Premiums are based on your age at the time you join the plan but don't go up just because you get older. They may rise over time due to inflation, though.
Our Find a Plan tool makes it easy to compare Medigap plans in South Dakota. Simply enter your location information to review Medicare plan options in your area.
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