Medicare Advantage Plans (Medicare Part C) in South Dakota
Discover Your Options for Medicare Advantage Plans in South Dakota – Learn about the Benefits, Costs, and Provider Networks of Medicare Part C Plans Available in South Dakota.
Summary:
Medicare beneficiaries in South Dakota that are enrolled in Original Medicare, Part A and Part B, have the option of enrolling in a Medicare Advantage plan that offers the same coverage as Original Medicare with the potential for additional benefits. Additional benefits may include vision, dental, or prescription drug coverage. These plans are offered through private insurance companies, so costs and coverage may vary depending on your location in South Dakota.
Why choose a Medicare Advantage plan?
Prescription drug coverage
Prescription drug coverage is included in most Florida Advantage plans, a benefit not offered by Original Medicare.
Affordable or $0 premiums
Many Florida Medicare Advantage plans offer affordable or even $0 monthly premiums and deductibles.
Dental, vision and hearing care
Most Florida MA plans include coverage for dental, vision and hearing care, benefits not offered by Original Medicare. (Benefits vary by state and/or region.)
Understand Medicare Part C in South Dakota
Medicare Advantage Plans offer a few key differences that distinguish them from Parts A and B of the Original Medicare system managed by the federal government. While Part A pays for inpatient care at a hospital and Part B covers services and supplies used to treat or prevent medical conditions, Medicare Advantage Plans come with a few added benefits.
Plans are required to offer the same level of care as Original Medicare and may include additional health care benefits, such as prescription drug coverage, routine hearing, vision, and dental exams, and fitness club memberships:
Designed to be an all-in-one solution, Medicare Advantage Plans are offered by Medicare-approved private insurance companies. There are several types of Medicare Advantage Plans available, depending on your insurance provider and location. Learn the differences between these plans and how they affect your coverage so that you can make the right choice for your medical situation.
Medicare Advantage Plans in South Dakota
Compare ratings of some of South Dakota’s Medicare Advantage Plan providers:
| Compare Medicare Advantage Plans in South Dakota | ||||
| Insurance company | Medicare rating | A.M. Best rating | BBB rating | J.D. Power ranking |
| Aetna | 4 stars | A | A+ | 6th out of 9 |
| Blue Cross Blue Shield | 4.5 stars | A | A+ | Not rated |
| Humana | 4 stars | A- | A+ | 2nd out of 9 |
| UnitedHealthcare | 3.5 stars | A- | A- | 4th out of 9 |
How to Choose a Medicare Advantage Plan in South Dakota
Consider these factors as you compare Medicare Advantage Plans available in your area:
| How to compare Medicare Advantage Plans in South Dakota | ||
| Monthly premium | In addition to your regular monthly payment for Medicare Part B, you will also have to pay an extra premium for Medicare Part D drug coverage. This payment is mandatory and remains the same regardless of whether you use your benefits or not. It's a good idea to find a plan in your area that includes drug coverage, with no additional premium, to reduce your overall healthcare costs. | |
| Provider network | It's important to confirm if your doctors, hospitals, and pharmacies are included in the network of your plan to ensure that you can receive the lowest possible costs for your healthcare. | |
| Out-of-pocket max | The maximum amount that you will pay for Medicare-covered services is limited, excluding your premium, deductible, and drug expenses, as long as you adhere to the plan's guidelines for both in and out of network coverage. | |
| Deductibles, coinsurance & copays | Cost-sharing expenses are incurred when you utilize your benefits and may vary depending on the type of plan you have. It's recommended to review your plan's fees for doctor's visits, treatments, services, and prescription drugs. | |
| Drug coverage/formulary | It's important to check whether the medication you take is listed in the plan's formulary and the cost for each prescription fill. Discuss with your doctor the possibility of using generic or alternative options for your medication needs. | |
| Additional benefits | When choosing a plan, think about which additional benefits are essential to you. Keep in mind that many plans have network requirements and may charge higher premiums for more extensive coverage. | |
Types of Medicare Advantage Plans in South Dakota
South Dakota’s Medicare Advantage program offers four plan options, namely Health maintenance organization (HMO), preferred provider organization (PPO), private fee-for-service (PFFS), and special needs plan (SNP). The level of flexibility in the network of care providers and the cost of each plan may vary. However, all Medicare Advantage Plans provide the same coverage as Original Medicare. Depending on the plan, you may receive additional benefits at an increased premium.
HMOs
HMO’s typically require that you receive all services from in network providers:
- you must designate a primary care physician (PCP) and obtain referrals for specialist care and some prescriptions.
- Drug coverage is usually included. You aren’t able to purchase standalone drug coverage.
- Staying within the plan’s network results in lower out-of-pocket costs.
PPOs
PPO’s are only for people with specific conditions and characteristics, and include care coordination and targeted benefits tailored to meet your specific needs:
- You don’t need to choose a primary care doctor or obtain referrals for specialists.
- Drug coverage is typically included.
- You aren’t able to purchase stand-alone drug coverage.
- Higher out-of-network costs and premiums.
PFFS Plans
PFFS plans don’t require a primary care physician or referrals for specialists:
- You can go to any Medicare-approved health care provider or facility that accepts the plan’s payment terms and agrees to treat you.
- May include drug coverage, or you can purchase a standalone drug plan.
- Higher cost if you choose a provider that doesn’t agree to the plan’s terms.
SNPs
SNP’s are only for people with specific conditions and characteristics, and include care coordination and targeted benefits tailored to meet your specific needs:
- You need a primary care physician and referrals to specialists.
- Drug coverage is always included.
- If you’re eligible, you can join an SNP at any time.
When to sign up for Medicare Advantage Plans in South Dakota
To qualify for enrollment in a Medicare Advantage Plan in South Dakota, you must first be enrolled in both Medicare Part A and Part B, and cannot have an existing Medigap plan. This option is available to individuals aged 65 and above as well as those with a qualifying disability.
There are three periods when you can enroll:
- The first is the Initial Coverage Election Period when you first become eligible. This period includes the three months before your 65th birthday, the month of your birthday, and the three months following. If you have a disability, this period will occur three months before or after your 25th month of receiving benefits.
- The Annual Election Period runs from October 15 to December 7. During this period, you can switch from Original Medicare to a Medicare Advantage Plan. If you’re already enrolled in Medicare Advantage, you can switch between plans during this period.
- The Open Enrollment Period takes place between January 1 and March 31. You can switch between Medicare Advantage Plans or go back to Original Medicare during this period.
Our Agents
Our team is made up of compassionate, friendly individuals who understand the unique needs of older adults. We take the time to listen to your concerns and provide personalized solutions that work for you. We provide additional and detailed information on Medicare Health Plans and a no-cost plan comparison to determine if you qualify for additional benefits.
