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Medicare in South Dakota

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By the numbers

The following is some information on Medicare enrollment in South Dakota as of December 2018*:

  • Number of beneficiaries enrolled in Medicare Advantage or other Medicare health plans: 35,459
  • Number of beneficiaries who have Medicare prescription drug coverage: 119,269
  • Total number of beneficiaries enrolled in Medicare: 172,774

Original Medicare is the government-sponsored health insurance program for American citizens and legal permanent residents of at least five continuous years who qualify by age or disability. You’re usually eligible when you turn 65 unless you qualify through disability or having certain health conditions. Original Medicare includes Part A, hospital insurance, and Part B, medical insurance. You might be automatically enrolled into the program when you turn 65 or receive disability benefits for a certain period of time.

You might have other Medicare plan options in South Dakota beyond Original Medicare. For example, if you decide to stay with Original Medicare, you can add a Medicare Part D Prescription Drug Plan and a Medicare Supplement insurance (Medigap) plan, described below.

  • Original Medicare doesn’t come with prescription drug coverage, except in limited situations. For example, Medicare may cover prescription drugs you receive as a hospital inpatient as part of your care, or certain drugs that are administered to you as a hospital outpatient. So if you want coverage to help pay for your daily prescription medications, you may want to consider a stand-alone Medicare Part D Prescription Drug Plan. Available from private insurance companies approved by Medicare, Medicare Prescription Drug Plans work alongside your Original Medicare coverage.
  • What about the out-of-pocket costs of Original Medicare? Some examples of these costs are copayments, coinsurance, and deductibles. To help pay these expenses, you can apply for a Medicare Supplement insurance (Medigap) plan. Ten standardized Medigap plans are available in most states, including South Dakota.

Instead of getting your Medicare benefits through Original Medicare, you may have another choice: Medicare Advantage (Medicare Part C). Offered by private, Medicare-approved insurance companies, Medicare Advantage plans include the same benefits covered by Medicare Part A and Part B (except hospice care, which is still covered under Medicare). Many Medicare Advantage plans offer additional benefits, such as prescription drug coverage, routine dental care, or routine hearing care. You must continue paying your Medicare Part B premium, along with any premium the plan may charge.

Medicare resources in South Dakota

Medicare Savings Programs in South Dakota: Residents with limited income and resources who struggle to pay their health-care costs can apply for Medicare Savings Programs in South Dakota. These plans may help pay for some or all of your out-of-pocket health-care expenses if you qualify.

South Dakota State Health Insurance Counseling and Assistance Program (SHIP): Senior Health Information and Insurance Education (SHIINE) is South Dakota’s free and unbiased information resource for beneficiaries. SHIINE can help you understand Medicare and your benefits, with offices and staff in various locations in South Dakota.

* Statistical data from the Centers for Medicare & Medicaid Services (CMS) “Medicare Enrollment Dashboard,” from the CMS Office of Enterprise Data & Analytics, February 2019.

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