Medicare Advantage plans in South Dakota for 2027
East River has far more choice than the Black Hills, and the plan with the lowest out-of-pocket cap in the state is not technically a Medicare Advantage plan.
Clay, South Dakota: plans open to everyone on Parts A and B
14 plans
2 with a $0 premium and drug coverage · out-of-pocket limits $3,900 to $7,150 · best rating 4.5★ · 6 plan IDs of 2026 not renewed here
14 plans shown · monthly premium = Part C + Part D, before your Part B premium · stars: 2027 ratings published October 8, 2026
| Plan | Premium | Drug deductible | Max out of pocket | Stars |
|---|---|---|---|---|
| AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO)UnitedHealthcare · PPO · H2001-139-0 | $0 | no drugs | $7,150 | 4.5★ |
| Aetna Medicare Eagle Classic (PPO)Aetna Medicare · PPO · H1608-061-0 | $0 | no drugs | $7,150 | 3.5★ |
| Aetna Medicare Signature (PPO)Aetna Medicare · PPO · H5521-756-0 | $0 | $700 | $7,150 | 4.0★ |
| Aetna Medicare Signature Classic (PPO)Aetna Medicare · PPO · H1608-120-0 | $0 | $700 | $7,150 | 4.0★ |
| Medica Prime Solution Thrift (Cost)Medica · Cost · H2450-030-0 · was $49 in 2026 | $53 | no drugs | $7,150 | 3.0★ |
| Aetna Medicare Enhanced Classic Extra (PPO)Aetna Medicare · PPO · H1608-119-0 · was $52 in 2026 | $60 | $700 | $7,150 | 4.0★ |
| Aetna Medicare Enhanced Extra (PPO)Aetna Medicare · PPO · H5521-757-0 | $60 | $700 | $7,150 | 4.0★ |
| Align SecureChoice (PPO)Align powered by Sanford Health Plan · PPO · H8385-005-0 | $60 | $500 | $7,150 | 4.0★ |
| Medica Prime Solution Thrift w/Rx (Cost)Medica · Cost · H2450-007-0 · was $92.80 in 2026 | $91 | $700 | $7,150 | 3.0★ |
| Align SecureChoice Gold (PPO)Align powered by Sanford Health Plan · PPO · H8385-006-0 | $100 | $350 | $6,500 | 4.0★ |
| Medica Prime Solution Core (Cost)Medica · Cost · H2450-034-0 · was $98 in 2026 | $103 | no drugs | $4,900 | 3.0★ |
| Medica Prime Solution Premier (Cost)Medica · Cost · H2450-036-0 · was $217 in 2026 | $227 | no drugs | $3,900 | 3.0★ |
| Medica Prime Solution Standard (Cost)Medica · Cost · H2450-044-0 | n/a | no drugs | $7,150 | 3.0★ |
| Medica Prime Solution Standard w/Rx (Cost)Medica · Cost · H2450-049-0 | n/a | $500 | $7,150 | 3.0★ |
Compiled by Radif Partners from the CMS landscape file of September 2026 · How the data is read
South Dakota's 2027 market is small and lopsided. 21 plans are open to anyone with Parts A and B: 15 PPOs and 6 Medicare cost plans, with no HMO. Sioux Falls and the southeast corner get the most, 14 in Minnehaha, Lincoln and neighboring counties, while Pennington County, around Rapid City, has 5. Only 2 drug-covering plans charge a $0 premium, so most people here pay something each month, up to $296. The lowest in-network cap, $3,900, belongs to a cost plan, Medica Prime Solution Premier (Cost), at $227 a month; nearly every other plan caps at $7,150. 13 plans hold four stars or more. Medica files 13 of the open plans, and Sanford Health, the Sioux Falls hospital system, 2. 9 stand-alone drug plans are listed below.
The cost plan that sets the state's lowest cap
Medica's Prime Solution plans are cost plans, an older model that the 2027 file still lists in only a few states. The rules that govern them sit in a different part of federal law, 42 CFR Part 417. The practical difference for a member: the plan has to disclose that services may be received through any Medicare provider and supplier, not just its own (42 CFR 417.436), and it must open enrollment for at least 30 consecutive days a year. In South Dakota the richest of these, Medica Prime Solution Premier (Cost), pairs the state's lowest cap with its highest monthly price. That is a deliberate trade: a large fixed cost for a small worst case.
Prime Solution with or without drugs
Some of the 6 cost plans include Part D and carry "w/Rx" in the name; the others leave drugs to a stand-alone plan. Whichever route you take, the 2027 Part D rules let you spread a large pharmacy bill over the year instead of paying it at the counter in January.
Spread the bill: the payment plan
Per month with the payment plan
$200
| January without it | $1,150 |
| Year total, the same either way | $2,400 |
East River and West River
Clay, Lake, Lincoln, McCook, Minnehaha, Moody, Turner: these counties share the longest list, 14 plans each, all in the southeast around Sioux Falls. Across the Missouri, Butte, Campbell, Codington, Corson and others have 5. Medica Holding Company (13), CVS Health Corporation (5), Sanford Health (2), UnitedHealth Group, Inc. (1) are the only parent companies filing. The statewide total compares with 21 in 2026, the same number of plans, but 6 plan IDs in Minnehaha County were replaced or withdrawn, so check your plan's name in the county table.
Every county of South Dakota, 2027
| County | Plans open to all | $0 with drugs | Lowest max out of pocket | Rated 4★ or more | vs 2026 |
|---|---|---|---|---|---|
| Aurora | 7 | 0 | $3,900 | 1 | -7 |
| Beadle | 7 | 0 | $3,900 | 1 | -5 |
| Bennett | 6 | 0 | $3,900 | 0 | -2 |
| Bon Homme | 7 | 0 | $3,900 | 1 | -7 |
| Brookings | 12 | 2 | $4,450 | 10 | same |
| Brown | 7 | 0 | $3,900 | 1 | -2 |
| Brule | 6 | 0 | $3,900 | 0 | -5 |
| Buffalo | 6 | 0 | $3,900 | 0 | -5 |
| Butte | 5 | 0 | $4,450 | 4 | -3 |
| Campbell | 5 | 0 | $4,450 | 4 | -9 |
| Charles Mix | 7 | 0 | $3,900 | 1 | -7 |
| Clark | 7 | 0 | $4,450 | 6 | -5 |
| Clay | 14 | 2 | $3,900 | 7 | -2 |
| Codington | 5 | 0 | $4,450 | 4 | same |
| Corson | 5 | 0 | $4,450 | 4 | -9 |
| Custer | 5 | 0 | $4,450 | 4 | -3 |
| Davison | 5 | 0 | $4,450 | 4 | -5 |
| Day | 7 | 0 | $4,450 | 6 | -5 |
| Deuel | 7 | 0 | $4,450 | 6 | -5 |
| Dewey | 5 | 0 | $4,450 | 4 | -6 |
| Douglas | 9 | 0 | $3,900 | 3 | -7 |
| Edmunds | 6 | 0 | $3,900 | 0 | -4 |
| Fall River | 5 | 0 | $4,450 | 4 | -3 |
| Faulk | 6 | 0 | $3,900 | 0 | -2 |
| Grant | 6 | 0 | $3,900 | 0 | -2 |
| Gregory | 6 | 0 | $3,900 | 0 | -5 |
| Haakon | 5 | 0 | $4,450 | 4 | -7 |
| Hamlin | 5 | 0 | $4,450 | 4 | -3 |
| Hand | 6 | 0 | $3,900 | 0 | -2 |
| Hanson | 9 | 0 | $3,900 | 3 | -7 |
| Harding | 5 | 0 | $4,450 | 4 | -6 |
| Hughes | 6 | 0 | $3,900 | 0 | -2 |
| Hutchinson | 9 | 0 | $3,900 | 3 | -7 |
| Hyde | 6 | 0 | $3,900 | 0 | -2 |
| Jackson | 5 | 0 | $4,450 | 4 | -7 |
| Jerauld | 6 | 0 | $3,900 | 0 | -7 |
| Jones | 6 | 0 | $3,900 | 0 | -2 |
| Kingsbury | 7 | 0 | $4,450 | 6 | -5 |
| Lake | 14 | 2 | $3,900 | 7 | -2 |
| Lawrence | 5 | 0 | $4,450 | 4 | -3 |
| Lincoln | 14 | 2 | $3,900 | 7 | -2 |
| Lyman | 6 | 0 | $3,900 | 0 | -2 |
| Marshall | 7 | 0 | $4,450 | 6 | -5 |
| McCook | 14 | 2 | $3,900 | 7 | -2 |
| McPherson | 6 | 0 | $3,900 | 0 | -4 |
| Meade | 5 | 0 | $4,450 | 4 | -3 |
| Mellette | 6 | 0 | $3,900 | 0 | -2 |
| Miner | 9 | 0 | $3,900 | 3 | -7 |
| Minnehaha | 14 | 2 | $3,900 | 7 | -2 |
| Moody | 14 | 2 | $3,900 | 7 | -2 |
| Oglala Lakota | 6 | 0 | $3,900 | 0 | -2 |
| Pennington | 5 | 0 | $4,450 | 4 | -3 |
| Perkins | 5 | 0 | $4,450 | 4 | -6 |
| Potter | 6 | 0 | $3,900 | 0 | -2 |
| Roberts | 7 | 0 | $4,450 | 6 | -2 |
| Sanborn | 7 | 0 | $4,450 | 6 | -5 |
| Spink | 5 | 0 | $4,450 | 4 | -3 |
| Stanley | 6 | 0 | $3,900 | 0 | -2 |
| Sully | 6 | 0 | $3,900 | 0 | -2 |
| Todd | 6 | 0 | $3,900 | 0 | -2 |
| Tripp | 6 | 0 | $3,900 | 0 | -2 |
| Turner | 14 | 2 | $3,900 | 7 | -2 |
| Union | 12 | 2 | $3,900 | 5 | -2 |
| Walworth | 5 | 0 | $4,450 | 4 | -9 |
| Yankton | 12 | 2 | $3,900 | 5 | -2 |
| Ziebach | 5 | 0 | $4,450 | 4 | -6 |
Stand-alone Part D plans in South Dakota
| Plan | Monthly premium | With full Extra Help | Deductible | 2026 premium | 2027 Part D stars |
|---|---|---|---|---|---|
| Wellcare Value Script (PDP)Wellcare · S4802-158-0 | $5.30 | $5.30 | $700 | $9.60 | 3.0 |
| AARP Medicare Rx Saver from UHC (PDP)UnitedHealthcare · S5921-370-0 · Extra Help benchmark | $10.30 | $0 | $700 | $5.30 | 3.0 |
| Wellcare Classic (PDP)Wellcare · S4802-089-0 · Extra Help benchmark | $16.30 | $0 | $700 | $12.70 | 3.0 |
| Humana Basic Rx Plan (PDP)Humana · S5884-145-0 · Extra Help benchmark | $18.30 | $0 | $700 | $4.70 | 4.5 |
| Humana Value Rx Plan (PDP)Humana · S5884-204-0 | $33.30 | $18.50 | $687 | $20.80 | 4.5 |
| HealthSpring Assurance Rx (PDP)Blue Cross and Blue Shield of IL, NM, OK, TX · S5715-043-0 | $117.10 | $92.50 | $700 | new | 2.5 |
| Humana Premier Rx Plan (PDP)Humana · S5884-171-0 | $123 | $98.40 | $350 | $103.70 | 4.5 |
| MedicareBlue Rx Standard (PDP)MedicareBlue Rx · S5743-001-0 | $179.10 | $154.50 | $700 | $101 | 3.0 |
| AARP Medicare Rx Preferred from UHC (PDP)UnitedHealthcare · S5921-406-0 | $222.90 | $198.30 | $300 | $140.20 | 3.0 |