South Dakota Open Enrollment 2027: Dates, Insurers and Rate Changes

By Michael Sprague, Licensed Health Insurance Agent · Reviewed by Heather Sprague, Licensed Health Insurance Agent

South Dakota open enrollment runs from November 1, 2026 to January 15, 2027 on HealthCare.gov. Pick a plan by December 15 if you want coverage to start January 1. All three Marketplace insurers return for 2027, with an average approved increase of about 10.4% before subsidies, one of the smaller increases in the country.

This guide covers the key dates, which insurers are selling plans in South Dakota for 2027, how much rates are changing and how to keep your costs down. For free help comparing plans, call a licensed Vivna agent at 888-730-6031.

Key Dates for South Dakota Open Enrollment

Date	What happens
November 1, 2026	Open enrollment starts on HealthCare.gov
December 15, 2026	Last day to enroll for coverage starting January 1, 2027
January 15, 2027	Open enrollment ends. Plans picked by this date start February 1
After January 15	You need a qualifying life event for a special enrollment period

If you have a plan now and do nothing, HealthCare.gov may automatically renew you into the same or a similar plan. Auto-renewal can cost you money when rates and subsidies change, so compare before December 15.

Which Insurers Sell Plans in South Dakota for 2027

South Dakota has the same three Marketplace insurers for 2027 that it had in 2026:

Insurer	2027 status	Approved average rate change
Avera Health Plans	Returning	11.3%
Sanford Health Plan	Returning	10.9%
Wellmark Blue Cross Blue Shield of South Dakota	Returning (select counties)	6.7%

Avera and Sanford sell plans across the state. Wellmark sold plans in 42 of the state's 66 counties in 2026. Enter your ZIP code on HealthCare.gov, or have a licensed agent check it for you.

How Much Are Rates Going Up in South Dakota

South Dakota regulators approved average increases of 11.3% for Avera, 10.9% for Sanford Health Plan and 6.7% for Wellmark. The weighted average is about 10.4%, well below the national median of about 15%.

These are full-price changes before subsidies. If you get a premium tax credit, your subsidy usually rises with the benchmark silver plan, so your own change may be smaller.

How Subsidies Work in South Dakota for 2027

The enhanced federal subsidies that were in place from 2021 through 2025 expired. For 2027, premium tax credits are available to households with income from 100% to 400% of the federal poverty level that do not have access to affordable employer coverage. Above 400%, there is no subsidy.

Your subsidy is tied to the cost of the second-lowest-cost silver plan in your area. When that benchmark plan goes up, your subsidy usually goes up too. That is why some people see little change in what they pay, while people who earn too much for a subsidy pay the full increase.

If your income is near the 400% line, small changes can make a big difference. See our guide to the ACA subsidy cliff.

Medicaid in South Dakota

South Dakota voters approved Medicaid expansion, and it took effect in mid-2023. Adults with income up to 138% of the federal poverty level may qualify, and you can apply any time of year. People who qualify for Medicaid cannot get Marketplace subsidies.

How to Enroll in South Dakota

• Gather your information: household members, Social Security numbers, income estimate for 2027 and current coverage details.
• Estimate your 2027 income carefully. Your subsidy is based on it, and you reconcile it at tax time.
• Compare plans: look at premiums, deductibles, out-of-pocket maximums, networks and drug lists, not just the monthly price.
• Check your doctors and prescriptions in each plan's network and formulary.
• Enroll on HealthCare.gov or with a licensed agent at no extra cost.
• Pay your first premium to start coverage.

Ways to Lower Your Costs in South Dakota

• Compare bronze, silver and gold plans. If your income is under 250% of the poverty level, a silver plan may give you cost-sharing reductions.
• Consider an HSA-eligible bronze plan if you are healthy and want a tax-free savings account.
• Add hospital indemnity or accident insurance to a lower-premium plan to cover big bills.
• Use our open enrollment checklist so you do not miss a step.

Missed Open Enrollment in South Dakota

After January 15, you can only enroll in a Marketplace plan if you have a qualifying life event, such as losing other coverage, moving, getting married or having a baby. Medicaid enrollment is open all year. If you do not qualify for either, a licensed agent can walk you through dental, vision and supplemental plans you can buy any time. See how to buy health insurance after open enrollment.

South Dakota Open Enrollment: FAQ

When is open enrollment in South Dakota for 2027

November 1, 2026 to January 15, 2027 on HealthCare.gov. Enroll by December 15 for coverage that starts January 1.

How many insurers sell Marketplace plans in South Dakota for 2027

Three: Avera, Sanford Health Plan and Wellmark Blue Cross Blue Shield of South Dakota. Wellmark is only in some counties.

Are South Dakota health insurance premiums going up in 2027

Yes, but less than most states. Approved increases are 11.3% for Avera, 10.9% for Sanford and 6.7% for Wellmark, about 10.4% on average.

Can I get a subsidy in South Dakota

Yes, if your household income is between 100% and 400% of the federal poverty level and you do not have affordable job-based coverage. Adults under 138% usually qualify for Medicaid instead.

What if I miss the deadline

You need a qualifying life event, such as losing other coverage or moving, for a special enrollment period. Otherwise you wait for the next open enrollment.

Next Steps for South Dakota open enrollment

Review your 2027 options before December 15, especially if your insurer is leaving or your rate is going up. Compare plans in your ZIP code and update your income estimate. See our national guide to open enrollment deadlines by state and our South Dakota health insurance page.

Want a licensed agent to help? Call 888-730-6031, Monday through Friday, 9 a.m. to 6 p.m. Eastern, or request a free quote.

Sources

1. healthinsurance.org: South Dakota Marketplace
2. ACASignups: South Dakota 2027 rate changes
3. South Dakota Division of Insurance: Marketplace insurers
4. HealthCare.gov

Related Guides

• Open enrollment deadlines by state
• Open enrollment checklist
• ACA subsidy cliff
• South Dakota health insurance

Vivna Insurance is a licensed independent agency, not a government website. Our help is free; we are paid by the insurance companies we work with. Coverage options, deadlines and costs vary by plan and state.