Sanford Individual TRUE $6,500
Expanded Bronze · HMO · Sanford Health Plan · South Dakota
At age 40 it costs between $433.24 and $443.29 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What CMS publishes about it
| Plan ID | 31195SD0080007 |
|---|---|
| Insurer | Sanford Health Plan |
| Metal level | Expanded Bronze |
| Plan type | HMO |
| Deductible (individual) | $6,500 |
| Deductible (family) | $13,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,750 |
| Family maximum | $19,500 |
| Primary care visit | $50 |
| Specialist visit | $140 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | $35 |
| Preferred brand drugs | 50% Coinsurance after deductible |
| Specialty drugs | 50% Coinsurance after deductible |
| Adult dental included | No |
| Child dental included | Yes |
| Share of premium buying essential health benefits | 100.00% |
| Network directory | Who is in network |
| Summary of benefits | Summary of benefits and coverage |
| Drug list | Formulary |
| Customer service | 1-800-752-5863 · TTY 1-877-652-1844 |
Where it is sold, and what it costs there
6 counties. The premium is the price before any tax credit; what you pay depends on your income.
| County | At 21 | At 30 | At 40 | At 50 | At 60 |
|---|---|---|---|---|---|
| Clay County | $339 | $384.76 | $433.24 | $605.45 | $920.03 |
| Lincoln County | $339 | $384.76 | $433.24 | $605.45 | $920.03 |
| Minnehaha County | $339 | $384.76 | $433.24 | $605.45 | $920.03 |
| Turner County | $339 | $384.76 | $433.24 | $605.45 | $920.03 |
| Union County | $339 | $384.76 | $433.24 | $605.45 | $920.03 |
| Brown County | $346.86 | $393.69 | $443.29 | $619.50 | $941.38 |
Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.
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When this plan’s price or benefits change.
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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.