Sanford Individual Simplicity $1,750
Gold · PPO · Sanford Health Plan · South Dakota
At age 40 it costs between $751.07 and $933.66 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 | 31195SD0110001 |
|---|---|
| Insurer | Sanford Health Plan |
| Metal level | Gold |
| Plan type | PPO |
| Deductible (individual) | $1,750 |
| Deductible (family) | $3,500 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,000 |
| Family maximum | $18,000 |
| Primary care visit | No Charge |
| Specialist visit | $60 |
| Emergency room | 30% Coinsurance after deductible |
| Inpatient stay | 30% Coinsurance after deductible |
| Generic drugs | $15 |
| Preferred brand drugs | $30 |
| Specialty drugs | 30% 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
66 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 | $587.69 | $667.03 | $751.07 | $1,049.61 | $1,594.98 |
| Lake County | $587.69 | $667.03 | $751.07 | $1,049.61 | $1,594.98 |
| Lincoln County | $587.69 | $667.03 | $751.07 | $1,049.61 | $1,594.98 |
| McCook County | $587.69 | $667.03 | $751.07 | $1,049.61 | $1,594.98 |
| Minnehaha County | $587.69 | $667.03 | $751.07 | $1,049.61 | $1,594.98 |
| Moody County | $587.69 | $667.03 | $751.07 | $1,049.61 | $1,594.98 |
| Turner County | $587.69 | $667.03 | $751.07 | $1,049.61 | $1,594.98 |
| Union County | $587.69 | $667.03 | $751.07 | $1,049.61 | $1,594.98 |
| Beadle County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Brookings County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Brown County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Campbell County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Clark County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Codington County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Corson County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Day County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Deuel County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Dewey County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Edmunds County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Faulk County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Grant County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Hamlin County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Kingsbury County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Marshall County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| McPherson County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Potter County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Roberts County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Spink County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Walworth County | $601.33 | $682.51 | $768.50 | $1,073.97 | $1,632 |
| Aurora County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Bon Homme County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Brule County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Buffalo County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Charles Mix County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Davison County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Douglas County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Gregory County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Hand County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Hanson County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Hughes County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Hutchinson County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Hyde County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Jerauld County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Lyman County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Miner County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Sanborn County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Stanley County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Sully County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Tripp County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Yankton County | $637.21 | $723.24 | $814.36 | $1,138.06 | $1,729.39 |
| Bennett County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Butte County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Custer County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Fall River County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Haakon County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Harding County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Jackson County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Jones County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Lawrence County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Meade County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Mellette County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Oglala Lakota County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Pennington County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Perkins County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Todd County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
| Ziebach County | $730.56 | $829.19 | $933.66 | $1,304.78 | $1,982.74 |
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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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.