Sanford Individual Simplicity Standardized $7,500
Expanded Bronze · PPO · Sanford Health Plan · South Dakota
At age 40 it costs between $540.28 and $671.63 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 | 31195SD0110016 |
|---|---|
| Insurer | Sanford Health Plan |
| Metal level | Expanded Bronze |
| Plan type | PPO |
| Standardised design | Design 1 — a plan CMS defined the benefits of, so it can be compared like for like |
| Deductible (individual) | $7,500 |
| Deductible (family) | $15,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $10,000 |
| Family maximum | $20,000 |
| Primary care visit | $50 |
| Specialist visit | $100 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | $25 |
| Preferred brand drugs | $50 Copay after deductible |
| Specialty drugs | $500 Copay 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 | $422.76 | $479.83 | $540.28 | $755.04 | $1,147.35 |
| Lake County | $422.76 | $479.83 | $540.28 | $755.04 | $1,147.35 |
| Lincoln County | $422.76 | $479.83 | $540.28 | $755.04 | $1,147.35 |
| McCook County | $422.76 | $479.83 | $540.28 | $755.04 | $1,147.35 |
| Minnehaha County | $422.76 | $479.83 | $540.28 | $755.04 | $1,147.35 |
| Moody County | $422.76 | $479.83 | $540.28 | $755.04 | $1,147.35 |
| Turner County | $422.76 | $479.83 | $540.28 | $755.04 | $1,147.35 |
| Union County | $422.76 | $479.83 | $540.28 | $755.04 | $1,147.35 |
| Beadle County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Brookings County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Brown County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Campbell County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Clark County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Codington County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Corson County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Day County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Deuel County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Dewey County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Edmunds County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Faulk County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Grant County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Hamlin County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Kingsbury County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Marshall County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| McPherson County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Potter County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Roberts County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Spink County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Walworth County | $432.57 | $490.96 | $552.82 | $772.56 | $1,173.98 |
| Aurora County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Bon Homme County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Brule County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Buffalo County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Charles Mix County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Davison County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Douglas County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Gregory County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Hand County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Hanson County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Hughes County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Hutchinson County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Hyde County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Jerauld County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Lyman County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Miner County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Sanborn County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Stanley County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Sully County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Tripp County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Yankton County | $458.38 | $520.26 | $585.81 | $818.67 | $1,244.04 |
| Bennett County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Butte County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Custer County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Fall River County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Haakon County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Harding County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Jackson County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Jones County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Lawrence County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Meade County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Mellette County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Oglala Lakota County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Pennington County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Perkins County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Todd County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
| Ziebach County | $525.53 | $596.48 | $671.63 | $938.60 | $1,426.29 |
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.