Sanford Individual Simplicity Standardized $6,000
Silver · PPO · Sanford Health Plan · South Dakota
At age 40 it costs between $663.83 and $825.21 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What this Silver plan costs if your income qualifies
Below certain incomes the marketplace improves a Silver plan's cost sharing automatically — you do not apply for it, and it happens on Silver and on no other metal level. The premium does not change; the deductible and what you pay at the doctor do.
| If your income is | Deductible | Most you could pay in a year | Primary care | Generic drugs |
|---|---|---|---|---|
| Above 250%, or not applied for | $6,000 | $8,900 | $40 | $20 |
| up to 150% of the federal poverty level | $0 | $2,200 | No Charge | No Charge |
| 150% to 200% | $700 | $3,300 | $20 | $10 |
| 200% to 250% | $3,000 | $7,400 | $40 | $20 |
CMS calls these cost-sharing reductions. The percentages are actuarial values, not discounts. HealthCare.gov works out which one you get from the income you report when you apply.
What CMS publishes about it
| Plan ID | 31195SD0110017 |
|---|---|
| Insurer | Sanford Health Plan |
| Metal level | Silver |
| Plan type | PPO |
| Standardised design | Design 1 — a plan CMS defined the benefits of, so it can be compared like for like |
| Deductible (individual) | $6,000 |
| Deductible (family) | $12,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,900 |
| Family maximum | $17,800 |
| Primary care visit | $40 |
| Specialist visit | $80 |
| Emergency room | 40% Coinsurance after deductible |
| Inpatient stay | 40% Coinsurance after deductible |
| Generic drugs | $20 |
| Preferred brand drugs | $40 |
| Specialty drugs | $350 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 | $519.43 | $589.55 | $663.83 | $927.70 | $1,409.72 |
| Lake County | $519.43 | $589.55 | $663.83 | $927.70 | $1,409.72 |
| Lincoln County | $519.43 | $589.55 | $663.83 | $927.70 | $1,409.72 |
| McCook County | $519.43 | $589.55 | $663.83 | $927.70 | $1,409.72 |
| Minnehaha County | $519.43 | $589.55 | $663.83 | $927.70 | $1,409.72 |
| Moody County | $519.43 | $589.55 | $663.83 | $927.70 | $1,409.72 |
| Turner County | $519.43 | $589.55 | $663.83 | $927.70 | $1,409.72 |
| Union County | $519.43 | $589.55 | $663.83 | $927.70 | $1,409.72 |
| Beadle County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Brookings County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Brown County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Campbell County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Clark County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Codington County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Corson County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Day County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Deuel County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Dewey County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Edmunds County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Faulk County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Grant County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Hamlin County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Kingsbury County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Marshall County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| McPherson County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Potter County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Roberts County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Spink County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Walworth County | $531.48 | $603.23 | $679.23 | $949.22 | $1,442.44 |
| Aurora County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Bon Homme County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Brule County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Buffalo County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Charles Mix County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Davison County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Douglas County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Gregory County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Hand County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Hanson County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Hughes County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Hutchinson County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Hyde County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Jerauld County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Lyman County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Miner County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Sanborn County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Stanley County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Sully County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Tripp County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Yankton County | $563.20 | $639.23 | $719.77 | $1,005.87 | $1,528.52 |
| Bennett County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Butte County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Custer County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Fall River County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Haakon County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Harding County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Jackson County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Jones County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Lawrence County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Meade County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Mellette County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Oglala Lakota County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Pennington County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Perkins County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Todd County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
| Ziebach County | $645.71 | $732.88 | $825.21 | $1,153.23 | $1,752.44 |
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.