Sanford Individual Simplicity Standardized $2,000
Gold · PPO · Sanford Health Plan · South Dakota
At age 40 it costs between $725.69 and $902.11 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 | 31195SD0110018 |
|---|---|
| Insurer | Sanford Health Plan |
| Metal level | Gold |
| Plan type | PPO |
| Standardised design | Design 1 — a plan CMS defined the benefits of, so it can be compared like for like |
| Deductible (individual) | $2,000 |
| Deductible (family) | $4,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,200 |
| Family maximum | $16,400 |
| Primary care visit | $30 |
| Specialist visit | $60 |
| Emergency room | 25% Coinsurance after deductible |
| Inpatient stay | 25% Coinsurance after deductible |
| Generic drugs | $15 |
| Preferred brand drugs | $30 |
| Specialty drugs | $250 |
| 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 | $567.83 | $644.49 | $725.69 | $1,014.14 | $1,541.09 |
| Lake County | $567.83 | $644.49 | $725.69 | $1,014.14 | $1,541.09 |
| Lincoln County | $567.83 | $644.49 | $725.69 | $1,014.14 | $1,541.09 |
| McCook County | $567.83 | $644.49 | $725.69 | $1,014.14 | $1,541.09 |
| Minnehaha County | $567.83 | $644.49 | $725.69 | $1,014.14 | $1,541.09 |
| Moody County | $567.83 | $644.49 | $725.69 | $1,014.14 | $1,541.09 |
| Turner County | $567.83 | $644.49 | $725.69 | $1,014.14 | $1,541.09 |
| Union County | $567.83 | $644.49 | $725.69 | $1,014.14 | $1,541.09 |
| Beadle County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Brookings County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Brown County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Campbell County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Clark County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Codington County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Corson County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Day County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Deuel County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Dewey County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Edmunds County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Faulk County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Grant County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Hamlin County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Kingsbury County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Marshall County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| McPherson County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Potter County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Roberts County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Spink County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Walworth County | $581.01 | $659.44 | $742.53 | $1,037.68 | $1,576.85 |
| Aurora County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Bon Homme County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Brule County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Buffalo County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Charles Mix County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Davison County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Douglas County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Gregory County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Hand County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Hanson County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Hughes County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Hutchinson County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Hyde County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Jerauld County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Lyman County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Miner County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Sanborn County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Stanley County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Sully County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Tripp County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Yankton County | $615.68 | $698.80 | $786.84 | $1,099.60 | $1,670.95 |
| Bennett County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Butte County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Custer County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Fall River County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Haakon County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Harding County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Jackson County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Jones County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Lawrence County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Meade County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Mellette County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Oglala Lakota County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Pennington County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Perkins County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Todd County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
| Ziebach County | $705.88 | $801.17 | $902.11 | $1,260.70 | $1,915.75 |
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.