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Best Medicare Advantage Plans in South Dakota for 2020

For someone who is newly enrolled in Medicare Part A and Part B, shopping for the best Medicare Advantage plans in South Dakota for 2020 might be a great way to reduce out-of-pocket expenses for healthcare while enjoying more perks and benefits. If you haven’t shopped for Medicare Advantage plans in South Dakota, then you might not be aware of how much you can save on the coinsurance, deductibles and copayments that go along with Original Medicare (Medicare Part A and Medicare Part B). We’re here to help you learn how one of these policies can help you manage your 2020 healthcare expenses and enjoy increased coverage.

Overview of the Best Medicare Advantage Plans in South Dakota for 2020

Medicare Supplement plans (also known as Medicare Supplement insurance or Medigap) are popular for those who want to fill in the gaps of their Original Medicare (Medicare Part A and Part B) coverage.

If you don’t want to sign up for a Medigap policy, then you have another option: a Medicare Advantage plan in South Dakota for 2020. Instead of filling in the gaps of Medicare Part A and Part B, Medicare Advantage plans actually replace Original Medicare. The federal Medicare program provides a subsidy to private insurance companies that offer these policies and require them to provide their customers with a certain level of benefits. Beyond that, these health insurance companies have freedom to offer more perks, such as included prescription drug coverage or other benefits.

Medicare Advantage plans are a little tougher to compare and shop for; after all, they aren’t the same from company to company like Medigap policies are. These health plans come in the form of HMO, HMO-POS, PPO, MSA, PFFS and other types of policies. This guide will help you understand the different types of Medicare Part C plans in South Dakota for 2020 so that you will know which one is best for you, your budget and your needs for healthcare.

Best Medicare Advantage Plans in South Dakota: When Can You Enroll?

You’ll need to be enrolled in Medicare Part A and Part B first. Then, you can sign up for a South Dakota Medicare Part C plan during these Medicare Advantage enrollment periods:

  • Medicare Initial Coverage Election Period ICEP: When you first sign up for Original Medicare {Medicare Part A and Part B), you will have a period of time during which you can become a beneficiary of Medicare Advantage.
  • Medicare Annual Election Period AEP: During a period running from October 15 to December 7 of each year, you’re able to enroll in, disenroll from or change your Medicare Advantage Plan in South Dakota for 2020.
  • Medicare Advantage Disenrollment Period MADP: Before it was discontinued, this was a period that you could use to disenroll from a Medicare Advantage plan. This allowed people to switch back to Original Medicare (Medicare Part A and Part B).
  • Medicare Advantage Open Enrollment Period MA OEP: A new period as of 2019, this enrollment period runs from January 1 to March 31st of each year.
  • Medicare Special Election Periods SEP: it is possible to sign up for a policy outside of a standard Medicare Enrollment Period if an SEP is triggered. This happens if you lose your dual-eligible status for Medicaid, if your insurance company no longer offers MA policies, if you move and more.

Best Types of Medicare Advantage Plans in South Dakota for 2020

Each type of Medicare Advantage plan offers its own pros and cons. If you’re eligible for Medicare and want to sign up for a Medicare Part C plan in South Dakota for 2020, you’ll want to check out these popular options so that you’ll know which type of plan you want to become a beneficiary of:

PPO Preferred Provider Organization Plans (PPO) in South Dakota

  • Has provider network service areas
  • Allows you to see a doctor or hospital outside of your provider network
  • Allows you to pay less when you see in-network doctors, hospitals and other healthcare providers, such as nursing homes that offer short-term care
  • Does not require referrals

HMO Health Maintenance Organization Plans (HMO) in South Dakota

  • Has the lowest monthly premiums of the Medicare Part C options in South Dakota in most cases; some policies have $0 premium
  • Doesn’t pay for care with providers outside of the network, except in emergency situations
  • Requires you to see an in-network primary care doctor (PCP) to get referrals

Private Fee-for-Service PFFS in South Dakota

  • The insurer itself determines coverage for a fee-for-service plan
  • Doesn’t have network restrictions

Special Needs Plans SNPs in South Dakota

  • Designed for people with chronic health conditions and institutional conditions; end stage renal disease ESRD is one example of a condition that qualifies people for Special Needs Plans
  • Required by Medicare to include Medicare Part D prescription drug plans

Not every company will offer each type of Medicare Part C plan in South Dakota for 2020, so you’ll need to do your research to find the right fit.  Some notable companies to look for in your area are, Humana, Aetna, and Cigna.

Enrollment Figures for South Dakota Medicare Advantage Plans

If you’d like to know more about South Dakota enrollment in Medicare Part C/Medicare Advantage plan options and Original Medicare, see these stats:

  • The five largest counties in South Dakota are Minnehaha, Pennington, Lincoln, Brown and Brookings.
  • There were 174,017 Medicare beneficiaries in South Dakota in 2018.
  • 33,163 of Medicare beneficiaries in South Dakota were enrolled in Medicare Advantage in 2018.

Do Medicare Advantage Plans in South Dakota Cover Prescription Drugs?

When you compare Medicare Advantage Plans in South Dakota for 2020, you’ll probably want to look at options that include Medicare Advantage prescription drug plans. These are known as MAPD policies. Look at the formulary and prescription drug tiers when you compare insurance plans that include Medicare prescription drug plans (Medicare Part D plans).

Also be aware that many Medicare Part C policies that include restrictions about in-network providers also have pharmacy network restrictions. It’s best to know about these things when comparing rates for policies that include prescription drug coverage.

Network Restrictions for Medicare Advantage Plan in South Dakota?

It’s best to know about these network restrictions when you’re comparing rates and looking for the best policy:

  • In-Network vs. Out-of-Network Within Coverage Area: HMO Medicare Advantage plans and PPO Medicare Advantage plans will both cover out-of-network emergency care. An HMO will not pay for out-of-network care in other situations, but a PPO will. Out-of-pocket costs are higher when you use an out-of-network provider with a PPO, though.
  • Traveling With Plan: Emergency care will be covered when you travel throughout the United States with both health maintenance organization HMO plans or preferred provider organization PPO Medicare Advantage plans in South Dakota. You can seek other types of care when traveling with a PPO, but it’s going to cost more than it would when seeing in-network providers.
  • Moving Across State Lines: Medicare Part A and Part B are not affected when you move, but Medicare Part C is. If you do move to another state, you’ll need to change policies in 2020.

Added Benefits of Medicare Advantage Plan in South Dakota

Consider looking for health plans with these perks when shopping for Medicare Advantage:

  • Hearing care, routine vision and dental care
  • Wellness programs
  • Silver Sneakers or other similar gym membership
  • Recommendations for diet and nutrition
  • Allowance for over-the-counter medication costs
  • Healthy living seminars and classes
  • Transportation to and from medical appointments
  • Payment of some or all of the Medicare Part B premium

Here are a few changes for 2020:

  • Starting in 2020, insurance companies that provide Medicare Advantage plans in South Dakota will be able to add some supplemental non-health related benefits to certain beneficiaries, such as providing help with making structural changes to the home when needed. This is designed to help those who might need help with widening doorways or installing ramps for their homes.
  • The Centers for Medicare and Medicaid Services approved a 2.53% payment increase to Medicare insurers that offer Medicare Advantage plans in South Dakota.

South Dakota Medicare Resources

For a complete description of benefits for your Medicare coverage and the Medicare plans that are available, check out these resources:

Additionally, if you need help with finding a Medicare Advantage policy in South Dakota with a high star rating for 2020, our insurance agents are here to help. Give us a call so that we can help you with your search and so that we can assist you in getting enrolled in the policy of your choice. We can also help with things like shopping for Supplemental policies or stand-alone Part D policies.