South Dakota Health Insurance

Buying health insurance can be a confusing process, but it can be made far less troublesome by learning more about the rules under which insurance companies in your state must operate.  In the case of South Dakota, these regulatory guidelines can be particularly significant for those seeking individual coverage or are trying to set up health plan for a small business.  The list below elaborates on the most important regulations that you should know about before buying health coverage in South Dakota.

• Every health insurance policy sold in this state is legally required to include a clause guaranteeing its renewability.  This means that, assuming you’ve paid your premiums in full and on time, you will always have the option of renewing your health coverage each time it expires.  In addition, your insurer is prohibited from cancelling your health coverage on the grounds of health complications.
• South Dakota’s state government has also taken some steps to help new parents: if your current health insurance includes coverage for dependents, any newborn or newly-adopted children in your family will automatically be covered under that policy for up to 31 days.  Any dependents you already have who suffer from some form of handicap or disability are also granted the option of remaining under your health coverage even after they have become too old to normally qualify.
• When setting up a new health insurance policy, insurers in this state are allowed to declare certain pre-existing conditions— which can include any health issue treated or diagnosed within 12 months before the start of your new plan— to be excluded from coverage for up to one year.  This means that any costs that arise from the excluded health problem over the course of that first year of coverage will never be paid by that insurer, but once that exclusion period ends any new expenses will be covered as normal.  If you switch insurers, any exclusion you’ve experienced under your old insurance will credit toward your new policy; insurers also have the option of inserting an elimination rider to permanently exclude one or more health issues from ever being covered, however, so you should carefully read over any offered policy for such language.
• Typically, insurers in South Dakota are permitted to take your health, age and other risk factors into account when choosing whether to sell you a new policy and determining how much your coverage will cost.  Those residents who have maintained continuous health coverage for at least twelve months beforehand, however, can expect to have access to a state-standardized health plan that includes automatic coverage for all pre-existing conditions. 
• If you have access to any individual health plan from any insurers in South Dakota, they are also required by law to offer a family health plan at your request.
• Small businesses operating in South Dakota are guaranteed access to group health coverage, and every business that has between 2 and 50 employees is legally entitled to purchase a health plan with benefits comparable to what is offered to other small businesses of the same status.
• Small businesses health coverage may come with certain strings attached, such as a requirement that at least a certain percentage of the company’s employees participate in this coverage or a mandatory employer contribution to the insured employees’ premiums.  Failing to meet the conditions specified by the insurer can mean termination of the policy, but no policy may ever be cancelled on the grounds of illness among the employees.
• While there are some limits in place, group coverage for any small business can vary widely in cost based on typical risk factors like the age, health, and family background of the insured.
• Self-employed South Dakota residents do not automatically gain access to group coverage as a small business would, unless there is at least one other employee involved.  Those who choose to purchase individual health coverage instead, however, can potentially deduct nearly all of their premiums from their total tax liability.

Once you’ve gained a good understanding of what you can expect from insurers in your state, you’ll be better-equipped to decide on the specific form of coverage you’d like to buy.  Once you know what you’re looking for it will be far more straightforward to compare price quotes from competing insurers, and to thereby acquire the best available insurance at the lowest price.

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