Medicare health insurance options in South Dakota
At Wellmark, we can help you find the best Medicare plan to fit your needs. Get the right amount of Medicare coverage with options to choose from, including Part A, Part B, Part C (Medicare Advantage), Part D and Medicare supplement.
Understanding the Medicare basics
Medicare Part A and Medicare Part B, also known as Original Medicare, is managed by the federal government for people 65+ or who have certain disabilities. While Original Medicare helps cover hospital care and doctor visits, it will not cover all your Medicare expenses and does not include prescription, dental, vision or hearing coverage.
To apply for Original Medicare (Parts A and B)
- ONLINE — Visit Social Security online External Site and follow the instructions. The application takes less than 10 minutes. After you submit the application, you will get a receipt and an application number you can use to check the status of your application later. Once you are enrolled, Social Security will send you a "Welcome to Medicare" packet that includes your Medicare card.
- BY PHONE — Call the Social Security national customer hotline at 800-772-1213.
- IN PERSON — Visit your local Social Security office.
You have four opportunities to enroll in Medicare.
Initial Enrollment Period (IEP)
During your IEP, you can enroll in any part of Medicare. Your IEP begins three months before the month you turn 65 and ends three months after you turn 65. Note: Part B and Part D may have a late enrollment penalty if you wait to enroll.
Annual Enrollment Period (AEP)
Every year from Oct. 15—Dec. 7, you have the option to add, switch or drop a Part C (Medicare Advantage), Part D (prescription drug) or Medicare supplement plan. During AEP, you can also enroll in Original Medicare for coverage starting Jan. 1.
Open Enrollment Period (OEP)
If you are enrolled in a Part C (Medicare Advantage) plan, during Jan. 1—March 31, you are allowed to make a one-time change to another Medicare Advantage plan or switch back to Original Medicare. If you enroll in Original Medicare, you may add a Medicare supplement or a prescription drug plan during this time.
Special Enrollment Period (SEP)
Certain events may qualify you to enroll or change your plan outside of IEP, AEP or OEP. You may qualify for an SEP if:
- You move outside your plan's service area.
- You lose your employer or union coverage.
- Your insurance company cancels your health plan.
- You are eligible for both Medicare and Medicaid.
- You qualify for extra help in paying for Medicare prescription drug coverage.
- You are able to get other coverage such as an employer or union plan, TRICARE or PACE.
- See other special situations
Next, choose additional coverage
Because Original Medicare doesn't cover everything, many choose to purchase Medicare Advantage or Medicare supplement coverage through a private insurance company.Wellmark, a local company trusted by South Dakotans for over 80 years, offers both Medicare Advantage and Medicare supplement plans. Consider some key differences when choosing between the plans.
Option 1: Medicare Advantage (Part C)
All coverage rolled into one plan
- You prefer the convenience of an all-in-one plan.
- You prefer to save money on your monthly premium in exchange for higher out-of-pocket costs as they come up.
- You’re willing to see a provider in your plan's network.
- You plan to receive most of your health care while at home, or you’re willing to have network restrictions when receiving care while traveling.
- Pay a lower monthly premium in exchange for higher out-of-pocket costs.
- One bill and ID card for all your Medicare benefits.
- Little or no monthly premium for your policy.
- Will have a deductible, copays and coinsurance costs.
- Choose a doctor who participates in your plan's network or, in some cases, pay extra to see an out-of-network doctor.
Option 2: Medicare supplement (Medigap) + Part D
Individual, stand-alone, customized plans
- You prefer to choose all your plans separately to get the exact level of coverage you need.
- You prefer to pay more up-front, for low or no out-of-pocket costs later on.
- You would like to see any doctor who accepts Medicare.
- You travel for part of the year and want unrestricted access to health care while away from home.
- Pay a higher monthly premium in exchange for lower out-of-pocket costs.
- Multiple bills and ID cards from separate Medicare policies.
- Will have a monthly premium for your policy.
- Will cover all or most costs left over from Original Medicare.
- See any doctor nationally who accepts Medicare, plus emergency care worldwide.
- Not included; would need to purchase Part D separately
- Not included; would need to be purchased separately