Private Health Plans for the Self-Employed in South Dakota

I am an independent, licensed health insurance broker, and I am licensed in South Dakota. If you are self-employed, a 1099 contractor, or a freelancer, this page covers the options that sit outside the Marketplace — what is actually available in South Dakota, what the trade-offs are, and when a private plan is the wrong answer. There is no fee for my help. The insurance company pays the broker, not you.

South Dakota caps short-term coverage at 185 days, and allows Farm Bureau health plans that are not regulated as insurance.

South Dakota at a glance for the self-employed

South Dakotans shop on HealthCare.gov in one of the smallest markets I serve. Three carriers, Avera, Sanford Health Plan and Wellmark Blue Cross Blue Shield, are selling for 2026 and 2027. About 51,000 people picked a plan for 2026.

• Milder 2027 rates. Carriers proposed about 10% on average: about 11% at Avera and Sanford and about 7% at Wellmark.
• Medicaid expanded by voters. South Dakotans approved expansion in 2022, and it took effect in mid-2023 for adults up to 138% of the poverty level.
• Farm Bureau plans. South Dakota allows Farm Bureau health plans that are not regulated as insurance and are medically underwritten.
• New subsidy rule for 2027. Starting in 2027, some lawfully present immigrants lose subsidy eligibility. Lawful permanent residents still qualify.

The 400% line matters more here than most people expect. For 2027 the credit stops above $63,840 for one person and $132,000 for a family of four, and there is no phase-out. See the full 2027 income limits.

Your private options in South Dakota

• Short-term plans. South Dakota caps short-term coverage at 185 days, which makes it a stopgap between jobs rather than a plan to live on.
• Farm Bureau health plans. South Dakota allows these membership plans. They are medically underwritten and not regulated as insurance, so compare the benefits carefully against a regular policy.
• Medically underwritten private plans. Health questions up front, often lower premiums for healthy applicants, broad PPO networks, and applications accepted any month.
• Supplemental coverage. Accident, critical-illness and hospital plans can soften a high deductible. How it works.

When private is the right call in South Dakota, and when it is not

With three carriers on HealthCare.gov for 2027 and proposed 2027 increases averaging about 10%, a healthy South Dakota freelancer or business owner over the subsidy line often saves real money with a private plan.

Stay with HealthCare.gov if you have an ongoing condition, are pregnant or planning to be, take expensive prescriptions, or qualify for a meaningful tax credit. If that is you, I will say so.

The tax piece

Most self-employed people can deduct their health insurance premiums, which also lowers the income that counts toward a subsidy. How it works for 1099 workers.

South Dakota questions I hear a lot

Which carriers sell Marketplace plans in South Dakota?

Three for 2026 and 2027: Avera, Sanford Health Plan and Wellmark Blue Cross Blue Shield.

How much are South Dakota premiums going up for 2027?

Carriers proposed about 10% on average, from about 7% at Wellmark to about 11% at Avera.

Can I get a Farm Bureau health plan in South Dakota?

South Dakota allows Farm Bureau health plans. They ask health questions and are not regulated as insurance.

What if I earn more than 400% of the poverty level in South Dakota?

You pay the full Marketplace price. Compare it with Farm Bureau and private medically underwritten plans. I do that at no cost.

Posey Health Solutions · National Producer Number 20609967 · licensed in South Dakota and 30 other states. This page is general information, not advice about a specific plan, and it is not tax advice. Plan availability, carrier participation, and duration limits vary by county, carrier, and plan year, and the rules can change.