Head-to-head, from CMS Plan Year 2026 data.
Prefer to talk? Call (713) 575-9904
Licensed Independent Agent · NPN #22052447 · 23 States
South Dakota is the cheaper of the two: a 40-year-old pays about $725/month for the median Silver plan, versus $807 — a difference of $82/month (11%) before subsidies.
| South Dakota | Texas | |
|---|---|---|
| Median Silver @40 | $725 | $807 |
| Cheapest Silver @40 | $512 | $540 |
| Most expensive county @40 | $882 | $1,409 |
| Age 27 | $420 | $443 |
| Age 60 | $1,087 | $1,146 |
| Carriers | 3 | 15 |
| Counties | 66 | 254 |
| 1-carrier counties | 0 | 7 |
| Plan types | EPO, HMO, PPO | EPO, HMO, POS |
Network note: Texas has no PPO plans in 2026 while South Dakota does.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape. Full-price filed rates before premium tax credits; not a quote or an offer of coverage.
This page sets two states against each other. For county-by-county carriers, plan data and help actually enrolling, I publish a page for each state on Coverage by County: South Dakota or Texas. There is also a blog covering deductibles, subsidies and special enrollment periods.
Change the age or income and both states recalculate: the 2027 marketplace price after any tax credit, and the private plan estimate.
| Monthly, age 45, $85,000 | South Dakota | Texas |
|---|---|---|
| Marketplace benchmark Silver, full price | $815 | $852 |
| Tax credit | none | none |
| You pay for the benchmark plan | $815 | $852 |
| Private plan estimate (low end: no deductible) | $255–$485 | $375–$475 |
At 45 on $85,000, the benchmark plan costs $448 a year more in Texas than in South Dakota, at full price in both, since that income is over the tax-credit line.
2027 estimates: KFF 2026 benchmark raised by each state’s average 2027 change, on the federal age curve; 2027 tax credit rules. Your county will differ. Every state at once: what you would pay in each state.
Put your ZIP code in and a licensed agent will show you the carriers filing in your county, what the cheapest plan costs, and what you would actually pay after any help you qualify for. No cost, and you talk to a licensed agent — not a call center.
Moving permanently from South Dakota to Texas is a qualifying life event, so you get a 60-day special enrollment window counted from the move date — time enough to work through the 15 carriers filing in Texas without waiting for open enrollment. Two conditions trip people up: you generally need to have held qualifying coverage for at least one day in the 60 days before the move, and relocating purely for treatment or a holiday will not qualify.
Your plan will not come with you. Marketplace coverage is sold state by state, so the South Dakota policy ends and a Texas application begins — new network, new premium, even if the name on the card stays the same.
There is no overlap to lean on: none of South Dakota’s 3 carriers file in Texas, where 15 other insurers write instead. Changing state means changing company.
This is the asymmetry that bites. South Dakota has PPO plans across all 66 counties; Texas sells none in any of its 254. The PPO is the plan type most likely to pay outside its own network, so heading toward Texas usually costs you the ability to see South Dakota providers for anything short of an emergency.
You cannot carry one plan in South Dakota and a second in Texas. Eligibility follows primary residence, the address on your return, and everything received in the other state is normally out of network.
State averages hide enormous county-level spread. Whichever of South Dakota or Texas you are in, your ZIP is what sets your premium.
★★★★★
“I run my own business and my time is valuable. Daniel handled everything — compared the private options, explained what I was actually getting, and had me covered fast. Way better experience than trying to navigate it myself.”