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 $805 — a difference of $80/month (11%) before subsidies.
| South Dakota | Utah | |
|---|---|---|
| Median Silver @40 | $725 | $805 |
| Cheapest Silver @40 | $512 | $559 |
| Most expensive county @40 | $882 | $1,125 |
| Age 27 | $420 | $526 |
| Age 60 | $1,087 | $1,134 |
| Carriers | 3 | 6 |
| Counties | 66 | 29 |
| 1-carrier counties | 0 | 1 |
| Plan types | EPO, HMO, PPO | EPO, HMO |
Network note: Utah 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 Utah. There is also a blog covering deductibles, subsidies and special enrollment periods.
Put your ZIP code in and I 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 me — not a call center.
A South Dakota-to-Utah move triggers a 60-day special enrollment period, so the 6 carriers filing in Utah are open to you outside the usual window. The catch is on both ends — you normally need to have carried qualifying coverage for a day or more in the 60 days before moving, and moves made for treatment or travel are excluded.
Nothing transfers. You close the South Dakota plan and enroll fresh against Utah’s 29 counties, which means a new network and a new price regardless of which insurer you land on.
No insurer spans both. South Dakota has 3 carriers filing, Utah has a separate 6, so a move means a new company as well as a new plan.
This is the asymmetry that bites. South Dakota has PPO plans across all 66 counties; Utah sells none in any of its 29. The PPO is the plan type most likely to pay outside its own network, so heading toward Utah usually costs you the ability to see South Dakota providers for anything short of an emergency.
Splitting the year does not mean splitting the coverage. You can hold a marketplace plan only in your state of primary residence — the address you file from — not one in South Dakota and another in Utah. The cost lands on care received in whichever of the two you did not choose.
State averages hide enormous county-level spread. Whichever of South Dakota or Utah you are in, your ZIP is what sets your premium.