Ranked 7 of 15 states · median $725/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old carpenter in South Dakota pays a median $725/month for a Silver plan before subsidies — 7th of 15 on cost. The cheapest plan in the state is $512 from Avera in Lincoln. On highest out-of-pocket maximum, South Dakota ranks 12 of 15 for this occupation.
For work with real injury exposure the premium is the wrong headline number. What decides a bad year is the annual out-of-pocket maximum — the ceiling you stop paying at. A fall, a fracture, an imaging series and a course of physical therapy will reach that ceiling on any metal tier, so the states below are ordered by worst-case exposure.
Occupational context: Saw and nail-gun injuries; hearing loss; back strain from lifting.
This is background for choosing a plan, not for pricing one. Since 2014 every South Dakota exchange plan has been guaranteed issue and community rated: same age, same ZIP, same tobacco status means the same filed premium whether you are a carpenter or an accountant. Occupation changes the shopping criteria, nothing else.
Premium is set by rating area, so a carpenter in one South Dakota county can pay materially more than one an hour away. Six counties from across the state, cheapest Silver plan for a 40-year-old:
| County | Cheapest Silver @40 | Issuer | Deductible | Carriers |
|---|---|---|---|---|
| Minnehaha | $512 | Avera | $6,000 | 2 |
| Hutchinson | $532 | Avera | $6,000 | 2 |
| Clark | $679 | Sanford | $6,000 | 3 |
| Faulk | $679 | Sanford | $6,000 | 3 |
| Roberts | $679 | Sanford | $6,000 | 3 |
| Charles Mix | $702 | Avera | $6,000 | 2 |
The spread across just these six is $190/month — $2,285 a year for the same metal tier. Statewide the range runs $512 to $882. Coverage by County publishes all 66 South Dakota counties individually.
| South Dakota — worst-case exposure | 2026 |
|---|---|
| Lowest annual out-of-pocket maximum | $0 |
| Highest annual out-of-pocket maximum | $0 |
| Cheapest Gold plan @40 | $559 — Sanford |
| Gold deductible | $2,000 |
| Cheapest Silver @40 | $512 — Avera |
| Cheapest Silver @50 | $715 |
For a carpenter, the gap between $0 and $0 in annual out-of-pocket maximum is worth more than any premium difference on this page. One serious injury reaches that ceiling regardless of which plan you picked.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. 1,822 plan records across 66 South Dakota counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: Alabama ($680), Wisconsin ($687), Michigan ($708). More expensive: Oklahoma ($731), Kansas ($765), Florida ($789).
Side-by-side: South Dakota vs Wisconsin · South Dakota vs Michigan · South Dakota vs Oklahoma · South Dakota vs Kansas
Read the comparison as context, not as a shopping list. Your county of residence determines what you can buy, and for a carpenter that is fixed unless you relocate. Where it is actionable is a move already in progress — that is a qualifying life event, and you have 60 days on either side of it.
If you file a Schedule C as a carpenter, the categories that usually show up are: Tools, truck, lumber, jobsite travel, liability insurance. The health premium itself is normally an above-the-line deduction under IRC §162(l), which reduces AGI rather than requiring you to itemize. Your CPA should confirm it against your actual situation.
If your household income is above the subsidy range, ACA is not automatically the answer. There are other categories of coverage that may fit, and they work very differently. That is a conversation, not a web page.
The cheapest Silver plan for a 40-year-old in South Dakota is $512 per month from Avera, with a state median of $725. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
No. South Dakota exchange plans are guaranteed issue and community rated, so a carpenter pays exactly what anyone else of the same age in the same ZIP pays. Occupation is not on the application as a rating factor.
Yes. Plan types filed for 2026: EPO, HMO, PPO.
South Dakota ranks 7 of 15 states covered here, at a median $725 per month. Indiana is cheapest at $558 and Nebraska is most expensive at $875.
This page compares states. For South Dakota specifically — county-by-county carriers, plan data and enrollment help — I publish that on Coverage by County, including a page written for Carpenters in South Dakota and a blog covering deductibles, subsidies and special enrollment.