Ranked 7 of 15 states · median $725/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old musician 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 median Silver premium, South Dakota ranks 7 of 15 for this occupation.
When you use coverage regularly, the annual total is driven by what each visit costs and whether the clinician you already see is contracted. A plan $40 cheaper that drops your specialist is not cheaper. These rankings pair median premium with how many carriers actually file in the state.
Occupational context: Noise-induced hearing loss; repetitive strain; travel fatigue.
Worth being clear about what this does and does not affect: a carrier in South Dakota cannot ask what you do for a living, cannot charge a musician more than a librarian of the same age in the same ZIP, and cannot exclude anything you were already treated for. Occupation only tells you which plan structure to shop for.
Premium is set by rating area, so a musician 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 |
|---|---|---|---|---|
| Roberts | $679 | Sanford | $6,000 | 3 |
| Charles Mix | $702 | Avera | $6,000 | 2 |
| Lyman | $702 | Avera | $6,000 | 2 |
| Butte | $761 | Wellmark of South Dakota | $5,000 | 3 |
| Lawrence | $761 | Wellmark of South Dakota | $5,000 | 3 |
| Ziebach | $761 | Wellmark of South Dakota | $5,000 | 3 |
The spread across just these six is $82/month — $981 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 — network and cost | 2026 |
|---|---|
| Median Silver premium @40 | $725 |
| Cheapest Silver @40 | $512 — Avera (Lincoln) |
| Most expensive Silver @40 | $882 |
| Carriers filing in the state | 3 — Avera, Sanford, Wellmark of South Dakota |
| Plan types available | EPO, HMO, PPO |
| Counties with only one carrier | 0 of 66 |
South Dakota has 3 carriers filing and 0 of 66 counties served by a single issuer. For a musician with an established provider relationship, that carrier count is the number that decides whether you keep your doctor.
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 musician 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 musician, the categories that usually show up are: Instruments, gear, studio time, touring travel. 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 musician 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 Musicians in South Dakota and a blog covering deductibles, subsidies and special enrollment.