Ranked 7 of 15 states · median $725/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old nutritionist 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.
Patient-facing and standing work means steady, predictable utilization — regular visits, prescriptions, physical therapy. Copay structure and network breadth drive real annual cost more than the headline premium, so these pages rank states on median premium and carrier count together.
Occupational context: Sedentary counseling strain.
Two things get confused here constantly. Risk exposure decides what coverage you should buy. It does not decide what you are charged — South Dakota carriers rate on age, ZIP, tobacco and family size, full stop. A nutritionist with a bad back and a healthy 40-year-old office worker in the same county see the same number.
Premium is set by rating area, so a nutritionist 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 |
|---|---|---|---|---|
| Bon Homme | $702 | Avera | $6,000 | 2 |
| Hughes | $702 | Avera | $6,000 | 2 |
| Sully | $702 | Avera | $6,000 | 2 |
| Harding | $761 | Wellmark of South Dakota | $5,000 | 3 |
| Pennington | $761 | Wellmark of South Dakota | $5,000 | 3 |
| Clay | $516 | Sanford | $6,000 | 3 |
The spread across just these six is $245/month — $2,941 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 nutritionist 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
This only matters if you can actually choose — you buy in the state where you live, not where you work. If you are a nutritionist who moved this year, that move is a qualifying life event and opens a special enrollment period.
Self-employed Nutritionists in South Dakota typically deduct: Certification, practice software, CE credits. Health premiums sit separately, above the line under IRC §162(l), and only when neither you nor a spouse could have joined an employer plan — eligibility disqualifies you even if you declined the coverage.
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 nutritionist 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 Nutritionists in South Dakota and a blog covering deductibles, subsidies and special enrollment.