Ranked 7 of 15 states · median $725/mo · CMS PY2026
Prefer to talk? Call (713) 575-9904
Licensed Independent Agent · NPN #22052447 · 23 States
A 40-year-old occupational therapist 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: Lifting and transfer injuries; repetitive 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 occupational therapist 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 occupational therapist 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 |
|---|---|---|---|---|
| Perkins | $761 | Wellmark of South Dakota | $5,000 | 3 |
| Turner | $516 | Sanford | $6,000 | 3 |
| Lake | $664 | Sanford | $6,000 | 3 |
| Corson | $679 | Sanford | $6,000 | 3 |
| Hamlin | $679 | Sanford | $6,000 | 3 |
| Walworth | $679 | 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 occupational therapist 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 occupational therapist who moved this year, that move is a qualifying life event and opens a special enrollment period.
Expense categories that typically apply to this trade: Licensing, equipment, malpractice insurance, CE. Premiums are generally deductible above the line under IRC §162(l) when no employer plan is available to you or your spouse — a question for your CPA, not your agent.
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 occupational therapist 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.
Above the cliff. At this income a single-person household receives no premium tax credit for 2026 and pays the full premium.
This occupation is above the cliff in all 21 states reported.
What this figure is. It is the median annual wage BLS reports for Occupational Therapists (SOC 29-1122) in South Dakota. BLS surveys wage and salary workers and excludes the self-employed, so it is a benchmark for the occupation in this state — not the income of a self-employed occupational therapist. Premium tax credit eligibility is set by household modified adjusted gross income and household size, not by occupation, so treat this as a reference point rather than a determination of what you qualify for.
Why the cliff is back. The enhanced premium tax credits expired on 31 December 2025. For plan year 2026 the 400% FPL limit applies again, so household income above $62,600 ends premium tax credit eligibility outright.
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 Occupational Therapists in South Dakota and a blog covering deductibles, subsidies and special enrollment.
← Occupational Therapists in all 21 states · All occupations
South Dakota has 3 carriers filing across 66 counties right now. That list is rebuilt every year, so what you can choose from in November may not match what you see today — and for an occupational therapist buying your own cover, who stays matters more than the headline rate.
On price the only honest number today is national: the Peterson-KFF read of 2027 filings puts the median proposed rise near 15%, spanning −1% to 54%. Final South Dakota rates are not approved, so any precise 2027 figure quoted for this state is guesswork.
The window opens November 1, 2026, and December 15 is the date worth writing down — it is what secures January 1 cover in South Dakota and everywhere else. You will find later dates quoted; they stem from a 2025 rule that was vacated in June 2026 and is under appeal.
In your favour: PPOs are sold in all 66 South Dakota counties. That is the type most likely to pay toward out-of-network care, and worth defending at renewal if your work as an occupational therapist takes you around.
Nothing about 2027 is urgent yet, which is exactly why it is worth ten minutes now. Come November you will be choosing between South Dakota’s carriers under a deadline; today you can do it without one.
Give me a ZIP and I will tell you three things:
Two Occupational Therapists on opposite sides of South Dakota can be quoted very different premiums for the same plan. Your ZIP is what decides it.