Ranked 7 of 15 states · median $725/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old realtor 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 counties covered, South Dakota ranks 13 of 15 for this occupation.
Work that crosses county and state lines makes network geography the binding constraint. A cheap HMO that only contracts in one metro is worthless 200 miles away, so these pages rank states by network reach and flag the ones with no PPO on the exchange at all.
Occupational context: High driving exposure; irregular hours; showing-related risk.
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 realtor or an accountant. Occupation changes the shopping criteria, nothing else.
Premium is set by rating area, so a realtor 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 |
|---|---|---|---|---|
| Lincoln | $512 | Avera | $6,000 | 2 |
| Davison | $532 | Avera | $6,000 | 2 |
| Brookings | $679 | Sanford | $6,000 | 3 |
| Dewey | $679 | Sanford | $6,000 | 3 |
| McPherson | $679 | Sanford | $6,000 | 3 |
| Brule | $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 — network reach | 2026 |
|---|---|
| Counties in the state | 66 |
| Counties with only one carrier | 0 (0%) |
| Plan types available | EPO, HMO, PPO |
| PPO available on exchange | Yes |
| Carriers filing in the state | 3 |
| Cheapest Silver @40 | $512 — Lincoln |
South Dakota has PPO plans available. For a realtor covering distance, that single fact outweighs premium: 0 of 66 counties here are served by one carrier, so an HMO bought in one metro may leave you out of network for the rest of your route.
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
Cross-state numbers are useful for understanding whether South Dakota is treating you well, not for arbitrage. You cannot buy an out-of-state exchange plan. If you are a realtor weighing a relocation for other reasons, the premium difference is a real line item worth putting in the decision.
Expense categories that typically apply to this trade: Vehicle, NAR dues, MLS fees, E&O insurance, marketing. 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. Under the ACA, carriers cannot rate, decline, or exclude based on occupation or health history. Rates vary only by age, ZIP code, tobacco use and household size.
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 Realtors in South Dakota and a blog covering deductibles, subsidies and special enrollment.