Medicare in South Dakota

Mike Olmos by Mike Olmos | Licensed since 2010
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This article was updated on: 09/16/2018

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If you’re a Medicare beneficiary in South Dakota, it can be a good idea to get familiar with all the available coverage options. Keep in mind that your Medicare options will depend on where you live, but may include the options of Medicare Advantage, Medicare Part D, and Medigap plans.

About Medicare in South Dakota

If you have Original Medicare, costs and benefits are the same for every state. This is the federal health insurance program for United States citizens 65 and older and permanent residents of at least five years. Some people may qualify for Medicare before 65 if they receive disability benefits or have certain conditions, such as amyotrophic lateral sclerosis or end-stage renal disease.

Original Medicare is made up of two parts, Part A and Part B. Medicare Part A covers inpatient services, such as hospital or skilled nursing facility care, limited home health care, or hospice care. Medicare Part B covers outpatient services, such as doctor visits, some durable medical equipment, preventive services, and certain other items and services.

If you have Original Medicare in South Dakota, keep in mind that Medicare Part A and Part B won’t cover every health-related cost. Original Medicare doesn’t include prescription drug benefits, which are available through Medicare Part D. You’re also not covered for benefits like routine vision and dental coverage, long-term care, or alternative medicine. Some of these benefits may be covered through a Medicare plan, available through private insurance companies.

Types of Medicare coverage in South Dakota

South Dakota beneficiaries may have other Medicare options available, as well. The specific benefits and costs can vary by location, but may include:

Medicare Advantage (Medicare Part C) plans are sold by private insurance providers on contract with the Medicare program. These plans are required to offer at least the same amount of coverage as Original Medicare, Part A and Part B (excluding hospice care). Some plans may offer additional benefits, like routine vision and dental, hearing, and prescription drug coverage.

Medicare Supplement (Medigap) insurance is also available through private insurance companies. These plans cover some Original Medicare out-of-pocket costs, like deductibles, coinsurance, and copayments. Some plans also cover benefits that aren’t covered under Original Medicare, like limited overseas emergency health coverage. Most states offer up to 10 different plan types, each with standardized benefits and designated by a letter (A, B, C, D, F, G, K, L, M, and N). Benefits are the same under each plan letter category, no matter where the plan is purchased.

Medicare prescription drug coverage (Medicare Part D) can be purchased separately if you have Original Medicare. You can get this coverage through a stand-alone Medicare Part D Prescription Drug Plan, which works alongside Original Medicare. If you have a Medicare Advantage plan, you’d get prescription coverage by joining a Medicare Advantage Prescription Drug plan (MAPD).

Applying for Medicare in South Dakota

To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years.

If you’re eligible for Medicare, there are some situations where you could be enrolled automatically in Original Medicare, Part A and Part B. This happens if:

  • You’re already receiving Social Security benefits or Railroad Retirement benefits before 65. You’ll be automatically enrolled on the first day of the month you turn 65. If your birthday falls on the first day of the month, you’ll be automatically enrolled on the first day of the month prior to your 65th birthday.
  • You collect disability benefits from Social Security or certain disability benefits from the Railroad Retirement Board for two years. You’ll be automatically enrolled in the 25th month of collecting disability benefits.

Keep in mind that there are limited enrollment periods when you can sign up for Original Medicare. If you need to apply for Medicare manually, you can apply by:

  • Visiting the Social Security website.
  • Calling Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
  • Visiting a Social Security office in person. Visit SSA.gov to find a location near you.
  • Calling the Railroad Retirement Board, if you worked at a railroad. Reach the Railroad Retirement Board at 1-877-772-5772 (TTY users, please call 1-312-751-4701), Monday through Friday, 9AM to 3:30PM.

For private Medicare insurance, enrollment works differently. Keep in mind that eligibility rules may be different, depending on the type of Medicare insurance, and you may only be able to enroll during certain times of the year. If you have questions about your Medicare coverage options, I can help you find plans in your area that may fit your needs. Feel free to start by viewing my profile to learn more about my experience. You can also use the links below to set up a phone appointment or have me contact you through email. If you’d like to view plans right away, our Compare Plans buttons will take you to our free plan comparison tool.

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