South Dakota · Plan Year 2026
Medicare Advantage plans in South Dakota, county by county
Medicare plans are sold by county — so the right answer in Sioux Falls is different from the right answer in Rapid City or Aberdeen. We pulled the 2026 CMS files for all 66 South Dakota counties: 51 have standard Medicare Advantage plans (from 1 to 12), and every county has real data below. About 202,610 South Dakotans are on Medicare.
Data refreshed: 2026-07-19
| County | Medicare beneficiaries | MA plans (2026) | $0-premium | Avg CMS rating | |
|---|---|---|---|---|---|
| Minnehaha | 40,327 | 8 | 6 | 3.63 | 2026 guide → |
| Pennington | 29,973 | 8 | 3 | 3.63 | 2026 guide → |
| Lincoln | 12,156 | 8 | 6 | 3.63 | 2026 guide → |
| Brown | 8,470 | 1 | 1 | 4.5 | 2026 guide → |
| Lawrence | 8,290 | 8 | 3 | 3.63 | 2026 guide → |
| Codington | 6,653 | 5 | 2 | 3.7 | 2026 guide → |
| Meade | 6,488 | 8 | 3 | 3.63 | 2026 guide → |
| Brookings | 5,946 | 12 | 7 | 3.58 | 2026 guide → |
| Yankton | 5,868 | 6 | 5 | 3.67 | 2026 guide → |
| Davison | 4,804 | 10 | 6 | 3.6 | 2026 guide → |
| Beadle | 3,985 | 4 | 4 | 3.75 | 2026 guide → |
| Union | 3,825 | 6 | 5 | 3.67 | 2026 guide → |
| Hughes | 3,766 | Cost plans only (8) | — | — | 2026 guide → |
| Custer | 3,555 | 8 | 3 | 3.63 | 2026 guide → |
| Fall River | 2,947 | 8 | 3 | 3.63 | 2026 guide → |
| Lake | 2,818 | 8 | 6 | 3.63 | 2026 guide → |
| Butte | 2,771 | 8 | 3 | 3.63 | 2026 guide → |
| Clay | 2,253 | 8 | 6 | 3.63 | 2026 guide → |
| Roberts | 2,200 | 9 | 4 | 3.61 | 2026 guide → |
| Grant | 2,129 | Cost plans only (8) | — | — | 2026 guide → |
| Turner | 2,077 | 8 | 6 | 3.63 | 2026 guide → |
| Charles Mix | 1,932 | 6 | 5 | 3.67 | 2026 guide → |
| Hutchinson | 1,905 | 8 | 6 | 3.63 | 2026 guide → |
| Bon Homme | 1,678 | 6 | 5 | 3.67 | 2026 guide → |
| Spink | 1,664 | 8 | 5 | 3.63 | 2026 guide → |
| Day | 1,639 | 12 | 7 | 3.58 | 2026 guide → |
| Kingsbury | 1,544 | 12 | 7 | 3.58 | 2026 guide → |
| Walworth | 1,512 | 6 | 5 | 3.67 | 2026 guide → |
| Moody | 1,427 | 8 | 6 | 3.63 | 2026 guide → |
| Oglala Lakota | 1,402 | Cost plans only (8) | — | — | 2026 guide → |
| Tripp | 1,383 | Cost plans only (8) | — | — | 2026 guide → |
| McCook | 1,376 | 8 | 6 | 3.63 | 2026 guide → |
| Brule | 1,256 | 3 | 3 | 3.5 | 2026 guide → |
| Hamlin | 1,232 | 8 | 5 | 3.63 | 2026 guide → |
| Gregory | 1,218 | 3 | 3 | 3.5 | 2026 guide → |
| Marshall | 1,176 | 12 | 7 | 3.58 | 2026 guide → |
| Hanson | 1,057 | 8 | 6 | 3.63 | 2026 guide → |
| Deuel | 1,045 | 12 | 7 | 3.58 | 2026 guide → |
| Todd | 980 | Cost plans only (8) | — | — | 2026 guide → |
| Edmunds | 939 | 2 | 1 | 3.5 | 2026 guide → |
| Hand | 898 | Cost plans only (8) | — | — | 2026 guide → |
| Dewey | 896 | 3 | 2 | 3.83 | 2026 guide → |
| Clark | 880 | 12 | 7 | 3.58 | 2026 guide → |
| Perkins | 863 | 3 | 2 | 3.83 | 2026 guide → |
| Douglas | 816 | 8 | 6 | 3.63 | 2026 guide → |
| Stanley | 793 | Cost plans only (8) | — | — | 2026 guide → |
| Lyman | 730 | Cost plans only (8) | — | — | 2026 guide → |
| McPherson | 710 | 2 | 1 | 3.5 | 2026 guide → |
| Potter | 684 | Cost plans only (8) | — | — | 2026 guide → |
| Aurora | 656 | 6 | 5 | 3.67 | 2026 guide → |
| Miner | 631 | 8 | 6 | 3.63 | 2026 guide → |
| Sanborn | 597 | 12 | 7 | 3.58 | 2026 guide → |
| Jerauld | 590 | 5 | 4 | 3.5 | 2026 guide → |
| Faulk | 588 | Cost plans only (8) | — | — | 2026 guide → |
| Haakon | 588 | 4 | 2 | 3.75 | 2026 guide → |
| Corson | 577 | 6 | 5 | 3.67 | 2026 guide → |
| Bennett | 511 | Cost plans only (8) | — | — | 2026 guide → |
| Jackson | 478 | 4 | 2 | 3.75 | 2026 guide → |
| Campbell | 441 | 6 | 5 | 3.67 | 2026 guide → |
| Mellette | 364 | Cost plans only (8) | — | — | 2026 guide → |
| Hyde | 360 | Cost plans only (8) | — | — | 2026 guide → |
| Sully | 339 | Cost plans only (8) | — | — | 2026 guide → |
| Harding | 309 | 3 | 2 | 3.83 | 2026 guide → |
| Jones | 250 | Cost plans only (8) | — | — | 2026 guide → |
| Buffalo | 206 | 3 | 3 | 3.5 | 2026 guide → |
| Ziebach | 189 | 3 | 2 | 3.83 | 2026 guide → |
Sources: CMS Medicare Advantage/Part D Landscape (PY2026) · CMS Medicare Monthly Enrollment (county) — accessed 2026-07-19.
South Dakota Medicare questions, answered
How many Medicare Advantage plans are there in South Dakota?
Availability varies county by county: for 2026, 51 of South Dakota's 66 counties have standard Medicare Advantage plans, ranging from 1 to 12 plans. Medicare Cost plans (a South Dakota specialty) and Special Needs Plans add options in most counties.
Why do Medicare plans differ between South Dakota counties?
Medicare Advantage and Part D plans are approved and priced at the county level, so the carriers, premiums, star ratings, and networks in Minnehaha County differ from those in Pennington or Brown. Pick your county below for its exact plan tables.
How many South Dakotans are on Medicare?
CMS counts about 202,610 Medicare beneficiaries across South Dakota's counties. Each county page shows local enrollment, the most-enrolled plans, and county health data.
Want the statewide view instead?
This page is the county index. If you want South Dakota as one market — every Medicare Advantage plan sold in the state, carriers ranked by enrollment, the 2026 Medicare Cost plan roster, CMS star-rating spread, statewide health data, and what to do in the counties with no Advantage plan — read the South Dakota Medicare guide (2026) →
Not sure which county page you need?
Tell us your ZIP — we'll pull your exact county's plans, free.