Medicare in Clay County, South Dakota · Plan Year 2026

Medicare Advantage Plans in Clay County, SD: Your Complete 2026 Guide

Clay County has 8 Medicare Advantage plans for 2026 — 6 with a $0 premium — serving a county where CMS counts 2,253 Medicare beneficiaries. 13% of plans are rated 4 stars or higher by CMS. Residents can also choose from 8 Medicare Cost plans, a South Dakota specialty. Below is the real data — every plan, premium, and rating — plus a live tool for your ZIP.

Page last revised: 2026-07-19 · Plan and enrollment data refreshed: 2026-07-19 · Plan year 2026

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2026 Medicare Advantage by the numbers

Clay County Medicare at a glance

$9.16average monthly plan premium (Part C)
6plans with a $0 premium
$5,568.75average in-network out-of-pocket max (highest $6,750)
$436average Part D drug deductible
13%of plans rated CMS 4★ or higher
2,253Medicare beneficiaries in Clay County (2025)
336enrolled in local MA plans (CMS county enrollment)
8Medicare Cost plans also serve Clay County

Sources: CMS Medicare Advantage/Part D Landscape (PY2026) · CMS Medicare Monthly Enrollment (county). Premium figures are Part C premiums; consolidated Part C + D average is $39.6/mo.

What neighbors actually chose

Most-enrolled Medicare Advantage plans in Clay County

Enrollment counts are CMS facts, not our recommendation — the right plan depends on your doctors, drugs, and budget.

  1. Blue Medicare Advantage Enhanced PPO (PPO) (PPO) — 120 enrollees
  2. Aetna Medicare Signature (PPO) (PPO) — 77 enrollees
  3. Align ChoicePlus (PPO) (PPO) — 66 enrollees
  4. Aetna Medicare Enhanced Extra (PPO) (PPO) — 35 enrollees
  5. AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) (PPO) — 25 enrollees

Source: CMS Medicare Advantage Enrollment by State/County/Contract (counts under 11 suppressed by CMS).

Plan type

Medicare Advantage PPO plans in Clay County

PPO (Preferred Provider Organization) plans let you see any provider that accepts the plan, in or out of network, with lower cost sharing in network. Every standard Medicare Advantage plan sold in Clay County for 2026 is a PPO, so network flexibility is the local baseline.

  • 8 PPO plans available
  • $9.16 average monthly premium
  • 6 with a $0 premium
  • $5,568.75 average out-of-pocket max
  • 336 Clay County enrollees
  • Most enrolled: Aetna Medicare Eagle (PPO)
  • 3 without drug coverage
PlanCMS ratingPremium/moOut-of-pocket maxPart D deductibleCMS plan ID
Blue Medicare Advantage Enhanced PPO (PPO)
Average (CMS 3.5★)
3.5★ $63 $4,200 $300 H5900_004
Aetna Medicare Signature (PPO)
Average (CMS 3.5★)
3.5★ $0 $6,750 $615 H1608_120
Align ChoicePlus (PPO)
Average (CMS 3.5★)
3.5★ $0 $4,900 $350 H8385_003
Aetna Medicare Enhanced Extra (PPO)
Average (CMS 3.5★)
3.5★ $0 $5,000 $615 H1608_119
AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO)
Strong (CMS 4★+)
4.5★ $0 $6,700 No drug coverage H2001_139
Align ChoiceElite (PPO)
Average (CMS 3.5★)
3.5★ $10.3 $3,500 $300 H8385_001
Aetna Medicare Eagle (PPO)
Average (CMS 3.5★)
3.5★ $0 $6,750 No drug coverage H1608_061
Blue Medicare Advantage Valor PPO (PPO)
Average (CMS 3.5★)
3.5★ $0 $6,750 No drug coverage H5900_007

Source: CMS Medicare Advantage/Part D Landscape (PY2026) · CMS Medicare Part C & D Star Ratings (2026). "Stability" is the plan's published CMS Overall Star Rating tier — a federal quality measure, not our opinion.

A South Dakota specialty

Medicare Cost plans in Clay County

South Dakota is one of the few states where Medicare Cost plans are still common. They combine plan benefits with a safety valve: outside the network, care simply falls back to Original Medicare rates. Clay County has 8 Cost plans for 2026 from Medica with 315 county enrollees. The most-enrolled Cost plan locally is Medica Prime Solution Standard (Cost).

Cost plans are quoted person-by-person — ask us to compare them against the Medicare Advantage table above for your situation.

Quality, in CMS's own numbers

Medicare Advantage plan ratings in Clay County

CMS ratingPlans% of plans
4.5★113%
3.5★788%

The average CMS rating across Clay County's 8 plans is 3.63. No 5-star plan is sold in Clay County for 2026 — which also means the year-round 5-star Special Enrollment Period is not available locally.

Source: CMS Medicare Part C & D Star Ratings (2026).

Health profile · why plan choice matters here

Chronic conditions among Clay County adults

The right coverage depends on your health. CDC PLACES model-based prevalence for Clay County (15,431 residents) — a reason to check each plan's drug formulary and specialist network before enrolling:

High blood pressure 24.5%
Obesity 34.7%
Arthritis 18.3%
Diagnosed diabetes 8.1%
Coronary heart disease 4.9%
Uninsured (18–64) 8.1%

Source: CDC PLACES: Local Data for Better Health, County (crude prevalence).

Hospitals serving Clay County

  • SANFORD VERMILLION MEDICAL CENTERVermillion · not yet rated by CMS

Source: CMS Hospital Compare — Overall Star Ratings.

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How and when to enroll in Clay County

When you can sign up

  • Initial Enrollment Period — the 7-month window around your 65th birthday (3 before, your birthday month, 3 after). Medicare 101 →
  • Annual Enrollment Period — October 15 to December 7 each year, for 2027 coverage decisions.
  • Medicare Advantage Open Enrollment — January 1 to March 31, one switch allowed if you already have an MA plan.
  • Special Enrollment Periods — after life events like moving counties, losing employer coverage, or qualifying for Extra Help.

Ways to enroll

  • With a licensed local agent (free)Big Sioux Benefits · (605) 555-0142 · Mon–Fri 8am–6pm CT. We compare the plans we offer in Clay County against your doctors and drugs.
  • Directly with a plan's carrier — using the CMS plan ID from the tables above.
  • Through Medicare.gov — the federal plan finder and enrollment portal.

Plan availability in Clay County

2026 plans in the tables above are sold county-wide. That includes residents of Burbank, Irene, Meckling, Vermillion, Wakonda, and all other Clay County communities. To enroll in Medicare Advantage or a Cost plan you must be enrolled in Medicare Part A and Part B and live in the plan's service area.

Clay County Medicare questions, answered

How many Medicare Advantage plans are available in Clay County, SD for 2026?

8 standard Medicare Advantage plans are sold in Clay County for 2026, 6 of them with a $0 Part C premium. Another 4 Special Needs Plans (D-SNP/I-SNP) serve residents who qualify. Clay County residents can also choose from 8 Medicare Cost plans.

How many people in Clay County are on Medicare?

CMS counts 2,253 Medicare beneficiaries in Clay County (2025), of whom about 757 (34%) are in Medicare Advantage or other non-Original-Medicare coverage.

What does a Medicare Advantage plan cost in Clay County for 2026?

The average Part C premium across Clay County's 8 plans is $9.16/month, and 6 plans charge $0. Including Part D drug premiums, the average consolidated premium is $39.6/month. The average in-network out-of-pocket maximum is $5,568.75 (highest: $6,750). You still pay your Part B premium with any plan.

What health conditions matter most for choosing a plan in Clay County?

Per CDC PLACES, among Clay County adults: high blood pressure 24.5%, obesity 34.7%, arthritis 18.3%, diagnosed diabetes 8.1%. Conditions like these are why we match a plan's drug formulary, specialist network, and out-of-pocket maximum to your actual health needs before you enroll.

When can I enroll in a Medicare plan in Clay County?

During your 7-month Initial Enrollment Period around your 65th birthday, the Annual Enrollment Period (October 15 to December 7), the Medicare Advantage Open Enrollment Period (January 1 to March 31, for current MA members), or a Special Enrollment Period after qualifying life events such as moving or losing employer coverage.

Sources, citations, and methodology

Methodology: plan counts, premiums, out-of-pocket maximums, Part D deductibles, and star ratings are computed from the CMS PY2026 Landscape source files for Clay County, South Dakota. Headline "average premium" and "$0 premium" figures use the Part C premium; the consolidated Part C + D premium is reported separately. Special Needs Plans (D-SNP, I-SNP) and Medicare Cost plans are excluded from Medicare Advantage averages and shown separately. County enrollment sums CMS contract-level enrollment for Clay County; CMS suppresses counts under 11, so totals are conservative. Health prevalence figures are CDC PLACES model-based estimates. Content is prepared by the Big Sioux Benefits Data Desk and reviewed for accuracy against the cited files; plan details change — verify with a licensed agent before enrolling.

Big Sioux Benefits is a licensed insurance agency, not affiliated with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Contact Medicare.gov or 1-800-MEDICARE for all options.

Comparing Clay County to the rest of South Dakota

Plans are approved county by county, so the list above is not the state's list. For the statewide picture — every plan sold in South Dakota, carrier enrollment, Medicare Cost plans, star-rating spread, and the counties with no Advantage plan at all — see the South Dakota Medicare guide (2026) → or browse all 66 county guides.

Talk to a licensed Clay County Medicare advisor

Free, no pressure — we compare the plans we offer against your doctors, drugs, and budget.

Book a free consultation →   (605) 555-0142

· Big Sioux Benefits Data Desk