Medicare in Fall River County, South Dakota · Plan Year 2026
Medicare Advantage Plans in Fall River County, SD: Your Complete 2026 Guide
Fall River County has 8 Medicare Advantage plans for 2026 — 3 with a $0 premium — serving a county where CMS counts 2,947 Medicare beneficiaries. 13% of plans are rated 4 stars or higher by CMS. 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
2026 Medicare Advantage by the numbers
Fall River County Medicare at a glance
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 $89/mo.
What neighbors actually chose
Most-enrolled Medicare Advantage plans in Fall River County
Enrollment counts are CMS facts, not our recommendation — the right plan depends on your doctors, drugs, and budget.
- Medica Advantage Select (PPO) (PPO) — 203 enrollees
- Medica Advantage Value (PPO) (PPO) — 128 enrollees
- Blue Medicare Advantage Enhanced PPO (PPO) (PPO) — 106 enrollees
- Medica Advantage Solution H8889-009 (PPO) (PPO) — 49 enrollees
- AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) (PPO) — 48 enrollees
Source: CMS Medicare Advantage Enrollment by State/County/Contract (counts under 11 suppressed by CMS).
Plan type
Medicare Advantage PPO plans in Fall River 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 Fall River County for 2026 is a PPO, so network flexibility is the local baseline.
- 8 PPO plans available
- $48.33 average monthly premium
- 3 with a $0 premium
- $5,618.75 average out-of-pocket max
- 615 Fall River County enrollees
- Most enrolled: AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO)
- 3 without drug coverage
| Plan | CMS rating | Premium/mo | Out-of-pocket max | Part D deductible | CMS plan ID |
|---|---|---|---|---|---|
| Medica Advantage Select (PPO) Average (CMS 3.5★) | 3.5★ | $80 | $5,000 | $355 | H8889_018 |
| Medica Advantage Value (PPO) Average (CMS 3.5★) | 3.5★ | $25 | $6,750 | $615 | H8889_017 |
| Blue Medicare Advantage Enhanced PPO (PPO) Average (CMS 3.5★) | 3.5★ | $63 | $4,200 | $300 | H5900_004 |
| Medica Advantage Solution H8889-009 (PPO) Average (CMS 3.5★) | 3.5★ | $0 | $6,750 | No drug coverage | H8889_009 |
| AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) Strong (CMS 4★+) | 4.5★ | $0 | $6,700 | No drug coverage | H2001_139 |
| Medica Advantage Preferred (PPO) Average (CMS 3.5★) | 3.5★ | $175.6 | $3,300 | $240 | H8889_013 |
| Blue Medicare Advantage Classic PPO (PPO) Average (CMS 3.5★) | 3.5★ | $43 | $5,500 | $300 | H5900_008 |
| 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.
Quality, in CMS's own numbers
Medicare Advantage plan ratings in Fall River County
| CMS rating | Plans | % of plans |
|---|---|---|
| 4.5★ | 1 | 13% |
| 3.5★ | 7 | 88% |
The average CMS rating across Fall River County's 8 plans is 3.63. No 5-star plan is sold in Fall River County for 2026 — which also means the year-round 5-star Special Enrollment Period is not available locally.
Health profile · why plan choice matters here
Chronic conditions among Fall River County adults
The right coverage depends on your health. CDC PLACES model-based prevalence for Fall River County (7,393 residents) — a reason to check each plan's drug formulary and specialist network before enrolling:
Source: CDC PLACES: Local Data for Better Health, County (crude prevalence).
Hospitals serving Fall River County
- FALL RIVER HOSPITAL - CAH — Hot Springs · not yet rated by CMS
See your Fall River County plans now
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How and when to enroll in Fall River 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 Fall River 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 Fall River County
2026 plans in the tables above are sold county-wide. That includes residents of Angostura, Ardmore, Dudley, Edgemont, Hot Springs, Maverick Junction, Oelrichs, Oral, Provo, Smithwick, and all other Fall River 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.
Fall River County Medicare questions, answered
How many Medicare Advantage plans are available in Fall River County, SD for 2026?
8 standard Medicare Advantage plans are sold in Fall River County for 2026, 3 of them with a $0 Part C premium. Another 2 Special Needs Plans (D-SNP/I-SNP) serve residents who qualify.
How many people in Fall River County are on Medicare?
CMS counts 2,947 Medicare beneficiaries in Fall River County (2025), of whom about 861 (29%) are in Medicare Advantage or other non-Original-Medicare coverage.
What does a Medicare Advantage plan cost in Fall River County for 2026?
The average Part C premium across Fall River County's 8 plans is $48.33/month, and 3 plans charge $0. Including Part D drug premiums, the average consolidated premium is $89/month. The average in-network out-of-pocket maximum is $5,618.75 (highest: $6,750). You still pay your Part B premium with any plan.
What health conditions matter most for choosing a plan in Fall River County?
Per CDC PLACES, among Fall River County adults: high blood pressure 43.1%, obesity 38%, arthritis 34.8%, diagnosed diabetes 16.4%. 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 Fall River 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
- CMS Medicare Advantage/Part D Landscape (PY2026) — accessed 2026-07-19
- CMS Medicare Part C & D Star Ratings (2026) — accessed 2026-07-19
- CMS Medicare Advantage Enrollment by State/County/Contract — accessed 2026-07-19
- CMS Medicare Monthly Enrollment (county) — accessed 2026-07-19
- CDC PLACES: Local Data for Better Health, County (crude prevalence) — accessed 2026-07-19
- CMS Hospital Compare — Overall Star Ratings — accessed 2026-07-19
- US Census Bureau — Places by County (2020) — accessed 2026-07-19
Methodology: plan counts, premiums, out-of-pocket maximums, Part D deductibles, and star ratings are computed from the CMS PY2026 Landscape source files for Fall River 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 Fall River 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 Fall River 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 Fall River County Medicare advisor
Free, no pressure — we compare the plans we offer against your doctors, drugs, and budget.