South Dakota Health Insurance

South Dakota has more health insurance regulations than most states. It's especailly important as a resident of South Dakota to read through and understand these fundamental health inurance regulations because they are sometimes confusing and complex.

This guide:

  • Describes South Dakota health insurance policy regulations.

  • Lists rules South Dakota health insurance companies must follow.

Health insurance policies are regulated by each state's own health insurance laws. South Dakota health insurance companies and policyholders alike must abide by established insurance laws.

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South Dakota health insurance policy provisions

Some of the most important South Dakota health insurance laws are the ones that influence the health insurance policy specifically.

For instance, every South Dakota health insurance policy must include a guaranteed renewability provision. This provision states that, as long as premiums have been met, your South Dakota health insurance company cannot deny you continued coverage.

South Dakota health insurance laws allow policies to include pre-existing condition exclusion periods, but the period can last no more than 12 months. During this time, the health insurance company is not responsible for any medical treatment relating to the condition.

States have different definition for what constitutes a pre-existing condition. South Dakota health insurance laws define them as any condition you received medical treatment for or were diagnosed with in the 12 months prior to the beginning of the plan.

If you are switching health insurance and have had continuous coverage, your old coverage can be used to credit the pre-existing condition period of your new South Dakota health insurance policy.

Also, South Dakota health insurance policies can include elimination riders, which permanently exclude treatment for certain conditions.

Finally, parents' individual South Dakota health insurance policies that cover dependents automatically cover newborns and adopted children for 31 days. And, dependents with handicaps that exceed the legal age limit can still be covered under a parent's individual South Dakota health insurance policy.

Regulating South Dakota health insurance companies

The other area of importance in regards to health insurance laws is the degree of influence your health insurance company has over your policy and its price.

The cost of South Dakota health insurance is controlled by the insurance company. South Dakota health insurance companies generally charge you the same amount as others in similar health, but they can choose to charge you more.

When you first apply for health insurance, you can be either be denied or charged higher premiums on the basis of your health. Additionally any South Dakota health insurance company is free to refuse you coverage.

However, South Dakota health insurance companies must offer you the state standardized health insurance policies if you have had prior continuous coverage of more than 12 months. These standardized plans impose no pre-existing condition exclusion period.

Also, South Dakota health insurance companies that offer you an individual health insurance plciy, must also sell you family coverage at your request.

Finally, South Dakota health insurance companies cannot refuse to renew your existing health insurance policy on the basis of illness.

Temporary South Dakota health insurance

Temporary South Dakota health insurance is necessary in times when you have breaks between your health insurance coverage. In South Dakota, conversion plans are available as an option for temporary health insurance.

To qualify for a conversion policy you must have left a job that provided you with health insurance and had no more than 20 other employees. You must also have first used up any COBRA continuation coverage to which you're entitled.

The benefits of conversion policies are similar to your old South Dakota health insurance plan's but the premiums will most likely be higher.

The advantages of conversion policies are that they can not be canceled due to illness and there can be no new pre-existing condition exclusion period imposed.

If you are ineligible for a conversion plan, there are some South Dakota health insurance companies that offer temporary health insurance.

More SD health insurance help

If you want more help getting the a good health insurance policy, read our guide to health insurance.

Also see the guide to South Dakota small business health insurance.

To find out more about SD health insurance laws and regulations, visit the official website of the South Dakota Department of Commerce & Regulation, Division of Insurance.