Obamacare 2023 Rates for Lake County

Obamacare > Rates > South Dakota > Lake County

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Obamacare is also known as the Affordable Care Act. This page gives you an overview of the rates for individual and family health insurance plans available from , the marketplace for Lake County, SD.

The health insurance rates listed below are for calendar year 2023.

For information on subsidies to make your coverage affordable, you must take one of the following actions:

  • Contact a licensed health insurance agent
  • Complete an application at Healthcare.gov
  • Contact the provider directly

Obamacare Providers, 23 Plans and 2023 Rates for Lake County, South Dakota

Below, you’ll find a summary of the 23 plans for Lake County, South Dakota and rates for each of these providers. This chart is designed to give you a preview of your health insurance options.

You may also be interested in:

Obamacare Rates and Providers for Other Years

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Sanford Health Plan

Local: 1-605-328-6800 | Toll Free: 1-800-752-5863 | TTY: 1-877-652-1844

Toc - Plan #1 Sanford Health Plan
Gold

(PPO) Sanford Simplicity $1,750

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$1,750 $3,500 Annual Deductible
$8,450 $16,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$517.70
$587.59
$661.62
$924.61
$1,405.04
$913.74
$983.63
$1,057.66
$1,320.65
$1,309.78
$1,379.67
$1,453.70
$1,716.69
$1,705.82
$1,775.71
$1,849.74
$2,112.73
$396.04
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,035.40
$1,175.18
$1,323.24
$1,849.22
$2,810.08
$1,431.44
$1,571.22
$1,719.28
$2,245.26
$1,827.48
$1,967.26
$2,115.32
$2,641.30
$2,223.52
$2,363.30
$2,511.36
$3,037.34
$396.04
Toc - Plan #2 Sanford Health Plan
Silver

(PPO) Sanford Simplicity $3,500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$535.06
$607.29
$683.80
$955.61
$1,452.14
$944.38
$1,016.61
$1,093.12
$1,364.93
$1,353.70
$1,425.93
$1,502.44
$1,774.25
$1,763.02
$1,835.25
$1,911.76
$2,183.57
$409.32
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,070.12
$1,214.58
$1,367.60
$1,911.22
$2,904.28
$1,479.44
$1,623.90
$1,776.92
$2,320.54
$1,888.76
$2,033.22
$2,186.24
$2,729.86
$2,298.08
$2,442.54
$2,595.56
$3,139.18
$409.32
Toc - Plan #3 Sanford Health Plan
Silver

(PPO) Sanford Simplicity $4,750

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$4,750 $9,500 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$497.94
$565.16
$636.37
$889.32
$1,351.41
$878.87
$946.09
$1,017.30
$1,270.25
$1,259.80
$1,327.02
$1,398.23
$1,651.18
$1,640.73
$1,707.95
$1,779.16
$2,032.11
$380.93
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$995.88
$1,130.32
$1,272.74
$1,778.64
$2,702.82
$1,376.81
$1,511.25
$1,653.67
$2,159.57
$1,757.74
$1,892.18
$2,034.60
$2,540.50
$2,138.67
$2,273.11
$2,415.53
$2,921.43
$380.93
Toc - Plan #4 Sanford Health Plan
Expanded Bronze

(PPO) Sanford Simplicity $6,900 HSA/HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$6,900 $13,800 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$384.43
$436.33
$491.31
$686.60
$1,043.35
$678.52
$730.42
$785.40
$980.69
$972.61
$1,024.51
$1,079.49
$1,274.78
$1,266.70
$1,318.60
$1,373.58
$1,568.87
$294.09
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$768.86
$872.66
$982.62
$1,373.20
$2,086.70
$1,062.95
$1,166.75
$1,276.71
$1,667.29
$1,357.04
$1,460.84
$1,570.80
$1,961.38
$1,651.13
$1,754.93
$1,864.89
$2,255.47
$294.09
Toc - Plan #5 Sanford Health Plan
Expanded Bronze

(PPO) Sanford Simplicity $6,000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$379.71
$430.97
$485.26
$678.15
$1,030.52
$670.19
$721.45
$775.74
$968.63
$960.67
$1,011.93
$1,066.22
$1,259.11
$1,251.15
$1,302.41
$1,356.70
$1,549.59
$290.48
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$759.42
$861.94
$970.52
$1,356.30
$2,061.04
$1,049.90
$1,152.42
$1,261.00
$1,646.78
$1,340.38
$1,442.90
$1,551.48
$1,937.26
$1,630.86
$1,733.38
$1,841.96
$2,227.74
$290.48
Toc - Plan #6 Sanford Health Plan
Expanded Bronze

(PPO) Sanford Simplicity $7,000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$381.93
$433.48
$488.10
$682.12
$1,036.54
$674.10
$725.65
$780.27
$974.29
$966.27
$1,017.82
$1,072.44
$1,266.46
$1,258.44
$1,309.99
$1,364.61
$1,558.63
$292.17
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$763.86
$866.96
$976.20
$1,364.24
$2,073.08
$1,056.03
$1,159.13
$1,268.37
$1,656.41
$1,348.20
$1,451.30
$1,560.54
$1,948.58
$1,640.37
$1,743.47
$1,852.71
$2,240.75
$292.17
Toc - Plan #7 Sanford Health Plan
Catastrophic

(PPO) Sanford Simplicity $9,100

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$9,100 $18,200 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$262.86
$298.35
$335.94
$469.47
$713.40
$463.95
$499.44
$537.03
$670.56
$665.04
$700.53
$738.12
$871.65
$866.13
$901.62
$939.21
$1,072.74
$201.09
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$525.72
$596.70
$671.88
$938.94
$1,426.80
$726.81
$797.79
$872.97
$1,140.03
$927.90
$998.88
$1,074.06
$1,341.12
$1,128.99
$1,199.97
$1,275.15
$1,542.21
$201.09
Toc - Plan #8 Sanford Health Plan
Silver

(PPO) Sanford Simplicity Enhanced - Diabetes & Asthma/COPD Care Plan $3,700

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$3,700 $7,400 Annual Deductible
$7,050 $14,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$524.06
$594.81
$669.75
$935.97
$1,422.30
$924.97
$995.72
$1,070.66
$1,336.88
$1,325.88
$1,396.63
$1,471.57
$1,737.79
$1,726.79
$1,797.54
$1,872.48
$2,138.70
$400.91
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,048.12
$1,189.62
$1,339.50
$1,871.94
$2,844.60
$1,449.03
$1,590.53
$1,740.41
$2,272.85
$1,849.94
$1,991.44
$2,141.32
$2,673.76
$2,250.85
$2,392.35
$2,542.23
$3,074.67
$400.91
Toc - Plan #9 Sanford Health Plan
Gold

(PPO) Sanford Simplicity Enhanced - Diabetes & Asthma/COPD Care Plan $1,250

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$1,250 $2,500 Annual Deductible
$5,500 $11,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$530.56
$602.18
$678.05
$947.57
$1,439.92
$936.44
$1,008.06
$1,083.93
$1,353.45
$1,342.32
$1,413.94
$1,489.81
$1,759.33
$1,748.20
$1,819.82
$1,895.69
$2,165.21
$405.88
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,061.12
$1,204.36
$1,356.10
$1,895.14
$2,879.84
$1,467.00
$1,610.24
$1,761.98
$2,301.02
$1,872.88
$2,016.12
$2,167.86
$2,706.90
$2,278.76
$2,422.00
$2,573.74
$3,112.78
$405.88
Toc - Plan #10 Sanford Health Plan
Expanded Bronze

(PPO) Sanford Simplicity - Standardized $7,500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,000 $18,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$389.32
$441.88
$497.55
$695.32
$1,056.60
$687.15
$739.71
$795.38
$993.15
$984.98
$1,037.54
$1,093.21
$1,290.98
$1,282.81
$1,335.37
$1,391.04
$1,588.81
$297.83
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$778.64
$883.76
$995.10
$1,390.64
$2,113.20
$1,076.47
$1,181.59
$1,292.93
$1,688.47
$1,374.30
$1,479.42
$1,590.76
$1,986.30
$1,672.13
$1,777.25
$1,888.59
$2,284.13
$297.83
Toc - Plan #11 Sanford Health Plan
Silver

(PPO) Sanford Simplicity - Standardized $5,800

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$5,800 $11,600 Annual Deductible
$8,900 $17,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$506.69
$575.09
$647.55
$904.95
$1,375.15
$894.31
$962.71
$1,035.17
$1,292.57
$1,281.93
$1,350.33
$1,422.79
$1,680.19
$1,669.55
$1,737.95
$1,810.41
$2,067.81
$387.62
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,013.38
$1,150.18
$1,295.10
$1,809.90
$2,750.30
$1,401.00
$1,537.80
$1,682.72
$2,197.52
$1,788.62
$1,925.42
$2,070.34
$2,585.14
$2,176.24
$2,313.04
$2,457.96
$2,972.76
$387.62
Toc - Plan #12 Sanford Health Plan
Gold

(PPO) Sanford Simplicity - Standardized $2,000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-752-5863

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$513.90
$583.28
$656.77
$917.83
$1,394.73
$907.04
$976.42
$1,049.91
$1,310.97
$1,300.18
$1,369.56
$1,443.05
$1,704.11
$1,693.32
$1,762.70
$1,836.19
$2,097.25
$393.14
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,027.80
$1,166.56
$1,313.54
$1,835.66
$2,789.46
$1,420.94
$1,559.70
$1,706.68
$2,228.80
$1,814.08
$1,952.84
$2,099.82
$2,621.94
$2,207.22
$2,345.98
$2,492.96
$3,015.08
$393.14

ADVERTISEMENT

Avera Health Plans

Local: 1-605-322-4545 | Toll Free: 1-888-322-2115

Toc - Plan #13 Avera Health Plans
Gold

(PPO) Avera 2000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$610.96
$693.43
$780.79
$1,091.16
$1,658.13
$1,078.34
$1,160.81
$1,248.17
$1,558.54
$1,545.72
$1,628.19
$1,715.55
$2,025.92
$2,013.10
$2,095.57
$2,182.93
$2,493.30
$467.38
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,221.92
$1,386.86
$1,561.58
$2,182.32
$3,316.26
$1,689.30
$1,854.24
$2,028.96
$2,649.70
$2,156.68
$2,321.62
$2,496.34
$3,117.08
$2,624.06
$2,789.00
$2,963.72
$3,584.46
$467.38
Toc - Plan #14 Avera Health Plans
Silver

(PPO) Avera 4800 HSA Eligible HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$4,800 $9,600 Annual Deductible
$4,800 $9,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$572.10
$649.32
$731.13
$1,021.76
$1,552.66
$1,009.75
$1,086.97
$1,168.78
$1,459.41
$1,447.40
$1,524.62
$1,606.43
$1,897.06
$1,885.05
$1,962.27
$2,044.08
$2,334.71
$437.65
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,144.20
$1,298.64
$1,462.26
$2,043.52
$3,105.32
$1,581.85
$1,736.29
$1,899.91
$2,481.17
$2,019.50
$2,173.94
$2,337.56
$2,918.82
$2,457.15
$2,611.59
$2,775.21
$3,356.47
$437.65
Toc - Plan #15 Avera Health Plans
Catastrophic

(PPO) Avera 9100

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$9,100 $18,200 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$276.82
$314.19
$353.77
$494.40
$751.28
$488.58
$525.95
$565.53
$706.16
$700.34
$737.71
$777.29
$917.92
$912.10
$949.47
$989.05
$1,129.68
$211.76
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$553.64
$628.38
$707.54
$988.80
$1,502.56
$765.40
$840.14
$919.30
$1,200.56
$977.16
$1,051.90
$1,131.06
$1,412.32
$1,188.92
$1,263.66
$1,342.82
$1,624.08
$211.76
Toc - Plan #16 Avera Health Plans
Silver

(PPO) Avera 3500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$9,000 $18,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$535.48
$607.76
$684.33
$956.35
$1,453.27
$945.11
$1,017.39
$1,093.96
$1,365.98
$1,354.74
$1,427.02
$1,503.59
$1,775.61
$1,764.37
$1,836.65
$1,913.22
$2,185.24
$409.63
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,070.96
$1,215.52
$1,368.66
$1,912.70
$2,906.54
$1,480.59
$1,625.15
$1,778.29
$2,322.33
$1,890.22
$2,034.78
$2,187.92
$2,731.96
$2,299.85
$2,444.41
$2,597.55
$3,141.59
$409.63
Toc - Plan #17 Avera Health Plans
Expanded Bronze

(PPO) Avera 6800

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$6,800 $13,600 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$381.89
$433.44
$488.05
$682.05
$1,036.44
$674.03
$725.58
$780.19
$974.19
$966.17
$1,017.72
$1,072.33
$1,266.33
$1,258.31
$1,309.86
$1,364.47
$1,558.47
$292.14
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$763.78
$866.88
$976.10
$1,364.10
$2,072.88
$1,055.92
$1,159.02
$1,268.24
$1,656.24
$1,348.06
$1,451.16
$1,560.38
$1,948.38
$1,640.20
$1,743.30
$1,852.52
$2,240.52
$292.14
Toc - Plan #18 Avera Health Plans
Expanded Bronze

(PPO) Avera 6850 HSA Eligible HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$6,850 $13,700 Annual Deductible
$6,850 $13,700 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$395.78
$449.20
$505.79
$706.84
$1,074.12
$698.54
$751.96
$808.55
$1,009.60
$1,001.30
$1,054.72
$1,111.31
$1,312.36
$1,304.06
$1,357.48
$1,414.07
$1,615.12
$302.76
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$791.56
$898.40
$1,011.58
$1,413.68
$2,148.24
$1,094.32
$1,201.16
$1,314.34
$1,716.44
$1,397.08
$1,503.92
$1,617.10
$2,019.20
$1,699.84
$1,806.68
$1,919.86
$2,321.96
$302.76
Toc - Plan #19 Avera Health Plans
Silver

(PPO) Avera 5800

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$5,800 $11,600 Annual Deductible
$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$514.55
$584.00
$657.58
$918.96
$1,396.46
$908.17
$977.62
$1,051.20
$1,312.58
$1,301.79
$1,371.24
$1,444.82
$1,706.20
$1,695.41
$1,764.86
$1,838.44
$2,099.82
$393.62
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,029.10
$1,168.00
$1,315.16
$1,837.92
$2,792.92
$1,422.72
$1,561.62
$1,708.78
$2,231.54
$1,816.34
$1,955.24
$2,102.40
$2,625.16
$2,209.96
$2,348.86
$2,496.02
$3,018.78
$393.62
Toc - Plan #20 Avera Health Plans
Expanded Bronze

(PPO) Avera 8000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$8,000 $16,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$375.86
$426.59
$480.34
$671.27
$1,020.06
$663.38
$714.11
$767.86
$958.79
$950.90
$1,001.63
$1,055.38
$1,246.31
$1,238.42
$1,289.15
$1,342.90
$1,533.83
$287.52
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$751.72
$853.18
$960.68
$1,342.54
$2,040.12
$1,039.24
$1,140.70
$1,248.20
$1,630.06
$1,326.76
$1,428.22
$1,535.72
$1,917.58
$1,614.28
$1,715.74
$1,823.24
$2,205.10
$287.52
Toc - Plan #21 Avera Health Plans
Gold

(PPO) Avera Standard 2000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$620.06
$703.76
$792.43
$1,107.42
$1,682.83
$1,094.40
$1,178.10
$1,266.77
$1,581.76
$1,568.74
$1,652.44
$1,741.11
$2,056.10
$2,043.08
$2,126.78
$2,215.45
$2,530.44
$474.34
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,240.12
$1,407.52
$1,584.86
$2,214.84
$3,365.66
$1,714.46
$1,881.86
$2,059.20
$2,689.18
$2,188.80
$2,356.20
$2,533.54
$3,163.52
$2,663.14
$2,830.54
$3,007.88
$3,637.86
$474.34
Toc - Plan #22 Avera Health Plans
Silver

(PPO) Avera Standard 5800

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$5,800 $11,600 Annual Deductible
$8,900 $17,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$488.80
$554.77
$624.67
$872.97
$1,326.57
$862.72
$928.69
$998.59
$1,246.89
$1,236.64
$1,302.61
$1,372.51
$1,620.81
$1,610.56
$1,676.53
$1,746.43
$1,994.73
$373.92
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$977.60
$1,109.54
$1,249.34
$1,745.94
$2,653.14
$1,351.52
$1,483.46
$1,623.26
$2,119.86
$1,725.44
$1,857.38
$1,997.18
$2,493.78
$2,099.36
$2,231.30
$2,371.10
$2,867.70
$373.92
Toc - Plan #23 Avera Health Plans
Bronze

(PPO) Avera Standard 9100

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-322-2115

Annual Out of Pocket Expenses:

Individual Family
$9,100 $18,200 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$370.07
$420.02
$472.94
$660.94
$1,004.36
$653.17
$703.12
$756.04
$944.04
$936.27
$986.22
$1,039.14
$1,227.14
$1,219.37
$1,269.32
$1,322.24
$1,510.24
$283.10
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$740.14
$840.04
$945.88
$1,321.88
$2,008.72
$1,023.24
$1,123.14
$1,228.98
$1,604.98
$1,306.34
$1,406.24
$1,512.08
$1,888.08
$1,589.44
$1,689.34
$1,795.18
$2,171.18
$283.10

‡Source: HealthCare.gov has released sample rates for all counties in the 36 states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Lake County here.

Lake County is in “Rating Area 2” of South Dakota.

Currently, there are 23 plans offered in Rating Area 2.

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