Availability of short-term health insurance in South Dakota

Yes. As of 2026, at least three insurers are offering short-term health insurance in South Dakota.

South Dakota allows short-term policies to have terms of less than 12 months.²

After the federal government stopped enforcing the 2024 rule that had limited short-term policies to total durations of no more than four months, carriers resumed the sale of longer short-term policies in South Dakota.

Some insurers in South Dakota limit their short-term policies to six or 12 months in total duration, but at least one insurer allows an applicant to purchase three 364-day terms with one application.

It’s important for consumers to ask questions when purchasing short-term health insurance, including whether the coverage is renewable, and if so, whether pre-existing condition exclusions start over on when the policy renews.

South Dakota statute requires insurers who provide short-term health insurance to provide a disclosure informing consumers that the plan does not cover pre-existing conditions and does not count as minimum essential coverage under the ACA.²

The South Dakota Division of Insurance warns consumers that short-term health insurance “is not subject to any of the key rules governing the federal Affordable Care Act’s single risk pool,” and notes that short-term policies “can be priced based on health status (medically underwritten), can discriminate against consumers with pre-existing conditions, and do not have to cover essential health benefits.”³

Short-term health insurance in South Dakota is available to residents who meet insurers’ underwriting guidelines.

Short-term health insurance plans usually include blanket exclusions for pre-existing conditions, so these types of plans may not be adequate for someone who needs medical care for ongoing or pre-existing conditions.⁴

If you’re in need of health insurance coverage in South Dakota and open enrollment for ACA-compliant plans (November 1 – December 15) has ended, check if you are eligible for a special enrollment period that would allow you to enroll in an ACA-compliant major medical plan. There are a variety of qualifying life events that trigger a special enrollment period.

If you’re eligible to enroll in an ACA-compliant plan, you can visit the South Dakota exchange/Marketplace (HealthCare.gov) to apply. These plans are purchased on a month-to-month basis – meaning you can terminate coverage at any time – so you can enroll in a plan even if you only need coverage for a few months before another policy takes effect (with a premium subsidy if you’re eligible).

A licensed agent or broker can provide information on coverage options and costs for short-term and other kinds of health insurance and determine which policies might fit your needs. Some things to keep in mind about short-term plans are the allowable plan durations (some of South Dakota’s insurers generally cap their plans at shorter durations than others, so the length of the available policies will vary), whether the insurer offers guaranteed renewability, and the specific benefits the plan covers.

Pay attention to things such as whether the plan covers outpatient prescription drugs (most short-term health insurance plans do not,⁴ but some do), and whether it imposes specific dollar limitations.

There may be situations when enrolling in an ACA-compliant plan is impossible. In those scenarios, a short-term plan might be an appropriate option, such as:

• If you missed open enrollment for ACA-compliant coverage or your employer’s healthcare plan, and do not have a qualifying life event that would trigger a special enrollment period.
• You’ve lost coverage from an employer and can’t afford COBRA or an ACA-compliant plan in the Marketplace to bridge the gap until you’re employed again at a job that will provide health benefits. But understand that short-term health insurance is not regulated by the ACA and thus does not provide the sort of consumer protections that you’d get with an ACA-compliant plan.
• If you are newly employed and have a waiting period until you can be covered by your new employer’s health insurance plan.
• If you will soon be eligible for Medicare and don’t have access to any other coverage in the meantime.
• If you’re not eligible for Medicaid or a premium subsidy in the exchange and can’t afford to pay full price for an ACA-compliant plan.