Medicare Advantage

Medicare and Medicaid in South Dakota: 5 Dual Special Needs Plans for 2027

SIOUX FALLS — For South Dakotans who have both Medicare and Medicaid, the 2027 plan year brings a modest set of coordinated coverage options. According to the CMS Medicare Advantage Landscape Source File for 2027, 5 of the 28 Medicare Advantage plans available statewide are Dual Special Needs Plans, built specifically for people enrolled in both programs. The 2027 plans go into effect January 1, 2027, for choices made during Annual Enrollment 2027, which runs October 15 through December 7, 2026.

What is a D-SNP and who qualifies for one in South Dakota in 2027?

A Dual Special Needs Plan is a type of Medicare Advantage plan limited to people who have both Medicare and some level of Medicaid, and in South Dakota for 2027 that status is confirmed by the state Medicaid agency. Depending on the plan, enrollees may be fully dual-eligible (Medicare plus full Medicaid benefits) or partially dual-eligible (Medicare plus a Medicare Savings Program that helps with Medicare cost-sharing).

D-SNPs are designed to coordinate the two programs so a member doesn't have to juggle them separately. Each plan sets its own eligibility category — some accept only full-benefit dual eligibles, others accept certain partial dual categories — and the South Dakota Medicaid agency is the authority that verifies a person's status. Anyone unsure of their category can contact South Dakota Medicaid directly before enrolling.

How many D-SNPs are offered in South Dakota for 2027, and which carriers offer them?

South Dakota has 5 Dual Special Needs Plans for 2027, out of 28 Medicare Advantage plans counted statewide, offered by two carriers: Aetna (CVS Health) with 3 plans and UnitedHealthcare with 2 plans. The statewide Special Needs Plan picture also includes 2 Institutional Special Needs Plans (I-SNPs) and 0 Chronic Condition Special Needs Plans (C-SNPs).

The 2027 D-SNP lineup, in alphabetical order by carrier, is: Aetna Medicare Dual Classic (PPO D-SNP), which was renamed from Aetna Medicare Dual (PPO D-SNP); Aetna Medicare Full Dual (PPO D-SNP), new for next year; Aetna Medicare Full Dual Classic (PPO D-SNP), renamed from Aetna Medicare Full Dual (PPO D-SNP); UHC Dual Complete SD-Q1 (PPO D-SNP); and UHC Dual Complete SD-S2 (PPO D-SNP). All five include drug coverage. The three Aetna plans are each offered in 10 counties, and the two UnitedHealthcare plans are each offered in 47 counties. The full details appear in the plan tables on this page.

Those county counts are important: a plan listed in the statewide total may or may not be available in a given reader's county. Availability is county by county, and the Medicare Plan Finder at medicare.gov shows what's offered at a specific ZIP code.

How often can a dual-eligible person in South Dakota change plans in 2027?

People who have both Medicare and Medicaid generally have more opportunities to change plans than other Medicare beneficiaries. In addition to Annual Enrollment 2027 (October 15 – December 7, 2026) and Medicare Open Enrollment 2027 (January 1 – March 31, 2027, for people already in a Medicare Advantage plan), dual-eligible individuals typically qualify for a Special Enrollment Period that lets them make a change once per calendar quarter during the first three quarters of the year.

That means a South Dakotan with full Medicaid who enrolls in a D-SNP effective January 1, 2027, generally has additional chances during 2027 to switch to a different D-SNP or return to Original Medicare if a plan isn't the right fit. The exact rules depend on a person's Medicaid category, so Medicare.gov and 1-800-MEDICARE are the places to confirm which Special Enrollment Period applies.

How do I check whether a D-SNP is offered in my South Dakota county for 2027?

The fastest way to check whether any of the 5 D-SNPs is offered in a specific South Dakota county for 2027 is to use the Medicare Plan Finder at medicare.gov and enter a ZIP code, or to call 1-800-MEDICARE (TTY 1-877-486-2048), available 24 hours a day, seven days a week. The Plan Finder lists each plan available at that address along with the plan's own documents.

Because the three Aetna (CVS Health) D-SNPs are each offered in 10 counties and the two UnitedHealthcare D-SNPs are each offered in 47 counties, availability varies widely across the state. For plan-specific information — premiums, cost-sharing, provider networks, drug formularies and star ratings — the authoritative sources are the Plan Finder, 1-800-MEDICARE, and each plan's own Evidence of Coverage and provider and pharmacy directories.

Where can South Dakotans get free help comparing D-SNPs for 2027?

Free, unbiased help is available from Medicare directly: Medicare.gov for online comparisons and 1-800-MEDICARE (TTY 1-877-486-2048) for live assistance any time of day. For Medicaid eligibility questions — which determine whether someone qualifies for a D-SNP in the first place — the South Dakota Medicaid agency is the authority.

It helps to have a few things ready before calling: a Medicare number, a Medicaid identification if available, a list of current medications and pharmacies, and the names of any doctors a reader wants to keep seeing. With those in hand, a comparison on the Plan Finder for 2027 goes much faster, and a representative at 1-800-MEDICARE can walk through the options at the reader's own pace.