Individuals may begin applying for Marketplace coverage as early as October 1, 2013. Upon application, individuals will find out whether or not they qualify for lower costs on insurance premiums or out-of-pocket costs. These savings are based on household income and size.
If an insurance plan is purchased outside the Marketplace (such as with a private insurer) individuals are not eligible for lower costs based on income.
If individual or household income falls below the amounts determined each year, they may qualify for coverage under South Dakota's Medicaid program. However, since South Dakota has not yet expanded Medicaid, and if the individual does not qualify for Medicaid under current state rules-- individuals cannot get lower costs on Marketplace coverage based on income. Individuals will have to pay the entire cost of a Marketplace insurance plan.