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Health Insurance That Works

Insurance for Individuals

Questions?

Call 605-322-4500 and ask for Janice if you have questions or want help picking out a plan.

We understand. It gets confusing when it comes to health insurance. We want to help you identify what coverage is best for you and your health care needs. 

Get a Quote Online 

Our online quote system will help you identify which plan meets your needs with only a couple of general questions:

online quote

 

Health Insurance Terms

Sometimes insurance terms can get confusing. A Uniform Glossary defining terms commonly associated with health insurance coverage may help you as you search for a new plan.


Wellness and Other Benefits 

As a member, you will have online resource tools to help you live a healthier lifestyle.


Find a Provider 

To search for potential physicians, clinics and hospitals in our network, click on the box below. If you do not live in South Dakota, you may want to call toll-free at 1-888-322-2115 to learn more about our provider network in other regions:

 

provider directory

  

  

 

 

 

 

Click Here for A List of Plans and the Summary of Benefits and Coverage

Summary of Benefits and Coverage

Doctor Visiting FamilyThe Affordable Care Act of March 23, 2010 requires health plans and health insurance issuers offering group or individual health insurance coverage to provide a Summary of Benefits and Coverage.

Avera MyPlan Summary of Benefits and Coverage:

Click Here for Additional Benefit Options

Additional Benefit Options

Benefit options are available to add to your health plan for an additional monthly premium. Click on the following tabs to learn more. For pricing, please call us toll-free at 1-877-322-4885 or email Sales@AveraHealthPlans.com

Maternity Coverage

NOTE: You must add this coverage before getting pregnant.

The following routine maternity benefits are covered with a $2,000 deductible, 30% coinsurance and a maximum out-of-pocket of $5,000:

  • Prenatal care
  • Hospital delivery
  • Postpartum care
  • Healthy newborn nursery care until the child is discharged from the hospital

Coverage for newborns after leaving the hospital will be provided if the newborn is added to your Avera MyPlan policy as a covered dependent within 30 days of delivery.

Preventive Vision

Our preventive vision benefits cover the following:

  • Annual routine eye exam — $0 co-pay and covered at 100%
  • A 20% discount on lenses and frames
  • A 15% discount on contact lens exams

Discounts are available from any VSP participating provider within 12 months of your last covered eye exam.

Visit www.vsp.com to find the most current listing of VSP participating providers.

Preventive Dental

Preventive dental office visits are important to identify issues early. Benefits include:

  • $25 co-pay and 100% coverage for two routine visits per year with a dental provider of your choice
  •  $25 co-pay sealant coverage is available once every 36 months for dependent children under 16 years of age

Ameritas provides a comprehensive dental insurance quote. Click here to learn more.

Comprehensive Dental Insurance

Ameritas provides a comprehensive dental insurance quote for Avera MyPlan members. Click here to learn more.

 

Annual Open Enrollment for Persons Under the Age of 19

Avera Health Plans offers an annual open enrollment period beginning July 1 through August 14. This is for anyone under the age of 19 that applies for individual health insurance coverage in South Dakota. Avera Health Plans may issue a rate adjustment for some individual policies based on the health status of the individual applying for coverage.

Additional Information

For more information, please call 605-322-4500 or toll-free at 1-888-322-4885, 8 a.m. to 5 p.m. CT, Monday through Friday. Questions may be emailed to Sales@AveraHealthPlans.com.