Medicare in Edmunds County, South Dakota · Plan Year 2026
Medicare Advantage Plans in Edmunds County, SD: Your Complete 2026 Guide
Edmunds County has 2 Medicare Advantage plans for 2026 — 1 with a $0 premium — serving a county where CMS counts 939 Medicare beneficiaries. 0% of plans are rated 4 stars or higher by CMS. Residents can also choose from 8 Medicare Cost plans, a South Dakota specialty. Below is the real data — every plan, premium, and rating — plus a live tool for your ZIP.
Page last revised: 2026-07-19 · Plan and enrollment data refreshed: 2026-07-19 · Plan year 2026
2026 Medicare Advantage by the numbers
Edmunds County Medicare at a glance
Sources: CMS Medicare Advantage/Part D Landscape (PY2026) · CMS Medicare Monthly Enrollment (county). Premium figures are Part C premiums; consolidated Part C + D average is $80/mo.
What neighbors actually chose
Most-enrolled Medicare Advantage plans in Edmunds County
Enrollment counts are CMS facts, not our recommendation — the right plan depends on your doctors, drugs, and budget.
- Blue Medicare Advantage Enhanced PPO (PPO) (PPO) — 46 enrollees
Source: CMS Medicare Advantage Enrollment by State/County/Contract (counts under 11 suppressed by CMS).
Plan type
Medicare Advantage PPO plans in Edmunds County
PPO (Preferred Provider Organization) plans let you see any provider that accepts the plan, in or out of network, with lower cost sharing in network. Every standard Medicare Advantage plan sold in Edmunds County for 2026 is a PPO, so network flexibility is the local baseline.
- 2 PPO plans available
- $31.5 average monthly premium
- 1 with a $0 premium
- $5,475 average out-of-pocket max
- 46 Edmunds County enrollees
- Most enrolled: Blue Medicare Advantage Enhanced PPO (PPO)
- 1 without drug coverage
| Plan | CMS rating | Premium/mo | Out-of-pocket max | Part D deductible | CMS plan ID |
|---|---|---|---|---|---|
| Blue Medicare Advantage Enhanced PPO (PPO) Average (CMS 3.5★) | 3.5★ | $63 | $4,200 | $300 | H5900_004 |
| Blue Medicare Advantage Valor PPO (PPO) Average (CMS 3.5★) | 3.5★ | $0 | $6,750 | No drug coverage | H5900_007 |
Source: CMS Medicare Advantage/Part D Landscape (PY2026) · CMS Medicare Part C & D Star Ratings (2026). "Stability" is the plan's published CMS Overall Star Rating tier — a federal quality measure, not our opinion.
A South Dakota specialty
Medicare Cost plans in Edmunds County
South Dakota is one of the few states where Medicare Cost plans are still common. They combine plan benefits with a safety valve: outside the network, care simply falls back to Original Medicare rates. Edmunds County has 8 Cost plans for 2026 from Medica with 193 county enrollees. The most-enrolled Cost plan locally is Medica Prime Solution Core (Cost).
Cost plans are quoted person-by-person — ask us to compare them against the Medicare Advantage table above for your situation.
Quality, in CMS's own numbers
Medicare Advantage plan ratings in Edmunds County
| CMS rating | Plans | % of plans |
|---|---|---|
| 3.5★ | 2 | 100% |
The average CMS rating across Edmunds County's 2 plans is 3.5. No 5-star plan is sold in Edmunds County for 2026 — which also means the year-round 5-star Special Enrollment Period is not available locally.
Health profile · why plan choice matters here
Chronic conditions among Edmunds County adults
The right coverage depends on your health. CDC PLACES model-based prevalence for Edmunds County (4,057 residents) — a reason to check each plan's drug formulary and specialist network before enrolling:
Source: CDC PLACES: Local Data for Better Health, County (crude prevalence).
Hospitals serving Edmunds County
- BOWDLE HOSPITAL - CAH — Bowdle · not yet rated by CMS
See your Edmunds County plans now
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How and when to enroll in Edmunds County
When you can sign up
- Initial Enrollment Period — the 7-month window around your 65th birthday (3 before, your birthday month, 3 after). Medicare 101 →
- Annual Enrollment Period — October 15 to December 7 each year, for 2027 coverage decisions.
- Medicare Advantage Open Enrollment — January 1 to March 31, one switch allowed if you already have an MA plan.
- Special Enrollment Periods — after life events like moving counties, losing employer coverage, or qualifying for Extra Help.
Ways to enroll
- With a licensed local agent (free) — Big Sioux Benefits · (605) 555-0142 · Mon–Fri 8am–6pm CT. We compare the plans we offer in Edmunds County against your doctors and drugs.
- Directly with a plan's carrier — using the CMS plan ID from the tables above.
- Through Medicare.gov — the federal plan finder and enrollment portal.
Plan availability in Edmunds County
2026 plans in the tables above are sold county-wide. That includes residents of Bowdle, Deerfield Colony, Hosmer, Ipswich, Mina, Pembrook Colony, Plainview Colony, Roscoe, and all other Edmunds County communities. To enroll in Medicare Advantage or a Cost plan you must be enrolled in Medicare Part A and Part B and live in the plan's service area.
Edmunds County Medicare questions, answered
How many Medicare Advantage plans are available in Edmunds County, SD for 2026?
2 standard Medicare Advantage plans are sold in Edmunds County for 2026, 1 of them with a $0 Part C premium. Edmunds County residents can also choose from 8 Medicare Cost plans.
How many people in Edmunds County are on Medicare?
CMS counts 939 Medicare beneficiaries in Edmunds County (2025), of whom about 251 (27%) are in Medicare Advantage or other non-Original-Medicare coverage.
What does a Medicare Advantage plan cost in Edmunds County for 2026?
The average Part C premium across Edmunds County's 2 plans is $31.5/month, and 1 plans charge $0. Including Part D drug premiums, the average consolidated premium is $80/month. The average in-network out-of-pocket maximum is $5,475 (highest: $6,750). You still pay your Part B premium with any plan.
What health conditions matter most for choosing a plan in Edmunds County?
Per CDC PLACES, among Edmunds County adults: high blood pressure 36.5%, obesity 33.7%, arthritis 30%, diagnosed diabetes 12.4%. Conditions like these are why we match a plan's drug formulary, specialist network, and out-of-pocket maximum to your actual health needs before you enroll.
When can I enroll in a Medicare plan in Edmunds County?
During your 7-month Initial Enrollment Period around your 65th birthday, the Annual Enrollment Period (October 15 to December 7), the Medicare Advantage Open Enrollment Period (January 1 to March 31, for current MA members), or a Special Enrollment Period after qualifying life events such as moving or losing employer coverage.
Sources, citations, and methodology
- CMS Medicare Advantage/Part D Landscape (PY2026) — accessed 2026-07-19
- CMS Medicare Part C & D Star Ratings (2026) — accessed 2026-07-19
- CMS Medicare Advantage Enrollment by State/County/Contract — accessed 2026-07-19
- CMS Medicare Monthly Enrollment (county) — accessed 2026-07-19
- CDC PLACES: Local Data for Better Health, County (crude prevalence) — accessed 2026-07-19
- CMS Hospital Compare — Overall Star Ratings — accessed 2026-07-19
- US Census Bureau — Places by County (2020) — accessed 2026-07-19
Methodology: plan counts, premiums, out-of-pocket maximums, Part D deductibles, and star ratings are computed from the CMS PY2026 Landscape source files for Edmunds County, South Dakota. Headline "average premium" and "$0 premium" figures use the Part C premium; the consolidated Part C + D premium is reported separately. Special Needs Plans (D-SNP, I-SNP) and Medicare Cost plans are excluded from Medicare Advantage averages and shown separately. County enrollment sums CMS contract-level enrollment for Edmunds County; CMS suppresses counts under 11, so totals are conservative. Health prevalence figures are CDC PLACES model-based estimates. Content is prepared by the Big Sioux Benefits Data Desk and reviewed for accuracy against the cited files; plan details change — verify with a licensed agent before enrolling.
Big Sioux Benefits is a licensed insurance agency, not affiliated with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Contact Medicare.gov or 1-800-MEDICARE for all options.
Talk to a licensed Edmunds County Medicare advisor
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