Wellmark Standard Gold EPO
Starting at
$754
/month before subsidy
Wellmark Standard Gold EPO is a 2026 Gold EPO health insurance plan from Wellmark of South Dakota, Inc., sold on the ACA Marketplace in South Dakota under plan ID 50305SD0310007. The monthly premium starts at $754 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $2,000 ($4,000 for a family), and the individual out-of-pocket maximum is $8,200 ($16,400 for a family). After the deductible, coinsurance is 25% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 50305SD0310007
- Plan year
- 2026
- State
- South Dakota
- Metal level
- Gold
- Plan type
- EPO
- HSA-eligible
- No
Individual Deductible
$2,000
Family: $4,000
Out-of-Pocket Max
$8,200
Family: $16,400
Coinsurance
25%
You pay after deductible
Network Type
EPO
SDN001
Medical Services
Prescription Drugs
- Medical care
- Member experience
- Plan administration
How well doctors manage and coordinate care
Member-survey satisfaction with the plan
Customer service, billing, and access to information
Having a baby
Normal delivery
$4,560
your estimated cost
- Deductible
- $2,000
- Copays
- $200
- Coinsurance
- $2,300
Managing type 2 diabetes
A year of routine care
$1,470
your estimated cost
- Deductible
- $50
- Copays
- $1,400
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$2,200
your estimated cost
- Deductible
- $1,900
- Copays
- $300
- Coinsurance
- $0
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This Gold EPO plan is designed for people who use healthcare frequently and want predictable costs when they visit the doctor.
Consider this plan if you:
- Have ongoing health conditions requiring regular care
- Take multiple prescription medications
- Prefer lower costs at the time of service
- Want peace of mind with comprehensive coverage
This summary is generated based on plan attributes for educational purposes only.
If you max out this year
$1,437/month
Annual Premium
$9,048
OOP Maximum
$8,200
💡 What this means:
With a $2,000 deductible, you pay 100% of costs until you've spent that much. After that, you pay 25% (coinsurance) until you hit $8,200 total. Then insurance covers everything else for the year.
More plans from Wellmark of South Dakota, Inc. in South Dakota
- Wellmark Bronze HDHP EPO HSA Qualifiedfrom $551/mo
- Wellmark Bronze HDHP EPO HSA Qualifiedfrom $499/mo
- Wellmark Bronze Traditional EPOfrom $540/mo
- Wellmark Bronze Traditional EPOfrom $489/mo
- Wellmark Standard Bronze EPOfrom $579/mo
- Wellmark Standard Bronze EPOfrom $524/mo
- Wellmark Silver Traditional EPOfrom $761/mo
- Wellmark Silver Traditional EPOfrom $689/mo
Frequently asked questions about Wellmark Standard Gold EPO
How much does Wellmark Standard Gold EPO cost per month?
Wellmark Standard Gold EPO from Wellmark of South Dakota, Inc. starts at $754 per month before any subsidy in South Dakota. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.
What is the deductible for Wellmark Standard Gold EPO?
The individual medical deductible is $2,000, and the family deductible is $4,000. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.
What is the out-of-pocket maximum for Wellmark Standard Gold EPO?
The most you would pay in a year for covered in-network care is $8,200 for an individual and $16,400 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Wellmark Standard Gold EPO HSA-eligible?
No. Wellmark Standard Gold EPO is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.
What type of network does Wellmark Standard Gold EPO use?
Wellmark Standard Gold EPO is a EPO plan. EPO plans cover in-network care only (except emergencies) and usually do not require referrals to see specialists.
Understand what you'd actually pay
- 2026 Federal Poverty Level (FPL) chart
The income table behind subsidy and Medicaid eligibility
- How ACA subsidies work
Premium tax credits and who qualifies
- The 2026 subsidy cliff
Why income near 400% FPL matters again this year
Important Notice
Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.