Health insurance in Lincoln County, South Dakota
2 insurers sell 41 marketplace plans here, and 6.9% of under-65 residents have no coverage at all.
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release.
Two insurers, and what that means
Two insurers sell here, offering 41 plans between them. If either leaves, Lincoln County becomes a single-insurer county. Each insurer averages about 20 plans, so most of the choice here is between products from the same company rather than between companies. The number has not changed since the previous plan year.
How many people here have no coverage
6.9% of Lincoln County's 64,397 under-65 residents have no health coverage — 4,436 people. That is below the South Dakota rate of 9.9%, and puts Lincoln County in the bottom quarter of the 1,817 counties on this site (1585th).
How much the marketplace is used
3,238 Lincoln County residents selected a marketplace plan for 2026: 50 per thousand under-65 residents, 1569th of 1,817. That is under the 78 per thousand typical of published counties. 536 of them — 17% — were new rather than renewing.
Lincoln County against South Dakota
Lincoln County is the smallest of the 3 South Dakota counties we publish a page for. Its uninsured rate runs 3.0 points lower than South Dakota overall and with 2 it has the fewest insurers of any South Dakota county. Marketplace use is well under the South Dakota rate.
| Lincoln County | South Dakota | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 6.9% | 9.9% | 9.9% |
| Insurers selling | 2 | 2–3 | 4 |
| Plans offered | 41 | — | 57 |
| Selections per 1,000 | 50 | 70 | 78 |
| New rather than renewing | 17% | 13% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Natrona County (Wyoming) | 65,258 | 11.8% | 2 | 23 |
| Grand Forks County (North Dakota) | 59,426 | 5.9% | 3 | 31 |
| Burleigh County (North Dakota) | 79,314 | 5.4% | 3 | 37 |
| Fairbanks North Star Borough (Alaska) | 79,659 | 11.5% | 2 | 15 |
Grand Forks County has 3 insurers against this county's 2 — a reminder that the county line, not the state line, is what decides your options.
All South Dakota counties · How the credit works · Enrollment dates