At 10.5%, the uninsured rate among under-65 residents in Pennington County is effectively the South Dakota average of 9.9% — about 9,263 people out of 88,305. It is the 32nd highest of the 66 counties in South Dakota. A county sitting on its state's average is the most ordinary case there is, which makes the state's own rules the thing worth reading rather than anything local.
Pennington County against South Dakota, and against the counties we cover
| Pennington County | South Dakota | Covered counties | |
|---|---|---|---|
| Uninsured, under 65 | 10.5% | 9.9% | 13.0% |
| Marketplace enrollees per 1,000 | 65 | — | 127 |
| Insurers selling here | 3 | 2 (median) | 5 |
| Individual plans offered | 28 | — | 84 |
State uninsured rate from the Census SAHIE series; the final column is the median across the 104 counties covered on this site. Enrollment density is CMS plan selections per 1,000 under-65 residents.
What you can actually buy here
3 insurers compete here. That is thin enough that switching carrier usually means switching hospital system too, and wide enough that the premiums genuinely differ. Both things are worth checking before either is dismissed. Between them they offer 28 plans, about 9 for each insurer, a short list by national standards. Short lists are easier to compare properly, which is a real advantage as long as one of them fits your doctors. The count is up from 2 last year. Insurers entering a county usually means they like what they see in the risk pool, and it tends to show up as more aggressive pricing the following year rather than immediately.
5,778 marketplace plan selections were recorded in Pennington County for 2026 — only 65 per thousand under-65 residents, against a typical 127 across the counties covered here. Employer coverage dominates locally, which has a specific consequence: when it goes, fewer people around you have any experience of what to do next. 851 of them were new consumers and 4,927 were renewals — a 15% new share, close to the national pattern. Roughly one in six enrollees here arrived within the year.
Nearest counties on coverage
The counties we cover in South Dakota whose uninsured rate sits closest to Pennington County. Worth a look if you are comparing across a county line or moving.
| County | Uninsured | Insurers | Enrollees |
|---|---|---|---|
| Minnehaha County | 9.4% | 2 | 8,638 |
| Lincoln County | 6.9% | 2 | 3,238 |
Everything that applies in South Dakota · How COBRA works · Work out your COBRA premium · After a job ends
Common questions
How many people are uninsured in Pennington County?
About 9,263 people under 65, out of 88,305 in that age group — 10.5%, the 32nd highest of the 66 counties in South Dakota. The South Dakota average is 9.9%. Census Bureau estimates for 2024, the most recent published.
How many health insurers sell in Pennington County?
3 insurers offer individual marketplace plans in Pennington County for 2026, up from 2 the year before, and between them they sell 28 individual medical plans. The median across the counties covered on this site is 5 insurers and 84 plans.
How many people in Pennington County buy marketplace coverage?
5,778 plan selections for 2026 — 851 new consumers and 4,927 renewals. That works out at 65 per thousand under-65 residents, against a median of 127 across the counties covered here. New consumers are the group most likely to have lost a job during the year.
Talk it through with a licensed agent
Which option is right depends on your state, your income and which doctors you need to keep. A licensed agent can walk through it with you in about eight minutes.
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Sources
- U.S. Census Bureau, Small Area Health Insurance Estimates, 2024 (released August 2026)
- Centers for Medicare & Medicaid Services, 2026 Marketplace Open Enrollment County-Level Public Use File
- Centers for Medicare & Medicaid Services, 2026 Service Area Public Use File
- Centers for Medicare & Medicaid Services, 2026 Plan Attributes Public Use File
- U.S. Department of Labor, FAQs on COBRA Continuation Health Coverage for Workers