KELLY ROSE WHARTON CNP
Accepted Insurance for NPI 1376216648
Nurse Practitioner - Family in Sioux Falls, SD
Accepted Insurance & Health Plans Health Insurance Marketplace
Marketplace plan participation on file for this provider · 2026 plan year
KELLY ROSE WHARTON CNP, a nurse practitioner provider in Sioux Falls, SD, is listed as in-network for 190 health insurance plans from 3 insurance companies, led by Security Health Plan, Medica and Sanford Health Plan. This list is compiled from the CMS Health Insurance Marketplace public use files for the 2026 plan year.
Medica
Medica Individual Choice Bronze $0 Copay PCP Visits
Medica Individual Choice Bronze HSA
Medica Individual Choice Bronze Share
Medica Individual Choice Bronze Share
Medica Individual Choice Expanded Bronze Standard
Medica Individual Choice Expanded Bronze Standard
Medica Individual Choice Gold $0 Copay PCP Visits
Medica Individual Choice Gold $0 Copay PCP Visits
Medica Individual Choice Gold Share
Medica Individual Choice Gold Share
Medica Individual Choice Gold Standard
Medica Individual Choice Gold Standard
Medica Individual Choice Silver $0 Copay PCP Visits
Medica Individual Choice Silver $0 Copay PCP Visits
Medica Individual Choice Silver Share
Medica Individual Choice Silver Share
Medica Individual Choice Silver Standard
Medica Individual Choice Silver Standard
Medica Insure Bronze Premier
Medica Insure Bronze Share
Medica Insure Expanded Bronze Standard
Medica Insure Gold $0 Copay PCP Visits
Medica Insure Gold Share
Medica Insure Gold Standard
Medica Insure Silver $0 Copay PCP Visits
Medica Insure Silver Share
Medica Insure Silver Standard
Sanford Health Plan
Sanford Individual TRUE $1,750
Sanford Individual TRUE $10,600
Sanford Individual TRUE $3,500
Sanford Individual TRUE $4,750
Sanford Individual TRUE $6,500
Sanford Individual TRUE $7,200 HSA Qualified
Sanford Individual TRUE Standardized $2,000
Sanford Individual TRUE Standardized $6,000
Sanford Individual TRUE Standardized $7,500
Security Health Plan
Enrich $1,500 - 30%
Enrich $2,000 - 25%
Enrich $2,500 - 20% Copay
Enrich $3,400 - 30% HDHP
Enrich $3,500 - 30%
Enrich $3,500 HDHP
Enrich $4,000 - 20% HDHP
Enrich $4,000 - 50%
Enrich $5,000 - 20% HDHP
Enrich $5,000 HDHP
Enrich $5,500 - 40% Copay
Enrich $6,000 - 40%
Enrich $7,500 HDHP
Enrich $7,500
Enrich $750 - 10%
Enrich $9,500
Enrich Protection
Premier $2,000 - 25%
Premier $3,500 - 30%
Premier $4,000 - 50%
Premier $5,000 HDHP
Premier $6,000 - 40%
Premier $7,500 HDHP
Premier $7,500
Premier HMO $1,500 - 30%
Premier HMO $2,500 - 20% Copay
Premier HMO $3,400 - 30% HDHP
Premier HMO $3,500 - 30%
Premier HMO $3,500 HDHP
Premier HMO $4,000 - 20% HDHP
Premier HMO $5,000 - 20% HDHP
Premier HMO $5,500 - 40% Copay
Premier HMO $7,500 HDHP
Premier HMO $750 - 10%
Premier HMO $9,500
Premier POS $1,500 - 30%
Premier POS $2,500 - 20% Copay
Premier POS $3,400 - 30% HDHP
Premier POS $3,500 - 30%
Premier POS $3,500 HDHP
Premier POS $4,000 - 20% HDHP
Premier POS $5,000 - 20% HDHP
Premier POS $5,500 - 40% Copay
Premier POS $7,500 HDHP
Premier POS $750 - 10%
Premier POS $9,500
Reliance $1,500 - 30%
Reliance $2,500 - 20% Copay
Reliance $3,400 - 30% HDHP
Reliance $3,500 - 30%
Reliance $3,500 HDHP
Reliance $4,000 - 20% HDHP
Reliance $5,000 - 20% HDHP
Reliance $5,500 - 40% Copay
Reliance $7,500 HDHP
Reliance $750 - 10%
Reliance $9,500
Select $2,000 - 25%
Select $3,500 - 30%
Select $4,000 - 50%
Select $5,000 HDHP
Select $6,000 - 40%
Select $7,500 HDHP
Select $7,500
Select $9,500
Select Protection
SimplyOne $1,500 - 30%
SimplyOne $2,000 - 25%
SimplyOne $2,500 - 20% Copay
SimplyOne $3,400 - 30% HDHP
SimplyOne $3,500 - 30%
SimplyOne $3,500 - 30%
SimplyOne $3,500 HDHP
SimplyOne $4,000 - 20% HDHP
SimplyOne $4,000 - 50%
SimplyOne $5,000 - 20% HDHP
SimplyOne $5,000 HDHP
SimplyOne $5,500 - 40% Copay
SimplyOne $6,000 - 40%
SimplyOne $7,500 HDHP
SimplyOne $7,500 HDHP
SimplyOne $7,500
SimplyOne $750 - 10%
SimplyOne $9,500
SimplyOne $9,500
SimplyOne Protection
Coverage Questions FAQs
Common questions about this provider’s insurance participation, answered from the CMS Health Insurance Marketplace and Medicare enrollment files.
What insurance does KELLY ROSE WHARTON CNP accept?
Marketplace files for the 2026 plan year list KELLY ROSE WHARTON CNP as in-network for 190 plans from 3 insurance companies. The largest networks are Security Health Plan (86 plans), Medica (27 plans), Sanford Health Plan (9 plans). The full list above shows each plan's metal level, network type, and plan IDs.
Is KELLY ROSE WHARTON CNP enrolled in Medicare?
Yes. CMS enrollment files show this provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for covered services. The provider is also enrolled in PECOS, which certifies them to order, refer, and prescribe for Medicare beneficiaries.
What network types does KELLY ROSE WHARTON CNP participate in?
The accepted plans include 64 HMO plans, 47 EPO plans and 11 POS plans. HMO (Health Maintenance Organization) plans cover care from network providers and typically require a primary care referral for specialists. EPO (Exclusive Provider Organization) plans cover network providers only, generally without referral requirements. POS (Point of Service) plans combine HMO-style referrals with partial out-of-network coverage.
Where does this insurance data come from and how current is it?
Plan participation is compiled from the official CMS Health Insurance Marketplace public use files for the 2026 plan year and refreshed as CMS publishes updated files. Networks change during the year, so always verify coverage with the insurance company or the provider's office before scheduling care.
