The new state health care plan has South Dakota state employees worried about their out of pocket costs for certain procedures, but Avera Medical Group patients will have new options. Dr. Tad Jacobs is the Chief Medical Officer for Avera and says patients needing Tier 1 services are concerned with the lack of choices.

Jacobs says patients will still abide by their insurance policies in most regards, but could use Avera facilities closer to home.

Letters were sent to about 10,000 state employees that are currently Avera patients on Monday outlining their options.