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State Farm Health Insurance For Drug Rehab: Coverage Options

Last Updated: February 15, 2022

Authored by Nena Messina, Ph.D.

Reviewed by Michael Espelin APRN

The “right to the enjoyment of the highest attainable standard of physical and mental health” is a fundamental human right first articulated in the 1946 Constitution of the World Health Organization (WHO). Since the inception of this goal, governments worldwide have tried to achieve this ideal through the use of policy, provision of universal basic medical services, and widespread information campaigns.

Addiction and substance use disorders (SUDs) represent an ever-increasing departure from sound health by all well-being metrics, especially the alarming increase in the rate of prescription drug misuse and abuse. However, getting the medical help needed to deal with substance abuse may be difficult due to the exorbitant cost of such treatments. State Farm Health Insurance is a form of comprehensive medical insurance which offers help to clients to pay for the medical services they need to defeat addiction and get their life on the right path to full health and recovery.

What Is State Farm Insurance?

State Farm Insurance was founded in 1922 in Bloomington, Illinois. They provide health insurance, auto insurance, home insurance, life insurance, and other forms of security to a wide range of clients. It is home to about 84 million policies and accounts, 57,672 employees, 18,000 agents, 343 claim offices, and 30 operations centers. It has been in business for a century and is undoubtedly one of the largest and most trusted insurance firms in the United States.

State Farm Health Insurance is a health insurance company that is a business subsidiary of the larger State Farm Insurance group. State Farm’s health coverage includes a variety of plans, products, and services that caters to families, individuals, and senior citizens.

State Farm Health Insurance plans offer a range of Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), Point-of-Service (POS), and High Deductible Health Plans (HDHP) options. In addition, each policy contains various packages that differ in deductible costs, degree of coverage, coinsurance, etc.

Does State Farm Health Insurance Cover Drug Rehab?

State Farm Health Insurance coverage includes drug rehabilitation and other forms of addiction therapy. The Affordable Care Act (ACA) passed in 2010 mandates that all marketplace insurance providers, such as State Farm Health Insurance, are required to cover drug and alcohol rehabilitation programs as part of the “ten essential health benefits.”

Receptionist at the clinic talking to a customer.

Also, since substance use disorders are classified as mental health diseases, according to the Mental Health Parity and Addiction Equity Act (MHPAEA), they must be covered by health insurance providers to the same degree as other medical claims.

The extent of your coverage depends on what coverage policy you have, the length, intensity, type of addiction treatment you plan to undergo, and your location. It’s best to reach out to a State Farm medical insurance agent for full information about any medical claims and to determine the full extent of your coverage, especially if you are new to the business of indemnity coverage.

Types Of State Farm Health Insurance

State Farm medical insurance plans for rehab can come in various forms.

Some of the Types of Medical Coverage They Offer Are:

  • Individual plans
  • Family plans
  • Group plans
  • Supplemental insurance
  • Medicare supplemental insurance
  • Medicare Part D coverage

State Farm Medicare Supplement

State Farm Medicare Supplement is a policy offered to individuals under Medicare coverage. It helps pay for some medical services not covered by the Medicare plan and reduces out-of-pocket expenses. It may include coinsurance, deductibles, and copayment amounts. Some personal State Farm Supplement products may even cover claims not covered by Medicare.

State Farm Medicare Supplement plans are available to individuals who are 65 or older and have enrolled in the Medicare Plan, Parts A and B. However, individuals below 65 can enroll for State Farm Supplement coverage in some states if they are Medicare-eligible due to disability or end-stage renal disease.

State Farm Medicare Supplement also covers the cost of addiction treatment and mental health therapy. Contact a customer care agent for more information on the State Farm Supplement policy, especially if you are new to the business of indemnity coverage.

Types of Drug Rehab Covered

Due to the Affordable Care Act, insurance companies must cover substance abuse rehabilitation claims as robustly as they do any other essential service. It means that State Farm health insurance plans for rehab are fairly comprehensive. Detox, inpatient care, outpatient care, home care, and aftercare are all covered through most State Farm’s policies.

Detox

When someone is addicted to a substance that can cause deadly withdrawals, medically supervised detoxification is needed. Attempting detoxification at home can be dangerous and may lead to death or a new relapse episode. Your coverage provider for substance abuse rehab will cover this so long as needed. However, not every user will qualify for detoxification coverage. It depends on the personal plan the individual is under, the substance of abuse, and the treatment required.

Inpatient Treatment

Inpatient rehabilitation is when the recovering addict lives at the facility. How long they can remain will be determined by the coverage company. In general, stays longer than 30 days will require special approval, and all facilities must meet specific requirements set by the coverage provider.

Outpatient Treatment

Outpatient rehabilitation is less intensive than inpatient care and will generally be covered for longer than inpatient treatment. Just as with residential facilities, the outpatient care provider must be approved by the insurance company.

Psychologist comforting his patient.

The types of therapies covered by the policy can vary, so users should check with the company before using any alternative therapies or new treatments.

Medications And Aftercare

The indemnity coverage extends to medications and aftercare when the client has been discharged home. However, there are restrictions on this. Not all forms of medication management are covered, and even when they are, the user will need to seek approval first from the business. Aftercare can include things like ongoing therapy and specialized programs that help the user stay clean when starting their new life after treatment.

State Farm Health Insurance Plans

State Farm medical insurance plans come in several different business forms.

The Key Products Include:

  • Individual Medical Policy: This plan is tailored for individuals who do not possess medical coverage through their employers or as part of a group plan.
  • Medicare Supplement Coverage: The supplement plan is available to individuals who are 65 or older and have enrolled in the Medicare Plan, Parts A and B. In some states, individuals below 65 can enroll for the State Farm Supplement policy if they are Medicare-eligible due to certain disabilities which impact their life significantly.
  • Supplemental Health Coverage: This is a form of supplementary medical coverage which helps individuals and families cope with additional medical services and the extra costs associated with hospital stays. It covers fees such as outpatient surgery, unexpected child care, emergency room visits, deductibles, coinsurance amounts, and so on.

Contact a State Farm customer care agent for more information concerning the various products they offer or if you are new to the business of indemnity coverage.

How To Use State Farm Medical Insurance For Drug Rehab

Coverage plans can be complicated to understand, including State Farm’s drug rehab coverage. The insurance industry relies heavily on jargon that the average person may not be familiar with, and frequently, there is conflicting language in a policy. To use insurance for drug rehab, users should seek help.

Contact Company Directly

This help can come from contacting a company agent directly. Users need to have their name, date of birth, and coverage policy number ready when they call. However, it might be easier to let others handle this. Drug rehab centers have staff on hand who can walk patients through the process of verifying coverage or even handle this for them. Once substance abuse treatment coverage is confirmed, they can explain what is covered, what isn’t, and how much the patient can expect to pay out of pocket.

Contact Primary Care Provider

Sometimes, it may be necessary to start with a primary care provider. They will then write the referral for drug rehab, allowing the patient to access the care they need. It is done to ensure that rehab is medically necessary before your indemnity provider covers it.

Most people using State Farm rehab will need to find an in-network provider or be prepared to pay more of the costs out of pocket – potentially the cost of treatment in full. Before enrolling in a program, the insured needs to check that the facility they have chosen is within their network. If it isn’t, they should find out what it will cost them and decide if the trade-off is worth it.

Make a Claim

Filing a claim is generally pretty easy, and in most cases, the drug rehabilitation facility will handle it for their patients. However, if the patient needs to handle this on their own, they can call the Health Response Center, send the claim and itemized bill via the postal service to the correct address for their location, or drop off the bills at a local agent’s office.

Should part or all of a claim be rejected, this does not mean that care is unaffordable. Many drug rehabilitation facilities offer special funding and flexible payment plans.

Verify Your Eligibility And Start Treatment

Medical insurance organizations offer a wide range of coverage for various forms of drug addiction and mental health therapy. With the support of federal policies like the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, these organizations are mandated to give drug addiction treatment and mental health therapy the same level of personal coverage as other medical procedures.

Therefore, if you or anyone in your life is struggling with substance abuse, reach out to the nearest rehabilitation center near you for further information. They will inform you about the available treatment plans and coverage options, including inpatient rehab and outpatient rehab services. Drug addiction is an illness just like any other illness, and you deserve all the personal support you need to get your life back on the path to health.

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Page Sources

  1. Schulden, J. D., Thomas, Y. F., & Compton, W. M. (2009). Substance abuse in the United States: findings from recent epidemiologic studies. Current psychiatry reports, 11(5), 353–359. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144502/
  2. State Farm Health Insurance. State Farm. https://www.statefarm.com/insurance/health
  3. Essential Health Benefits. HealthCare.gov https://www.healthcare.gov/glossary/essential-health-benefits/
  4. Medicare Supplemental Insurance. State Farm Health Insurance. State Farm. https://www.statefarm.com/insurance/health/medicare-supplemental

Published on: October 2nd, 2019

Updated on: February 15th, 2022

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.