State Farm Insurance Coverage for Substance Abuse Treatment

Does State Farm Insurance Cover Alcohol and Drug Rehab?

Founded in 1922 by a retired farmer and insurance salesman named George Jacob “G.J.” Mecherle, State Farm is a mutual company that insures cars, homes, and health.^{1 (Paragraph 1)} They now have about 19,000 agent offices nationwide.^{1 (Paragraph 6)} In addition to property and casualty insurance, annuities, and financial services, State Farm offers both life and health insurance policies.^{2 (“Lines of Business”)}

State Farm treatment center options are available if you or your loved one need them. A rehab center can check your coverage for you if you provide them with your plan information. Also, you can call the number located on the back of your insurance card to learn more about the specifics of your State Farm health insurance plan.

Check State Farm Insurance Coverage for Addiction Treatment

State Farm currently offers over 100 products and services in five lines of business, handling over 36,000 claims per day.^{1(Paragraph 3)} As far as health insurance goes, they have supplemental health insurance, Medicare supplement insurance, and individual medical coverage.³ Supplemental insurance helps with co-insurance and deductible amounts and pays out any reimbursements directly to you unless you direct them otherwise.⁴ If you have Medicare, State Farm’s Medicare Supplement Insurance picks up where that leaves off, paying some of your share of health-care costs not covered by your Medicare plan (such as co-insurance, co-payments, and deductibles).⁵ Additionally, Blue Cross Blue Shield State Farm is a marketing alliance that assists you with individual major medical insurance coverage.⁶

If you are unsure about whether your plan covers inpatient rehab or outpatient services, you can reach out to American Addiction Centers for assistance in verifying your insurance. Simply input the requested information into the form and see whether your provider is in-network or not. You can also call the AAC helpline to speak with a representative who can verify your insurance. You may ask them questions and get them answered right over the phone.

What Is State Farm?

Known for being a “good neighbor” by being “there” for customers, State Farm has been servicing Americans since 1922.^{1 (Paragraph 1)} They hold the number 36 spot on the Fortune 500 list of the biggest companies.^{1 (Paragraph 1)} What started as a single-line auto insurance company has turned into one that offers almost 100 services and products within five business lines.^{1 (Paragraph 3)} State Farm is a public leader when it comes to automobile safety and supports programs that create safer neighborhoods, homes, and highways.^{1 (Paragraphs 4-5)}

State Farm Plans

State Farm individual major medical insurance is only available in select states.^{6 (“State Farm health plan availability”)} You can use the form on their website to check if plans are available in your state. State Farm partners with Blue Cross Blue Shield to bring you these plans^{6 (Paragraph 1)} This means that you will be able to select a BCBS plan that fits your needs through your State Farm account. Any individual major medical coverage plan you select provides you with the essential benefits required by the Affordable Care Act, which includes mental health and substance use disorder services, including behavioral health treatment.^{7 (Page 105)}

Contact your state’s BCBS company to learn more about the specific plans they offer in partnership with State Farm.⁸ A local representative can go over the multiple tiers and plan types with you to find the one that works best at meeting your substance use disorder treatment needs.

What Will State Farm Insurance Cover?

Through its partnership with BCBS, your State Farm plan can cover some or all your addiction treatment, but that depends on which plan you have selected, including a government plan like Medicaid (which gives you a low- or no-cost health insurance plan that might cover your entire stay).⁹

If you have selected a BCBS HMO plan through State Farm, the outpatient services have a $50-per-visit co-pay with in-network providers.^{10 (Page 4)} An out-of-network provider or rehab center is not covered. ^{10 (Page 4)} Some services—such as substance use disorder treatment—will require preauthorization. ^{10 (Page 4)} Inpatient services through in-network providers have a $250-per-day co-pay; out-of-network services are not covered. ^{10 (Page 4)} There is a $250/day co-pay for the first three days of each benefit period, and preauthorization is required. ^{10 (Page 4)}

On the other hand, if you have the Blue Preferred Bronze PPO 206, outpatient services with an in-network provider have a 40% coinsurance while out-of-network providers have a 50% coinsurance.^{11(Page 4)} Inpatient services from an in-network provider cost $400 per visit plus 50% coinsurance. ^{11(Page 4)} It is $2,000 per visit plus 50% coinsurance with an out-of-network provider. ^{11(Page 4)}

Does State Farm Insurance Cover Mental Health Treatment Facilities?

Approximately 9.2 million American adults live with co-occurring disorders—a coexistence of a mental health condition and a substance use disorder.^{12 (Paragraphs 1-2)} Multiple combinations of these disorders exist, and bipolar disorder, mood and anxiety disorders, and major depressive disorder are all considered to be common in their co-occurrence with substance use disorders.^{12 (Paragraph 5)}

Under the Affordable Care Act (ACA), you can qualify for a health insurance subsidy if you make between 100% and 400% of the federal poverty level.^{6 (“Qualifying for subsidies”)} The ACA also ensures coverage for those who need mental health services.⁷ This law requires that most small employer and individual health insurance plans—including every plan offered through the Health Insurance Marketplace—covers substance use disorder and mental health services.⁷ Furthermore, it is required that these plans cover habilitative and rehabilitative services that assist people with behavioral health challenges.⁷

How Long Does State Farm Insurance Cover Inpatient Rehab?

State Farm Insurance costs and coverage will depend on how long you stay in rehab, and that is subject to your recommended treatment plan. Research demonstrates that proper durations of rehab stays are linked with positive rehab outcomes.¹³ Participating for at least 90 days is more significant in its effectiveness than stays lasting for less than 90 days, illustrating how lengthier rehab stays encourage more positive outcomes.^{13 (Paragraph 1)}

Since there are multiple plans and policy tiers offered by State Farm in conjunction with Blue Cross Blue Shield—as well as supplemental and Medicare coverage—you must learn what your plan covers before scheduling your stay in a State Farm rehab facility. You can utilize the information displayed on your insurance card to check the specifics of your plan’s coverage.

What if My State Farm Policy Does Not Cover Rehab?

Your State Farm policy might not cover all your stay in a rehab facility, but you might qualify for financial assistance through grants, scholarships, or other means of special funding. Certain non-profit organizations may provide grants and scholarships to assist people in their local community with addiction services. You might also wish to check with your local churches and faith-based charities to see if they can provide you with some financial assistance. Additionally, it could prove beneficial to contact the facility of your choice, as facilities sometimes offer their own grants and scholarships.

Waiting to get treatment will not help you out in the here-and-now; reaching out and asking for help only takes a few minutes and can be done over the phone or by submitting a form online. Knowing what your State Farm plan covers and how much you should expect to pay out of pocket are essential to getting this process started.

State Farm In-Network vs. Out-of-Network Rehab Centers

There are State Farm outpatient rehab and inpatient rehab services that are considered in-network. This means that these facilities already work with State Farm (and their partner, Blue Cross Blue Shield). An out-of-network State Farm treatment facility is a rehab that currently does not accept any State Farm plans. You can see if your chosen facility is in-network by checking with the facility itself, with your insurance provider, or by letting AAC validate your health insurance coverage online or over the AAC helpline.