Using State Farm Insurance for Drug and Alcohol Treatment

Last Updated: June 17, 2019

How can I use my State Farm insurance coverage to pay for drug and alcohol rehab?

State Farm may offer your health benefits directly, or the company may partner with another insurance company to deliver your coverage. That can make using your insurance policy a little confusing. You may not know whom to call, but your addiction care provider can help. Most treatment centers have dedicated staff members that can explain your health care coverage and get the paperwork you will need in order to use your benefits.

Ranked number 41 on the Fortune 500 list of largest companies, State Farm is known for being a “good neighbor” and provides insurance coverage in five different fields: auto, home and property, life, business, and medical insurance. Heavily invested and involved in local communities, State Farm strives to make the world a better place with Good Neighbor Citizenship programs and a Green Mission that focuses on environmental impact and solutions. Offering primary medical insurance coverage for families and individuals without health insurance coverage elsewhere, such as through an employer, as well as supplemental insurance options, State Farm provides the following types of health insurance coverage:

Supplemental insurance is used in addition to primary health insurance and can help to fund supplementary expenses that may not be covered under the primary coverage plan. State Farm provides primary medical insurance plans for individuals in the following states: Wisconsin, New York, California, Connecticut, Georgia, Colorado, Illinois, Missouri, Mississippi, Maine, Montana, Indiana, Ohio, Nevada, Oklahoma, Texas, South Carolina, and Virginia. A local State Farm agent can help individuals in these areas find the coverage that best suits their needs.

According to a comprehensive study done in 2013, the National Survey on Drug Use and Health (NSDUH) revealed that close to 25 million Americans aged 12 and older were classified as current illicit drug users, which means they had used drugs in the month prior to the survey being conducted. Drug and alcohol abuse and dependency cost society more than $700 billion per year in legal fees, law enforcement costs, healthcare expenses, and lost workplace production, the National Institute on Drug Abuse (NIDA) estimates.

Many people who struggle with drug or alcohol abuse or dependency may not seek or receive necessary treatment due to costs, lack of insurance coverage, or because they may not understand how to use the coverage they have. Alcohol and drug treatment programs usually save individuals, and society as a whole, money in the long run, and many facilities accept insurance as a method of payment.

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Guide to Using State Farm Insurance for Substance Abuse Treatment

Diagnostics of Mental Health
Drug and alcohol treatment centers generally have dedicated staff members on hand to help families and individuals better understand their health insurance coverage plans and how they might apply that coverage toward rehab and recovery programs.State Farm insurance agents may also be able to provide insight as to what specific plans cover and how the coverage works.

Each state, or coverage region, may have different insurance plans and coverage options available. State Farm may partner with local insurance carriers to provide coverage in specific regions, such as the Blue Cross Blue Shield Healthcare plan of Georgia in the state of Georgia, for instance. Many plans may include the use of a healthcare savings account (HSA) that allows individuals, and employers, to place money into a tax-free account to pay for medical expenses. Coverage can potentially help pay for substance abuse treatment programs that may include medical detox services, residential or outpatient programs, counseling, therapy, educational programs, and support groups.

Many plans may require that individuals start with their primary care doctors in order to for substance abuse coverage to be deemed “medically necessary” and to obtain referrals to appropriate providers. The Affordable Care Act helped to make both mental health and substance abuse treatment coverage mandatory under most health insurance plans. It requires that insurance companies cover these services much in the same way surgeries and other medical procedures are covered without prejudice. Specific coverage types and plans may cover these services differently, or more or less comprehensively, depending on the level and type of coverage.

With a health maintenance organization (HMO) coverage plan, individuals are required to use providers that are considered in-network in order to receive services. Individuals first make an appointment with their primary care doctor who will then authorize or grant verification and refer patients to an in-network substance abuse treatment provider. Individuals may pay a copay for office visits and medical services, and out-of-pocket expenses may be subject to an annual deductible amount. The higher the deductible, generally speaking, the lower the monthly premium amounts.

Some plans even offer catastrophic deductible plans that have very low monthly fees, for those experiencing financial difficulties. These plans provide a safety net should large medical or unexpected expenses come up. Once the deductible amount is met, expenses may be covered at a higher percentage, or even completely. Generally, coverage plans also have maximum out-of-pocket amounts for each year, so individuals can know the maximum amount they might be expected to pay on a yearly basis.

With a preferred provider organization (PPO) plan, individuals may seek medical treatment from doctors or providers that are in-network or out-of-network, although fees and out-of-pocket expenses are generally higher for out-of-network providers.

Many PPO plans may not require a referral from a primary care physician (PCP) first.Some health insurance plans may be the pay-as-you-go type, such as point of service (POS) plans that allow individuals to seek and receive treatment from out-of-network providers without a referral for a higher cost than using an in-network provider. Sometimes, individuals may be required to pay for services and then receive a reimbursement from the insurance company.

To file a claim through State Farm, individuals have three main options: call the Health Response Center number, send the claim and itemized bill to one of the provided State Farm Insurance Companies addresses, or take the bill(s) to a local State Farm agent’s office to get help using the “Hospital Income Claim Express” method. Substance abuse treatment facilities, and State Farm insurance agents, can help individuals discover if their State Farm medical insurance will cover preventative treatment and drug or alcohol recovery services, and what the specific steps for finding and enrolling in a program might be. Even when insurance may not cover drug and alcohol treatment completely, rehab facilities often have flexible payment and funding options available.

Last Updated on June 17, 2019