What is supplemental insurance?
Supplemental Health Insurance1 and Supplemental Health Insurance Plus2 is additional insurance you can purchase to help individuals and families deal with additional medical costs and the extra costs associated with hospital stays.
Get a Supplemental Health or Supplemental Health Plus quote*
*Offers vary by state and may go by such names as hospital confinement indemnity, hospital indemnity, or hospital income. Not available in Massachusetts, New Jersey or Rhode Island.
What’s the difference between Supplemental Health Insurance and Supplemental Health Insurance Plus?
While Supplemental Health Insurance pays up to $1000 more in admissions benefit, it lacks the additional Supplemental Health Insurance Plus benefits such as extended care, emergency accident, outpatient surgery, observation coverage and ambulance service.
Comparing Supplemental Health Insurance and Supplemental Health Insurance Plus
Coverage Benefits | Supplemental Health Insurance | Supplemental Health Insurance Plus |
|---|---|---|
Hospital Confinement/Admission | ||
Daily Confinement | ||
Intensive Care | ||
Extended Care | ||
Emergency Accident | ||
Outpatient Surgery | ||
Observation Benefits** | ||
Ambulance (Ground) | ||
Ambulance (Air) |
Comparing Supplemental Health Insurance and Supplemental Health Insurance Plus
Supplemental Health Insurance
Coverage Benefits | |
|---|---|
Hospital Confinement/ | |
Daily Confinement | |
Intensive Care | |
Extended Care | |
Emergency Accident | |
Outpatient Surgery | |
Observation Benefits** | |
Ambulance (Ground) | |
Ambulance (Air) |
Supplemental
Health Insurance Plus
Coverage Benefits | |
|---|---|
Hospital Confinement/ | |
Daily Confinement | |
Intensive Care | |
Extended Care | |
Emergency Accident | |
Outpatient Surgery | |
Observation Benefits** | |
Ambulance (Ground) | |
Ambulance (Air) |
**Benefit not available in New Mexico
Get a Supplemental Health or Supplemental Health Plus quote*
*Offers vary by state and may go by such names as hospital confinement indemnity, hospital indemnity, or hospital income. Not available in Massachusetts, New Jersey or Rhode Island.
Exploring the benefits/
coverage in detail
Not only can supplemental insurance help pay for things not covered by your primary health insurance policy, but it also has other advantages.
Benefits with Supplemental Health Insurance
Hospital Admission Benefit
State Farm® pays the hospital admission benefit amount of $3,500 for the first day the hospital confinement benefit is payable if a covered person is necessarily admitted and confined in a hospital ($1,500 in Montana and $3,000 in New Mexico and New York). This benefit is payable a maximum of one time per calendar year per covered person.
Hospital Confinement Benefit
State Farm pays the hospital confinement benefit amount of $2503 for each day a covered person is necessarily admitted and confined in a hospital. This benefit is payable a maximum of 365 days for any one confinement. If a hospital observation stay and a hospital confinement occur on the same day, only the hospital confinement benefit is payable.
Intensive Care Benefit
State Farm pays the intensive care benefit amount of $2503 for each day a covered person is necessarily confined in the intensive care unit of a hospital. This benefit is payable a maximum of 30 days (31 days in Idaho) for any one confinement and is in addition to the hospital confinement benefit.
Second Opinion Benefit (Maryland only)
If as a result of Maryland's state requirement of a utilization review for all patient's admitted to the hospital, you are billed for a Second Opinion, we will pay $125 per occurrence.
State Farm pays the hospital admission benefit amount of $2,500 for the first day the hospital confinement benefit is payable if a covered person is necessarily admitted and confined in a hospital ($1,000 in Montana). This benefit is payable a maximum of one time per calendar year per covered person.
State Farm pays the hospital confinement benefit amount of $250 for each day a covered person is necessarily admitted and confined in a hospital. This benefit is payable a maximum of 365 days for any one confinement. If a hospital observation stay and a hospital confinement occur on the same day, only the hospital confinement benefit is payable.
State Farm pays the intensive care benefit amount of $250 for each day a covered person is necessarily confined in the intensive care unit of a hospital. This benefit is payable a maximum of 30 days for any one confinement and is in addition to the hospital confinement benefit.
State Farm pays the hospital observation benefit amount of $250 for each day a covered person receives treatment as an outpatient in a hospital observation unit and an observation room charge is incurred. This benefit is payable a maximum of 14 days per observation stay. A maximum of three hospital observation stays shall be payable per calendar year per covered person. (Benefit not available in New Mexico. Limited supplemental coverage in Colorado and Pennsylvania).
State Farm pays the emergency accident benefit amount of $250 for each day a covered person requires emergency treatment as the result of an injury. Emergency treatment must be provided by a physician in a physician's office, urgent care facility, or hospital emergency room and be received within 72 hours of the injury, or within 12 months of the injury for New Hampshire and Washington.
This benefit is payable a maximum of three days per calendar year per covered person. Only one benefit shall be payable per day per covered person. (Limited supplemental coverage in Colorado and Pennsylvania).
State Farm pays the extended care benefit amount of $125 while a covered person is a resident inpatient in an extended care facility. An extended care facility stay must follow a hospital confinement of at least three days for which a hospital confinement benefit was payable, begin within 30 days after such hospital confinement, be for the sole purpose of receiving medical care for and during convalescence from the same injury or sickness which caused the hospital confinement, and must not exceed 60 days per calendar year. This benefit is not payable for custodial care.
State Farm pays the outpatient surgery benefit amount of $250 for a covered person's outpatient surgical operation. The surgery must be necessary for the treatment or diagnosis of an injury or sickness and performed by a physician in a medical facility. This benefit is payable a maximum of 12 days per calendar year per covered person.
Only one outpatient surgery benefit shall be payable per day, per covered person. This benefit is not payable while the covered person is confined in a hospital or is a resident inpatient in an extended care facility. (Limited supplemental coverage in Colorado and Pennsylvania).
State Farm pays the ambulance benefit amount of $500 for ground and $1000 for air if a covered person requires transportation by ambulance for an injury or sickness to or from a hospital or between medical facilities. This benefit is payable a maximum of one time per calendar year per covered person for ground ambulance and a maximum of one time per calendar year per covered person for air ambulance (Limited supplemental coverage in Colorado and Pennsylvania).
If as a result of Maryland's state requirement of a utilization review for all patient's admitted to the hospital, you are billed for a Second Opinion, we will pay $125 per occurrence.
Filing a health claim
Filing a health insurance claim is simple and can be done in one of two ways. Pick the option that's best for you.
- Take your bill(s) to your State Farm agent's office.
- Call our Health Response Center at 866-855-1212866-855-1212 to request a claim form.
Contact a local State Farm agent
Any of our 19,000 insurance agents are ready to help.
Want to know more about health coverage?
Explore Simple Insights about health insurance
From decoding jargon to understanding policies, learn what State Farm has learned over the years.
How to request a health policy change
Walk through the steps you’ll need to know to make a change to your current health policy.
Disclosures
This is a marketing tool intended for use in the sale of insurance. Completion of an application for a State Farm insurance policy will require contact with a State Farm agent/licensed insurance producer.
This is a supplement to health insurance and is not a substitute for major medical coverage. Lack of major medical coverage (or other minimum essential coverage) may result in an additional payment with your taxes.
If you currently have a health spending arrangement such as a Health Savings Account (HSA), or if you plan to open one in the future, please consult your tax advisor about the features offered in these supplemental health policies, and the possible tax implications of combining these plans.
This information provides only a brief description of coverage. It is not a contract. Certain exclusions and limitations apply. This policy may not be available in all states. Policy coverage, exclusions, and limitations may vary in some states. A complete statement of coverage is found only in the policy and any attached riders. For exact terms and conditions see: Supplemental Health Insurance policy series 97071 or 97072. The Supplemental Health Insurance policy form in ID is 97072ID. This policy is Guaranteed Renewable except in the event of fraud, material misrepresentation, nonpayment of premium, or expiration of the policy. Renewal premiums will increase periodically depending on your age. For additional details on coverage and cost, contact a State Farm agent/licensed insurance producer.
The following states require that policy exclusions, exceptions, and limitations be provided in this marketing material. For exact terms and conditions see the Supplemental Health Insurance policy available in your state.
Arizona –
This policy does not provide benefits for any loss incurred which is caused by or results from:
1. Normal pregnancy and childbirth; however, complications of pregnancy shall be considered as a Sickness; 2. Any attempt at suicide or any intentionally self-inflicted Injury, whether sane or insane; 3. Mental or nervous disease or disorder for more than 30 days per calendar year for the same or related disease or disorder; 4. Routine well-baby care for newborn children; 5. Any type of hernia or hemorrhoids or any ailment or disease of the tonsils, adenoids, or reproductive organs if the Confinement begins within 90 days after this policy becomes effective for the Covered Person. This exception shall not be applicable when the attending Physician certifies that such diseases or conditions are treated on an emergency basis; 6. Cosmetic and/or elective surgery unless caused by Injury or done for reconstructive purposes due to Injury or Sickness; 7. Intoxication (as defined by the state law where the loss occurs) or addiction to alcohol or any illegal or controlled substance, including treatment for overdose, detoxification and rehabilitation. This would not apply to treatment when a controlled substance is administered by a Physician and taken according to the Physician’s instructions; 8. Treatment provided outside the United States of America, its possessions and territories; or 9. The administration of any drug or device that is not approved by the U.S. Food & Drug Administration (FDA), including but not limited to any implant used for drug delivery.
Pre-existing Condition Limitations: These policies do not cover any loss incurred which is caused by or results from a pre-existing sickness or physical condition, as defined within the policies, subject to the time limit on certain defenses provision.
Connecticut –
This policy does not provide benefits for any loss incurred which is caused by or results from:
1. Normal pregnancy and childbirth; however, complications of pregnancy shall be considered as a Sickness; 2. Any attempt at suicide or any intentionally self-inflicted Injury, whether sane or insane; 3. Mental or nervous disease or disorder for more than 30 days per calendar year for the same or related disease or disorder; 4. Routine well-baby care for newborn children; 5. Any type of hernia or hemorrhoids or any ailment or disease of the tonsils, adenoids, or reproductive organs if the Confinement begins within 90 days after this policy becomes effective for the Covered Person. This exception shall not be applicable when the attending Physician certifies that such diseases or conditions are treated on an emergency basis; 6. Cosmetic and/or elective surgery unless caused by Injury or done for reconstructive purposes due to Injury or Sickness; 7. Intoxication (as defined by the state law where the loss occurs) or addiction to alcohol or any illegal or controlled substance, including treatment for overdose, detoxification and rehabilitation. This would not apply to treatment when a controlled substance is administered by a Physician and taken according to the Physician’s instructions; 8. Treatment provided outside the United States of America, its possessions and territories; or 9. The administration of any medication or device that is not approved by the U.S. Food & Drug Administration (FDA).
Pre-existing Condition Limitations: This policy does not cover any loss incurred which is caused by or results from a pre-existing sickness or physical condition, as defined within the policy, subject to the time limit on certain defenses provision.
Idaho -
This policy does not provide benefits for any loss incurred which is caused by or results from:
1. Normal pregnancy and childbirth; however, Complications of Pregnancy shall be considered as a Sickness; 2. Elective abortions; however, elective abortions to preserve the life of the female upon whom the abortion is performed, shall be considered as a Sickness; 3. Any attempt at suicide or any intentionally self-inflicted Injury, whether sane or insane; 4. Mental or nervous disease or disorder for more than 30 days per calendar year for the same or related disease or disorder; 5. Routine well-baby care for newborn children; 6. Cosmetic surgery, except that cosmetic surgery shall not include reconstructive surgery when the service is incidental to or follows surgery resulting from trauma, infection or other diseases of the involved part, and reconstructive surgery because of congenital disease or Congenital Anomaly of a covered dependent child; or 7. Treatment provided outside the United States of America, its possessions and territories.
Pre-existing Condition Limitations: This policy shall not deny, exclude or limit benefits for a covered person for covered expenses incurred more than 12 months following the effective date of the individual's coverage due to a pre-existing condition.
Kansas -
This policy does not provide benefits for any loss incurred which is caused by or results from:
1. Normal pregnancy and childbirth; however, complications of pregnancy shall be considered as a Sickness; 2. Any attempt at suicide or any intentionally self-inflicted Injury, whether sane or insane; 3. Mental or nervous disease or disorder for more than 30 days per calendar year for the same or related disease or disorder; 4. Routine well-baby care for newborn children; 5. Any type of hernia or hemorrhoids or any ailment or disease of the tonsils, adenoids, or reproductive organs if the Confinement begins within 90 days after this policy becomes effective for the Covered Person. This exception shall not be applicable when the attending Physician certifies that such diseases or conditions are treated on an emergency basis; 6. Cosmetic and/or elective surgery unless caused by Injury or done for reconstructive purposes due to Injury or Sickness; 7. Intoxication (as defined by the state law where the loss occurs) or addiction to alcohol or any illegal or controlled substance, including treatment for overdose, detoxification and rehabilitation. This would not apply to treatment when a controlled substance is administered by a Physician and taken according to the Physician’s instructions; 8. Treatment provided outside the United States of America, its possessions and territories; or 9. The administration of any drug or device that is not approved by the U.S. Food & Drug Administration (FDA), including but not limited to any implant used for drug delivery.
Pre-existing Condition Limitations: These policies do not cover any loss incurred which is caused by or results from a pre-existing sickness or physical condition, as defined within the policies, subject to the time limit on certain defenses provision.
Oklahoma -
This policy does not provide benefits for any loss incurred which is caused by or results from:
1. Normal pregnancy and childbirth; however, complications of pregnancy shall be considered as a Sickness; 2. Any attempt at suicide or any intentionally self-inflicted Injury, whether sane or insane; 3. Mental or nervous disease or disorder for more than 30 days per calendar year for the same or related disease or disorder; 4. Routine well-baby care for newborn children; 5. Any type of hernia or hemorrhoids or any ailment or disease of the tonsils, adenoids, or reproductive organs if the Confinement begins within 90 days after this policy becomes effective for the Covered Person. This exception shall not be applicable when the attending Physician certifies that such diseases or conditions are treated on an emergency basis; 6. Cosmetic and/or elective surgery unless caused by Injury or done for reconstructive purposes due to Injury or Sickness; 7. Intoxication (as defined by the state law where the loss occurs) or addiction to alcohol or any illegal or controlled substance, including treatment for overdose, detoxification and rehabilitation. This would not apply to treatment when a controlled substance is administered by a Physician and taken according to the Physician’s instructions; 8. Treatment provided outside th possessions and territories; or 9. The administration of any drug or device that is not approved by the U.S. Food & Drug Administration (FDA), including but not limited to any implant used for drug delivery.
Pre-existing Condition Limitations: These policies do not cover any loss incurred which is caused by or results from a pre-existing sickness or physical condition, as defined within the policies, subject to the time limit on certain defenses provision.
State Farm Mutual Automobile Insurance Company
Bloomington, IL
HI-4.14