If you are contemplating any change to your State Farm® health insurance policy, we suggest that you first contact your State Farm agent who will be happy to assist you.
If, for any reason, your State Farm agent is unavailable, you may initiate a change by completing, printing, signing, and mailing or faxing the Request Letter below.
Please do not submit your actual health policy with the Request Letter.
Note: If you have a health policy through Assurant Health, please do not use this Request Letter, but contact Assurant Health at 888-853-3267 .
Print, sign, and provide this Request Letter [PDF-1.4MB] to your State Farm agent's office.
Mail or fax the Request Letter to the Health Operation Center listed below.
For additional information, please contact your State Farm agent.
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Individual medical coverage