Cigna Coverage Information

Does Cigna Cover Drug Rehab? Learn the Basics

Because Cigna operates in multiple states and serves millions of customers with different needs, it’s important to understand the terms of your plan. In-network versus out-of-network care is one of the most important distinctions. In insurance terms, an in-network provider is a treatment facility that has agreed to charge a discounted rate for the services it provides. Because in-network facilities charge less than out-of-network facilities, you’ll typically pay less for in-network care. If you have a Cigna HMO plan, it may not cover any out-of-network treatment, so it’s important to check your plan details before you start substance abuse treatment.

You also need to be aware of what your out-of-pocket costs will be. Out-of-pocket costs include things like deductibles, co-pays and coinsurance. Your deductible is an amount of money you must pay for covered health services before your insurance kicks in. For example, on a Cigna health insurance plan with a $1,000 deductible, you’d have to pay for $1,000 worth of covered services before your Cigna coverage would apply.

A co-pay is a flat fee that applies to a covered service. If you need medications to manage your mental health or help you through your addiction treatment, you may need to pay a co-pay for each one. Cigna insurance plans may also have co-pays for primary care visits or visits to a medical specialist. Coinsurance is charged as a percentage of each covered service. How much you have to pay for each service depends on your Cigna plan. Some insurance plans have a 90/10 split, which means your insurance provider would pay 90% of the cost, leaving you to pay the remaining 10%. Other plans have a 60/40 split, meaning you’d have to pay a much larger percentage of your costs.

How Cigna Health Insurance Coverage Works for Substance Abuse Treatment

If you purchased your Cigna insurance coverage via the Health Insurance Marketplace or a state health insurance exchange, your out-of-pocket costs for addiction treatment will depend on whether you have a bronze, silver, gold or platinum plan. Bronze plans have the lowest premiums, but they usually have the highest deductibles and coinsurance requirements. Most bronze plans have a 60/40 split, meaning your insurance company would only cover 60% of each covered service. Silver plans cost a little more, but they usually have a 70/30 split, reducing your out-of-pocket costs for substance abuse treatment.

Gold and platinum plans have the most expensive premiums, but if you need residential mental health treatment or inpatient treatment for drug or alcohol addiction, your overall costs may be lower with a gold or platinum plan than they would be with a cheaper bronze or silver plan. For example, gold plans typically have a 20% insurance requirement, which is much less than the 40% you’d have to pay with a bronze plan.

If you have a group health plan, Medicare Advantage plan, or Medicaid plan through Cigna, your out-of-pocket costs will depend on the details of your policy. To minimize your costs as much as possible, make sure you do the following before you enter a Cigna alcohol rehab or seek treatment for drug abuse:

If your plan doesn’t cover out-of-network services, look for an in-network drug and alcohol rehab center.

  • Review your plan documents to determine how much you can expect to pay toward your drug and alcohol rehab costs.
  • Make sure your plan covers inpatient treatment programs if needed.
  • If necessary, seek a referral from your primary care doctor or another approved health care provider.
  • Check to see if prior approval is needed for inpatient or outpatient treatment.

Mental Health Services Covered By Cigna

Under the Patient Protection and Affordable Care Act, mental health care and substance abuse treatment services are considered “essential benefits.” All traditional health plans must cover outpatient counseling, inpatient and outpatient treatment for substance addiction, outpatient mental health services and psychotherapy. If you have a marketplace plan, the ACA also prohibits Cigna and other insurance companies from putting annual or lifetime limits on essential benefits, meaning your plan can’t stop covering your treatment just because your costs have reached a certain dollar amount.

Your Cigna plan may cover some of the following services:

  • Cognitive behavioral therapy (CBT)
  • Dialectical behavior therapy (DBT)
  • EMDR therapy for addiction related to traumatic experiences
  • Group therapy
  • Family therapy
  • Outpatient drug addiction treatment
  • • Medications for mental illness
  • • Residential drug rehab or alcohol rehab

Whether you need outpatient or residential treatment depends on the severity of your addiction and the recommendations of your health care providers. Inpatient care typically works best for people who’ve tried outpatient treatment without success, those who have co-occurring mental health conditions that require an integrated approach to treatment and people whose home situations make it difficult for them to abstain from drugs and alcohol.

Cigna is an international insurance provider offering health, dental and supplemental insurance plans to millions of subscribers. In addition to group health plans, Cigna offers Medicare Advantage plans and Medicaid plans in states that have implemented a managed-care model to reduce the cost of providing Medicaid benefits to those who need them, making coverage available to subscribers of all ages and backgrounds.

Behavioral Health Centers is a Florida-based rehab that accepts Cigna insurance where we offer addiction and mental health treatment programs. If you have an addiction to drugs or alcohol, you’ll be happy to know that Cigna rehab coverage also includes addiction treatment delivered on a residential or outpatient basis, making it more affordable to get help. Cigna mental health insurance is also available.

Verify Your Benefits

What is your addiction really costing you? Getting clean is within your reach. Behavioral Health Centers (BHC) is here to help.

Your insurance may cover all or some of your rehab at a BHC facility.

We Accept Most Insurance

Behavioral Health Centers does not accept Medicare or Medicaid.

Take Charge of Your Life

If you have a problem with drug or alcohol abuse, help is available. Behavioral Health Centers offers residential treatment in a safe, comfortable setting, giving you access to the support needed to turn your life around. We also accept a wide variety of insurance plans, including Cigna substance abuse treatment coverage, making it easier to get the care you need. Contact Behavioral Health Centers today to learn more about our treatment program and take the first step toward your recovery.