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Cigna Insurance Coverage for Rehab

Two people negotiating a Cigna insurance contract

Published: August 2, 2023

When it comes to accessing substance abuse treatment, for many, the most stressful part is financing. Addiction treatment can be expensive, depending on a few factors, which is why people often turn to insurance for assistance.

Insuring 190 million individuals across the globe, Cigna is a popular insurance company used by individuals and families across the nation.

If you or your loved one receives health insurance through Cigna, keep reading to learn more about the insurance provider and drug and alcohol addiction treatment. From specific treatment plans to types of addiction, you’ll find everything you need below.

Does Cigna Insurance Cover Drug Rehab?

Yes, Cigna does cover drug and alcohol rehab. Although, there are certain parameters to Cigna rehab coverage as well as several factors that can affect your coverage.

While coverage levels are contingent on multiple variables, the Affordable Care Act (ACA) requires that all marketplace plans cover behavioral health treatment, mental and behavioral health inpatient services, and substance use disorder (SUD) treatment.

All of these health services may be helpful in your addiction treatment journey.

What Types of Addiction Treatment Does Cigna Cover?

There is a wide variety of addiction treatment options. The type of care you receive can have specific benefits and be tailored to your individual needs.

When it comes to Cigna, there are several kinds of rehab services you may be able to get covered through your health insurance plan.

Read on to learn a bit about each kind of addiction treatment that Cigna covers.

Medical Detox

Medical detoxification is an addiction treatment service that will help your body get rid of the remaining addictive substances while also managing any withdrawal symptoms you may experience.

During medical detox, your healthcare providers will monitor your vitals and help you through withdrawal by administering treatments like fluids, nausea medication, and more.

Most Cigna plans cover some or all of detox costs, as long as you find a provider in Cigna’s network. Some plans may require prior authorization for detox coverage.

Medication-Assisted Treatment

Many Cigna plans also cover medication-assisted treatment (MAT). MAT is a U.S. Food and Drug Administration (FDA)-approved service that uses medication to help you through addiction recovery.

Depending on your specific plan, Cigna will cover some or 100% of the costs associated with MAT

Inpatient Rehab

Inpatient rehab is a highly effective drug and alcohol rehab program that provides 24/7 care in a designated facility. Inpatient rehab programs vary in length, often 30, 60, or 90 days, and can be quite expensive due to the constant care and provided services.

Inpatient treatment is a little bit trickier when it comes to coverage from Cigna. Some plans will require you to meet your deductible before covering any inpatient services, while others will cover a percentage of the cost.

Typically, more costly plans will cover more, but it’s vital to look into details concerning your plan to know for sure.

Dual Diagnosis Treatment

For many people, alcohol and drug addiction often occurs alongside mental health disorders, known as dual diagnoses. Many facilities offer what is called dual diagnosis treatment, which provides mental health disorder treatment alongside addiction treatment.

This kind of mental health treatment is typically provided in inpatient settings, so the coverage variables mentioned above will likely apply here. Be sure to ask your provider and Cigna representatives questions if you are unsure.

Outpatient Treatment Programs

Many Cigna plans also offer coverage for outpatient treatment programs. These kinds of programs require individuals to visit a care facility for an allotted amount of time each week to receive services like counseling or group therapy.

Outpatient rehab treatment is often best for people who have completed inpatient treatment and are starting to transition back to their day-to-day routine. Intensive outpatient programs (IOP) and partial hospitalization programs (PHP) are some other kinds of treatment you may receive.

Coverage levels for outpatient services vary between Cigna plans. Some may require a copay for each treatment visit while others may have you pay coinsurance outright. Check your plan for specific details.

Counseling & Behavioral Therapy

Counseling and behavioral therapy are also covered by a majority of Cigna health insurance plans, due to requirements of the ACA.

Counseling and behavioral therapy, such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT), are common in many addiction treatment programs.

Many treatment programs focus on reframing the individual’s mental processes and coping mechanisms to help them stay in recovery.

Continuing Care

After completing an addiction treatment program, many people opt for continuing care such as support groups or sober living facilities.

Support groups typically do not require any kind of payment, so there is no need to worry about coverage for this kind of care.

On the other hand, sober living facilities do have costs. Sober living facilities are covered by Cigna less often than other rehab services, but some plans do cover this care on a case-by-case basis. It’s best to talk with a Cigna representative to determine if you can receive coverage for continuing care.

Factors That Affect Cigna Coverage for Drug Rehab

Several factors can affect the amount of coverage Cigna provides for drug and alcohol addiction treatment.

These can include:

  • The type of plan you have
  • Where you live
  • The kind of care you need
  • Specific requirements from your plan

Cigna offers a variety of different healthcare plans, all with different levels of coverage, co-pays, deductibles, and provider requirements.

Based on your and your family’s needs, you can choose a plan that will work best for the kind of care you need and your financial situation.

You may find that your plan requires referrals or for you to see specific providers. While this may seem overwhelming, Cigna can help you find addiction treatment that meets these requirements, allowing you to receive coverage.

According to Cigna, many addiction treatment service authorizations “[require] a face-to-face assessment by facility staff who will contact their plan with clinical information and a request for authorization. The plan will then make a determination regarding the appropriate level of care to authorize based on medical necessity guidelines.”

Does Cigna Cover Out-of-Network Rehab Programs?

Yes, some Cigna plans provide out-of-network benefits that offer some coverage, but not all plans do. It’s important to check your specific plan to determine if you’ll receive coverage for out-of-network rehab programs.

It’s important to note, even with out-of-network providers and programs, Cigna still has a contracted rate that it will pay. However, your out-of-pocket cost will likely be higher or 100% your responsibility if your plan doesn’t have out-of-network insurance benefits.

That being said, with most Cigna plans, it’s best to find in-network providers. This way, you can receive the best level of coverage while receiving addiction treatment care.

Types of Cigna Healthcare Plans

Cigna provides a large range of plan options including:

  • Open Access Plus (OAP) plans
  • Preferred Provider Organization (PPO) plans
  • Health Maintenance Organization (HMO) plans
  • Point-of-Service (POS) plans
  • Exclusive Provider Organization (EPO) plans
  • Medicaid and Medicare plans

Depending on if you receive healthcare through your employer, you may have access to a few of these different options with Cigna. Certain plans have higher co-pays while others have higher deductibles. Depending on your needs, you can determine what kind of plan makes the most sense for you.

Cigna also offers bronze, silver, gold, and platinum plans. Scroll on to learn more about each.

Cigna metal levels:

  • Bronze: your plan will pay 60%, you’ll pay 40%
  • Silver: your plan will pay 70%, you’ll pay 30%
  • Gold: your plan will pay 80%, you’ll pay 20%
  • Platinum: your plan will pay 90%, you’ll pay 10%

The higher percentage your plan pays, the more you’ll pay in your premium. For example, platinum plans have a much higher premium than bronze plans. However, deductibles, co-pays, and out-of-pocket maximums vary from plan-to-plan within the metal levels.

Types of Addiction Covered by Cigna Insurance

Cigna does not determine coverage based on type of addiction. That being said, the type of treatment you receive will depend more on the facility you choose to receive care from.

Most treatment centers offer treatment for the most commonly abused substances.

Types of addiction that may be covered include:

Where to Find Rehab Centers That Accept Cigna Near You

Once you determine the amount of coverage you can receive for addiction treatment, you may be feeling overwhelmed with finding alcohol and drug rehab centers near you that accept Cigna.

The best way to find treatment facilities that accept your Cigna plan is to log in to your Cigna account, click “Find A Doctor,” enter your location, and search for addiction or substance abuse. From here, you’ll be able to see all of the centers that accept your plan.

If you find a rehab facility outside of using the internal search tool, you can always give them a call to check if they accept your insurance policy.

Additionally, if you’re struggling to find a facility and need some guidance, you can always ask your provider for recommendations. They may also do this automatically if you require a referral.

Finally, you can browse our list of addiction treatment centers by state, which provides information about accepted insurance for each facility.

Find Drug & Alcohol Rehab Programs Covered by Cigna

As you can see, there are plenty of ways to receive addiction treatment at a lower cost through your Cigna health insurance plan.

If you’re ready to take the first step in your journey toward recovery, give our helpline a call today to find an addiction program covered by Cigna near you.

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