More About Rehabs Accepting Cigna
More About Rehabs Accepting Cigna
Cigna is a global health services company that serves more than 178 million people worldwide.
With a focus on addressing whole-person health, Cigna is “dedicated to improving the health and vitality” of the people they serve.(1)
Many drug and alcohol rehab centers accept Cigna insurance. Cigna also covers primary mental health treatment.
About Cigna
Cigna began as a marine insurance company, the first in the United States, and now serves millions of Americans across the nation and globally. Cigna offers employer-sponsored health plans, health plans for government employees, international coverage, individual and family plans, and Medicare plans.
Cigna Plan Options
Cigna insurance plans offer many different types of coverage, which include:(1)
- Health insurance for individuals and families.
- Dental plans.
- Medicare plans.
- Supplemental Insurance.
- International health insurance.
- Behavioral health.
Cigna health plans can be broken down into several different categories. However, the specifics of Cigna insurance plans may vary based on:
- Employer (if you opted for health insurance through your employer).
- State of residence.
- Whether you qualify for government-funded healthcare. The two main types of government healthcare are:
- Medicaid, which mostly applies to low-income individuals.(2)
- Medicare, which is usually for seniors or people with certain specific health conditions.(3)
- Whether you chose your plan through the Affordable Care Act (ACA) marketplace (as opposed to your employer).
Like many other health insurance companies, Cigna insurance plans fit into several main categories:(4)
- Health Maintenance Organization (HMO). An HMO plan is an option for people who don’t mind limiting themselves to providers within the Cigna network. HMO plans cover services exclusively provided by physicians and facilities that contract with the health insurance company directly.
- Exclusive Provider Organization (EPO). EPO plans give customers more flexibility when it comes to choosing a physician or facility for healthcare needs. However, many services may not be covered if they are outside the Cigna network.
- Preferred Provider Organization (PPO). PPO plans allow customers to choose from a much wider variety of healthcare providers. However, going outside the network typically results in a much higher out-of-pocket cost for services.
Cigna also provides other options:
- Open Access Plus (OAP). OAP plans are similar to PPO plans, except the network of providers contracted directly is larger. Like with a PPO plan, OAP plans allow you to go outside this network for a higher cost.(5)
- This is an affordable route that allows you to choose from a limited network of healthcare services. You can opt to have your plan include out-of-network services (for a higher cost) or choose to limit yourself to the network for a lower premium.(6)
Cigna Out-of-Pocket Coverage
Out-of-pocket coverage means that after you meet your yearly out-of-pocket maximum, insurance will cover any costs above the maximum amount set by your plan. Out-of-pocket costs can include copayments, deductibles, and coinsurance.
Some plans are required to meet standards set by the Affordable Care Act (ACA), which calls for out-of-pocket maximums. If you have a plan through the ACA, be sure to check your coverage for the specific out-of-pocket maximum.(7)
Mental health and substance abuse coverage is a part of Cigna medical plans acquired through an employer and does not have a separate deductible to be met.(8) If you buy your own health plan, there may be different premiums and rules regarding out-of-pocket maximums, such as not being able to apply your deductible to the out-of-pocket maximum.(7)
It’s always important to check the details of your plan to confirm coverage. There may be some expenses that don’t count toward your out-of-pocket maximum, including:(7)
- Cosmetic procedures and alternative medicine.
- Costs above the allowed amount. If your plan sets an amount for a specific service, and costs exceed that amount, your plan may not cover that cost or apply it to out-of-pocket maximum.
- Out-of-network care and services.
- Plan premiums for individual health plans (not through employer).
- Most preventive care like flu shots, well-visits, routine screenings etc.
- Plan deductibles for certain plans.
Cigna Out-of-State Rehab Coverage
Out-of-state rehab coverage may depend on your specific Cigna health plan and which treatment providers are considered in-network or out-of-network. Make sure to check your plan details for information about receiving addiction treatment that’s out of your plan’s local service area.
Cigna and Medicare
Cigna Medicare plans are alternatives to Original Medicare, which is the federal health insurance program for people 65 or older and with certain disabilities. Cigna Medicare Advantage plans provide the same benefits as Original Medicare, but often with additional benefits, such as vision, hearing, and dental coverage. Cigna also offers Medicare Supplement and Medicare PDP (Part D) plans, which can be used to help cover the costs not covered by Original Medicare.
The specifics of what is covered by Cigna Medicare plans will vary depending on the plan you have and the state you live in. To learn more about what’s covered, you can look at your plan's coverage details or contact Cigna directly
What Types of Addiction Treatment Does Cigna Cover?
If you or a loved one are struggling with a substance use disorder (SUD), Cigna may cover various forms of drug and alcohol rehab, therapy for addiction treatment, and support, depending on your plan.
Substance addiction treatment services may include:(8)
- Medical detox.
- Inpatient rehab.
- Outpatient addiction treatment programs.
- Partial hospitalization programs (PHPs).
- Intensive outpatient programs (IOPs).
- Personalized coaching and support services.
- Referrals for support groups, behavioral coaches, and online resources.
What Length of Treatment Does Cigna Cover?
The length of treatment for substance misuse covered by Cigna (e.g., 28-30 days, or more long-term addiction treatment programs such as 60 day rehab programs and 90 day rehab programs) will depend on what is deemed medically necessary. Cigna will work with treatment providers to assess and find the appropriate level of care for a person who needs treatment for substance misuse. This could include the length of treatment, types of treatment, services and level of care, in addition to milestones to be met during treatment.(9)
Inpatient Rehab
Inpatient rehabilitation is one of the addiction treatment methods covered by Cigna insurance. Coverage may vary depending on the state you live in and the types of services you require, so it’s important to contact a Cigna representative for more information.(10) If you go outside the Cigna network for an inpatient treatment facility, it may result in no coverage.(10)
Outpatient Rehab
Another common form of addiction treatment covered by Cigna health insurance is outpatient rehabilitation in which a person visits a facility to receive treatment rather than stay overnight. Outpatient treatment can vary in intensity levels and include a range of services to help a person recover. Like inpatient treatment, outpatient programs that are outside the Cigna OAP network may not be covered.(10)
Cigna Coverage for Co-Occurring Disorder Treatment
When someone has a substance use disorder and a mental health disorder (e.g., anxiety, depression, PTSD) this is known as a comorbidity or co-occurring disorders. Mental health, behavioral health, and substance misuse treatments are all categorized together within Cigna health plans.
The coverage for mental health treatment in inpatient or outpatient treatment for mental health would be the same as it is for substance use.(10)
How to Use Cigna for Addiction Treatment and Rehab
If you have Cigna but you are unsure about which plan you have or what it covers, there are a few different ways to check your benefits. You can:
- Login to the myCigna website or mobile app. If you don’t have an account already, you will need to register. Creating an account is simple, though it will require your social security number (SSN) or Cigna membership ID number.
- Use the insurance paperwork that was provided by the Affordable Care Act (ACA) Marketplace or your employer when you enrolled in Cigna health insurance.
- Call customer service.
[sources]
- Cigna. (2020). About Cigna Healthcare.
- Centers for Medicare & Medicaid Services. (n.d.). Medicaid.
- U.S. Department of Health & Human Services. (n.d.). What’s medicare?
- Cigna. (n.d.). Comprehensive Health Insurance Plans for Employers: Group health insurance plans.
- Cigna. (n.d.). Comprehensive Health Insurance Plans for Employers: Cigna Open Access Plus medical plans.
- Cigna. (n.d.). Comprehensive Health Insurance Plans for Employers: Cigna LocalPlus plans.
- Cigna. (n.d.). What is an Out-of-Pocket Maximum and How Does It Work?
- Cigna. (n.d.). Mental Health and Substance Use Benefits.
- Cigna. (n.d.). Behavioral Health Providers.
- Cigna. (2024). Summary of benefits and coverage: what this plan covers & what you pay for covered services.