Cigna health insurance provides coverage for a number of essential health services, including addiction treatment. Learn which rehab programs are covered by your Cigna insurance plan and how to find a rehab center that accepts Cigna.
One of the primary reasons people don’t get help for their addiction to drugs or alcohol is because treatment can be expensive. Living with an addiction can hurt you financially, so it’s common for people who are trying to recover to have financial issues.
This is why it’s important to understand ways that you can afford treatment, so you can begin to live the life that you deserve. Drug and alcohol rehab centers that accept Cigna insurance can assist you on the road to recovery and give you the best care possible.
If you have a Cigna insurance plan, it’s important to understand how your coverage works. This can help you make a better decision when you’re getting ready to go into a treatment facility.
By having an understanding of how health insurance helps with the cost of alcohol and drug addiction treatment, you’ll know which type of care is going to be right for you.
When it comes to addiction, you sometimes only have one chance to get sober. Knowing your options will help improve your chances of a successful outcome upon completing treatment.
Rehab Centers That Accept Cigna Insurance
For many years, people believed that addiction was simply a person who was making bad decisions and could stop whenever they wanted to. Because of this misconception, there was a long time in which health insurance did not help cover the cost of treatment.
Over recent decades, there have been many studies in the realm of addiction treatment, and we now have a much better understanding about this disease. Science has proven that the brain of someone struggling with an addiction is much different than the average human brain.
In recent years, new laws were passed with the Affordable Care Act to help ensure you get help for your addiction and that it’s covered by your insurance plan.
Now, drug and alcohol rehab centers accept insurance plans such as Cigna because private and commercial plans are required to provide addiction treatment coverage.
Since your Cigna plan is going to be covering a majority of the cost for addiction treatment, it’s important to understand which rehab facilities will take your insurance.
Addiction treatment can be expensive, so your insurance company wants to ensure that you’re getting the best care possible to minimize your chances of relapse.
You’ll be able to use Cigna insurance for addiction treatment when the treatment center is using evidence-based treatment methods.
These various treatment methods have been scientifically proven to help people recover from addiction, so you’ll also know that you’re in good hands.
Depending on your insurance policy, you may have a portion to pay due to a deductible or co-pay. The good news is that many treatment centers want to help you recover and offer a variety of payment options so you can get the treatment you need.
Cigna Coverage For Addiction Treatment
One of the most expensive parts of the addiction treatment process is detox, which happens first. As you continue to abuse drugs or alcohol, you may become dependent on the substances. Your mind and body may have a difficult time functioning without the substances.
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If you’ve been abusing substances for a while, you’ve probably experienced some symptoms of withdrawal at one point or another. The best way to begin your recovery is to go to a qualified addiction treatment center that can help you through the detox process.
In some cases, withdrawal can lead to seizures or heart failure, which is why it’s so important to be under medical supervision. With your Cigna insurance, you won’t have to worry about the costs of the medical care that you receive during the detoxification process.
After detox comes treatment. Which rehab program a person will enter depends on the severity and duration of substance abuse.
Does Cigna Cover The Cost Of Inpatient Drug And Alcohol Treatment?
Those who only go through detox and don’t receive rehabilitation for their addiction have slim chances of staying clean and sober.
That’s why it’s important to know that your Cigna insurance will help cover the cost of the treatment needed to help you maintain your recovery. One of the most effective forms of care for addiction is inpatient rehab programs, which are covered by Cigna insurance.
To fully recover, it’s important to get down to the root causes of your addiction, and inpatient drug rehabilitation programs are fully equipped to help you do this. Many people who struggle with addiction have underlying mental health issues as well.
While in treatment, you’ll have the opportunity to receive individualized care from a therapist as well. Working with a therapist gives you a place where you can be open and honest about everything.
You’ll begin to get some clarity as to why you continue to turn to drugs or alcohol as a way to cope with life. A therapist is going to be able to help you understand your triggers, but they’ll also be able to help you learn healthy coping skills.
Addiction treatment centers that accept Cigna insurance are going to use the best therapeutic methods possible, including evidence-based treatments, to help you recover.
How much Cigna will pay toward your residential rehab program depends on the type of Cigna insurance policy you have. Some plans may only cover up to 40 percent of residential treatment costs, while others may pay as high as 80 percent.
Learn about your Cigna coverage for inpatient treatment in order to avoid paying high out-of-pocket costs and to help you determine a payment plan for drug rehab before heading to treatment.
Does Cigna Cover The Cost Of Outpatient Addiction Treatment?
Addiction treatment is designed to give you a foundation for your recovery, and this may be through inpatient treatment. As you begin to progress in your recovery, however, you can benefit from going to outpatient treatment as well.
This is a great way to continue strengthening your recovery while you transition back to everyday life. When you use your Cigna insurance for addiction treatment, you may be able to have outpatient treatment covered as well.
Many studies show that you have a much higher chance of long-term recovery when you transition into lower levels of care after completing a residential drug rehab program.
Your Cigna insurance also wants to give you the best chances of maintaining your recovery so you don’t have to return to treatment. Many Cigna insurance policies cover outpatient treatment to continue strengthening your recovery.
Does Cigna Cover The Cost Of Partial Hospitalization Programs?
There are many types of outpatient rehab programs with varying levels of intensity. Partial hospitalization programs (PHP) are perhaps the most intensive next to residential treatment. PHPs are covered by Cigna health insurance plans.
However, partial hospitalization programs may have to meet certain requirements in order to qualify for Cigna coverage.
Such requirements could include:
- prior authorization from the policyholder for treatment
- proof of medical necessity for treatment
- proof of ability to participate in treatment
- ability to participate in treatment without the need for medical supervision
- partial hospitalization treatment takes place 5 days per week for a minimum of 20 hours per week
Does Cigna Cover The Cost Of Intensive Outpatient Programs?
Intensive outpatient treatment programs (IOP) are also covered by Cigna insurance when a policyholder meets the requirements for treatment.
This form of care typically follows inpatient and/or partial hospitalization. One IOP may be up to 16 weeks in length. Some individuals may need to continue participating in treatment in order to stay on track for recovery goals.
If the policyholder continues to meet requirements and demonstrates a need for treatment, Cigna will continue to cover intensive outpatient treatment.
Requirements for Cigna coverage for intensive outpatient programs for addiction treatment can include:
- alcohol and drug assessment prior to enrolling in the intensive outpatient program
- professional recommendation by a behavioral health clinician
- proof of the medical need for treatment
- intensive outpatient treatment takes place 3-4 hours per day, 3-5 days per week
- recovering individual can live without 24-hour supervision and is in control of behavior
In order to obtain Cigna coverage for a partial hospitalization program or intensive outpatient program, it’s crucial to have a full clinical assessment no less than 72 hours prior to entering the rehab program.
Does Cigna Cover The Cost Of Suboxone?
Suboxone is a medication often used in helping people overcome opioid addiction. Medication-assisted treatment (MAT) programs that integrate Suboxone therapy are covered by Cigna insurance.
MAT combines medication alongside several forms of therapy, counseling, and other treatment methods for a comprehensive recovery approach. Both inpatient and outpatient rehab programs are covered by Cigna. However, the cost of Suboxone may come with a copay.
Since it is a medication, Suboxone will fall under pharmacy benefits. Cigna insurance plans provide coverage for many prescriptions. During prior authorization for treatment, you may be able to speak to a treatment specialist to determine what percent of Suboxone medication costs will be covered by your Cigna plan.
Does Cigna Cover The Cost Of Methadone?
Medication-assisted treatment programs may also use methadone to treat opioid abuse, which is covered by Cigna health plans.
Methadone works to block the action of opioids while easing opioid withdrawal symptoms. This helps recovering individuals get and stay sober. Methadone maintenance therapy may last months or even years. To continue to receive Cigna coverage, policyholders must meet medical necessity requirements and submit to regular clinical assessments.
This medication is available in pill form and taken daily or injected once a month. Methadone injections are considered outpatient treatment and are covered by Cigna plans, but may carry a copayment amount.
Your copayment for prescriptions covered by Cigna will vary by your coverage tier and the following other factors:
- whether the prescription is preferred or non-preferred
- whether the prescription is generic or brand name
- whether you get a 30-day, 60-day, or 90-day prescription
- how you buy your prescription: through a pharmacy (retail) or by mail
Does Cigna Cover The Cost Of Sober Living?
Some sober living costs may be covered by Cigna insurance plans. For example, most sober living homes require residents to participate in some form of outpatient treatment, such as a PHP or IOP. These program costs may be covered by Cigna.
Because treatment costs are covered, and patients are only required to participate in outpatient treatment to live in a sober living house, this frees them up to work while living in a supportive environment.
Cigna may pay for some of the fees associated with transitional living homes if the treatment program a person is enrolled in is associated with the home.
While it is often best for those with severe addictions to begin their recovery with inpatient treatment, this will not be the right course of action for each person. During your initial drug and alcohol evaluation, a provider can make a recommendation for the type of care you or your loved one may need.
From there, you can speak with a Cigna insurance adjuster to learn what’s covered by your insurance carrier. If you would rather have someone verify coverage for you and provide a list of rehab programs that fit your needs, you can also speak to one of our addiction treatment specialists.
How To Use Cigna Insurance To Pay For Addiction Treatment
If you’re struggling with an addiction to drugs or alcohol and have Cigna insurance, allow us to help you find a rehabilitation program that works for you.
Our goal is to help you find the best drug rehab center possible that will suit your needs while also accepting your insurance. Give us a call today so we can help you begin your road to recovery.
Updated on July 27, 2020
Written by the Addiction Resource Editorial Staff
This page does not provide medical advice. See moreArticle resources
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Cigna — 2020 Cigna Comprehensive Drug List (Formulary)
- Cigna — Cigna Standards And Guidelines/Medical Necessity Criteria
- HealthCare.gov—Affordable Care Act (ACA)
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