Cigna is a reputable global insurance provider that offers a wide range of health insurance options to help their members manage their health and wellbeing.
Cigna offers a variety of plans (described below) and provides coverage for a range treatments such as detox, inpatient, intensive outpatient rehab and therapy, behavioral health therapy and medications. Cigna also provides coverage for some alternative and holistic therapies.
To qualify for substance abuse treatment with Cigna, there are some specific criteria you must meet. Some of the questions you should be prepared to answer include:
- What substance use disorder are you seeking help for?
- Length of time you have been using?
- Frequency of use?
- Have you had previous treatment?
Don’t worry if you have had treatment for addiction in the past because Cigna will typically cover as many treatment episodes as necessary.
Medical necessity will have to be determined by way of an assessment by a doctor or therapist to determine what level of care is recommended.
The Importance of Having Cigna Insurance Coverage for Drug and Alcohol Rehab Treatment
Drug and alcohol addiction is a serious health problem affecting millions of individuals and families across the US and globally. Addiction has significant physical, emotional and financial consequences and often requires a professional treatment program at a rehab center to overcome their substance use disorder and improve their overall health and well-being.
Addiction insurance coverage for substance abuse provides financial support for people needing treatment for addiction and mental health disorders. It can help cover rehab costs for inpatient or outpatient treatment, medication, therapy and other necessary services.
The importance of this insurance coverage cannot be overstated. Without rehab insurance coverage, many people may not be able to afford to go to treatment.
This can lead to a range of negative consequences, including increased health problems, decreased quality of life and increased risk of relapse.
What Addiction Treatment Will Cigna Cover?
Cigna offers a wide range of coverage options for substance abuse and mental health to its members.
The extent of coverage depends on the specific plan, your individual needs and the type of treatment that is deemed necessary. At inpatient treatment it’s common to get approval for a set number of days during which time reports are sent on progress which are used to determine ongoing coverage.
Here is an overview of treatments provided by Cigna:
- Inpatient: Cigna can provide coverage for alcohol and drug addiction treatment at residential rehab facilities, which involves staying at the center for an extended period of time. This is typically recommended for individuals with severe alcohol abuse and drug addiction issues. Cigna typically covers 1 – 6 weeks of treatment.
- Outpatient: Cigna also covers outpatient treatment, intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs) which involve attending therapy and treatment sessions while living at home or in a sober living environment. This is recommended for people with less severe alcohol and drug abuse issues. Cigna will usually offer 4 – 12 weeks of coverage.
- Detoxification: Cigna covers medically-supervised detox to help individuals safely and comfortably withdraw from alcohol or drugs.
- Medications & Medication-assisted treatment (MAT): Cigna covers prescription medications and medication-assisted treatment (MAT), which is usually combined with therapy. A good example of MAT is suboxone to treat opioid addiction.
- Behavioral health counseling: Cigna provides coverage for mental health and co-occurring disorders such as depression, anxiety and PTSD. This therapy aims to teach skills and strategies to maintain sobriety.
Types of Addictions Cigna Drug and Alcohol Plans Cover
Cigna health insurance plans typically cover inpatient and outpatient treatment for substance use disorders and most addictions. The majority of drug and alcohol abuse programs that accept Cigna will be able to treat other addictions as well.
To successfully recover from substance use disorders and co-occurring mental health issues, a range of services should be tailored to meet your needs.
Cigna may offer coverage for the following addictions:
- Prescription drugs – opioids, benzodiazepines, sedatives, stimulants
- Other stimulants
Types of Cigna Plans
The types of plans Cigna offers include:
HMO – health maintenance organization
HMOs require you to choose a primary care provider from a local network. The cost of HMOs tend to be lower than most other plans as long as you receive care within the network.
EPO – exclusive provider organization
EPOs allow you to access services from a network of participating providers and you sometimes have to choose a primary care provider. If you get treatment out of network, there’s a good chance it won’t be covered.
POS – point-of-service
POS plans offer in-network services at lower costs and you are required to choose a primary care provider and to get referrals for specialists. You can see in- or out-of-network providers but will pay higher costs.
PPO – preferred provider organization
PPOs offer a large network of providers and you aren’t required to choose a primary care provider. You can see specialists without a referral.
PPO & HMO plans include:
- Bronze: The Bronze plan pays 60% and you pay 40%
- Silver: The Silver plan pays 70% and member pays 30%
- Gold: The Gold plan pays 80% and you pay 20%
- Platinum: The platinum plan pays 90% and you pay 10%
Cigna Rehab Coverage Deductibles and Co-pays
Deductibles are the amount of money that an individual must pay out of their own pocket before their insurance plan begins to pay for covered services. Co-pays, on the other hand, are a fixed amount that an individual pays for a covered service, while their insurance plan may cover the remainder.
Different plans will have different levels of deductibles and co-pays, as well as different rules about which services are covered and at what levels. Most plans have a deductible that must be met before coverage kicks in.
Cigna Health Insurance In-network and Out-of-network Coverage
In-network coverage refers to medical services that are provided by healthcare providers who are contracted with Cigna to offer services at a discounted rate. If you use an in-network provider, you will generally pay less out-of-pocket, as Cigna will cover a large portion of the cost.
Out-of-network coverage refers to services that are provided by healthcare providers who have not contracted with Cigna to offer services at a discounted rate to members.
If you use an out-of-network provider, you may be responsible for a larger portion of the cost, as Cigna will generally cover a smaller portion. It is important to note that some plans may not offer any out-of-network coverage at all.
To determine whether a treatment center is in-network with Cigna or out-of-network, you can use their provider directory or contact customer service.
Drug or Alcohol Rehab Center Eligibility and Benefits
To check your insurance benefits and eligibility of drug and alcohol rehabilitation treatment options, you can do the following:
- Log in to your Cigna account
- Call Cigna’s customer service
- Use Cigna’s mobile app
- Check your plan documents
Obtaining Authorization for Substance Abuse Treatment From Your Insurance Provider
Does your Cigna insurance plan cover addiction treatment at alcohol and drug rehab centers? If so, you will need to obtain authorization or pre-certification and should follow these steps:
- Check your documents: Your Cigna policy documents will have all the information you need about what services require prior authorization or pre-certification. You can also log in to your account on the Cigna website or mobile app to check your plan details.
- Get a referral: If your plan requires a referral from your primary care physician (PCP) for a specialist or service, make sure you get that referral before seeking authorization.
- Contact Cigna: To obtain authorization or pre-certification, call the customer service number on the back of your insurance card. You can also log in to your account and use the online tools to request authorization.
- Provide information: You will need to provide Cigna with information about the medical service or procedure, including the reason for the service, the provider who will perform it and any relevant medical records.
- Wait for a decision: Cigna will review your request and make a decision on whether to authorize or pre-certify the service or procedure. This process can take several days, so it’s important to start the process as soon as possible.
- Follow up: If your request is denied, you have the right to appeal the decision. Contact Cigna to find out how to appeal and what information you need to provide.
Tips for Maximizing Your Cigna Alcohol and Drug Rehab Coverage
Here are some tips for maximizing your coverage:
- Understand your coverage: Review your insurance plan and become familiar with your specific coverage. Make sure you understand what mental health and substance abuse services are covered, what your deductible and co-payments are and if there are any limitations or restrictions.
- Find an in-network provider: Cigna has a network of providers and using an in-network provider will usually result in lower out-of-pocket costs. You can use Cigna’s provider directory to find a list of in-network providers.
- Get pre-authorization: Most rehab services require pre-authorization before they are covered. Make sure to check with your provider and get pre-authorization if needed to avoid unexpected costs.
- Take advantage of Cigna resources: Cigna offers resources and support for individuals seeking treatment for drug and alcohol addiction. You can reach out to Cigna Behavioral Health for help finding a provider, managing your benefits and getting support during your recovery.
- Keep accurate records: Keep track of all your medical bills and treatment expenses, including receipts and explanations of benefits. This will help you monitor your coverage and ensure you are not overcharged.
- Utilize any additional benefits: Cigna may cover telehealth, mental health services and wellness programs that can help support your recovery journey. Be sure to take advantage of these benefits if they are available to you.
Cigna Insurance Accepted at Luxe Recovery
Cigna rehab coverage accepted at Luxe Recovery.
Luxe Recovery is located in Los Angeles and offers a world class drug and alcohol addiction treatment program. Getting treatment for substance abuse can be overwhelming but don’t worry, the team will support you every step of the way.
The team at Luxe Recovery will work with Cigna for insurance verification and to determine what is available under your specific plan. They will develop your individualized treatment plan and ensure all assessments and documentation is submitted and will work hard to ensure you get the most treatment possible from your plan.
If you have Cigna insurance and are looking for drug or alcohol addiction treatment, please give Luxe Recovery a call today and the knowledgeable admissions staff can help pave the road for your recovery journey.
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