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Cigna Insurance Coverage for Drug and Alcohol Rehab Treatment

There are hundreds of millions of patients who have health insurance through Cigna.1 For many, though, there is confusion about what exactly your insurance plan covers when it comes to substance abuse and mental health services. So, does Cigna cover the cost of addiction recovery treatment? The short answer is yes, it will cover at least some of the cost, but this page is intended to help you figure out what your Cigna healthcare does and does not cover.

American Addiction Centers (AAC) strives to provide you with the most updated information on each carriers’ addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels.

Does Cigna Cover Drug and Alcohol Rehab Treatment?

Yes, Cigna covers substance abuse treatment for its members. Cigna has partnerships with addiction rehab facilities throughout the country to provide a variety of detox, inpatient residential and outpatient services at discounted rates to members. The Affordable Care Act (ACA) requires that insurance companies provide some degree of coverage for mental health treatment, which includes substance use disorder (SUD) treatment (including coverage for drug and alcohol addiction).2

Examples of Cigna coverage:

Inpatient Addiction Recovery Treatment

Cigna covers at least some of the cost of inpatient rehabilitation for substance abuse treatment. Using the Cigna Connect 6500 EPO plan for an individual living in Wichita, Kansas as an example, this is how costs of care at a Cigna network inpatient facility would be shared:3

  • The customer must pay the $6,500 annual deductible before Cigna starts covering costs.
  • After the deductible is paid, the patient is still required to pay 50% of the remaining costs (known as the co-insurance rate) before reaching their out-of-pocket limit of $8,150. After the patient has met all those requirements, Cigna covers 100% of the remainder. The high cost of inpatient treatment makes it likely that this out-of-pocket maximum will be reached.

In this example, the 50% coinsurance rate also applies to any required prescription drugs (unless the out-of-pocket maximum has already been reached). Since this is an EPO plan, obtaining treatment outside of the network would lead to no rehab coverage.3

Outpatient Addiction Recovery Treatment

Cigna health insurance plans cover at least some of the cost of outpatient rehabilitation. For this example, we’ll look at an OAP plan for an individual living in Indiana. The breakdown of costs at an in-network outpatient facility includes the following:4

  • This plan does not have an overall deductible, so the patient only has to pay a $50 co-payment when they visit the facility.
  • The maximum out-of-pocket limit is $2,000, which would only be reached if the outpatient services for 40 days or more or if costs for other services had also been incurred.

This plan also includes a deductible for prescription medicines ($175f). Depending on the drug brand, the co-payment for prescription treatments range between $20-70. This plan does not cover any expenses if care is obtained outside of the Cigna OAP network.4

The amount of coverage you have can vary widely based on your state of residence, whether the facility is in- or out-of-network, the length of your stay, and your health insurance plan level. The cost of drug and alcohol addiction treatment will vary from person to person and will also depend on the rehab center, the type of program attended, and specific services received.

What Rehab Centers Take Cigna Insurance?

American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have an Cigna insurance plan, the following AAC facilities accept Cigna for drug and alcohol addiction rehab.

  • AdCare Rhode Island: With various facilities located in Rhode Island, AdCare provides innovative, quality, and cost-efficient addiction treatment. Its integrated system of care offers an inpatient treatment center in North Kingstown and a network of outpatient offices throughout Rhode Island. AdCare’s continuum of care includes detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, inpatient and outpatient services, and telehealth.
  • Sunrise House Treatment Center: Located in Lafayette Township, New Jersey, Sunrise House provides treatment for people suffering from substance abuse from a medical and holistic standpoint. With various evidence-based therapeutic interventions, personalized care is provided through detox, residential treatment, dual-diagnosis treatment, and outpatient services.

There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Cigna insurance.

You can also check on which rehab centers accept your Cigna insurance by filling out the form below.

Do Treatment Centers Need to Be In-Network to Accept Cigna Insurance?

In-network providers have a contract with the insurance carrier to offer rehab services at a set price. This means that your out-of-pocket expenses will typically be lower than if you choose an out-of-network facility. In some cases, you may even be responsible for the full cost of addiction treatment if you choose an out-of-network facility.

Whenever possible, try to choose a rehab facility that is in-network with Cigna. If you are unable to find an in-network provider or prefer a facility that is out-of-network, you may be able to work out a payment plan with the rehab facility so you can pay back the cost of treatment over time.

Different Types of Cigna Substance Abuse Treatment

Your Cigna health insurance plan may cover the following addiction treatment services:10,11

Detox Services

In some cases, you may need assistance when detoxing from drugs and alcohol, which can potentially be uncomfortable, painful, or even life threatening. Medical detox helps you safely withdrawal from drugs and alcohol, as you’ll receive around-the-clock medical supervision. You might also be given medications to help minimize withdrawal symptoms. Read more about Detox Centers Near Me.

Inpatient or Residential Care

Inpatient/residential live-in treatment centers provide drug and alcohol rehab while you live onsite at the facility. Most inpatient programs last anywhere from 15–90 days, depending on the program you’re in and your individual needs.

Partial Hospitalization Program (PHP)

Partial hospitalization programs give you the opportunity to live at home while attending treatment during the day.

Intensive Outpatient Program (IOP)

Intensive outpatient rehab and therapy involve attending treatment programs a few evenings a week. In an intensive outpatient program, you can live at home and even go to work during the day.

Outpatient Treatment

Individuals who have completed inpatient treatment often attend outpatient treatment for ongoing support on their journey to sobriety. You live at home and spend 10–12 hours a week at a rehab facility for therapy and support.

Your total out-of-pocket costs for addiction treatment depend on the specific Cigna plan you have. Monthly premiums, copays, deductibles, and other potential costs all vary depending on the plan. But, with Cigna health insurance, at least a portion of your costs should be covered under your plan.

How to Check Your Cigna Rehab Coverage and Insurance Benefits 

Before you decide which rehab center might be best for your needs, it’s important to check your insurance benefits to understand what costs are covered by your insurance provider, and which ones you are responsible for. Knowing exactly what your Cigna plan covers can give you peace of mind while you or your loved one is in recovery for drug and alcohol addiction. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles.

What Are the Coverage Levels and Plans for Cigna?

Cigna health plans fall into several categories, and the features of those plans may vary based on your:

  • State of residence.
  • Employer (if you obtained insurance through your employer).
  • Qualification for healthcare funded by the state/federal government. Typically, government-funded healthcare includes:5,6
    • Medicaid, which typically applies to low-income individuals.
    • Medicare, which is mostly for seniors or people with certain health conditions.
  • Decision to select your plan through the Affordable Care Act (ACA) marketplace (rather than your employer).

So what plans does Cigna offer? Cigna’s health insurance plans fall into several main categories:7

  • Health maintenance organization (HMO): An HMO plan tends to be a good option for people who are ok with a limited number of providers within the Cigna network that they can see. HMO plans cover care provided by physicians and facilities contracted directly with the insurance company
  • Exclusive provider organization (EPO): An EPO plan allows patients to have more flexibility in selecting a doctor or facility for healthcare needs. However, there are services that Cigna may not cover if they are out of network.
  • Preferred provider organization (PPO): A PPO plan lets patients choose from a wider range of healthcare providers. Still, receiving care outside of the network often results in higher out-of-pocket costs.

In addition, Cigna also provides two other options:8,9

  • LocalPlus: This plan is an affordable way that patients can receive healthcare services from a limited network. Your plan can either only include services from the network or you can include out-of-network services (for an additional cost).
  • Open access plan (OAP): While similar to a PPO plan, an OAP plan has a larger network of providers. OAP plans also permit you to pay additional costs to go outside of the network.

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