Cigna insurance offers behavioral health benefits, which cover mental illness and substance abuse treatment services, to thousands of customers in the United States. Are you one of them?
If you have decided it is finally time to seek treatment, you may wonder how to find rehabs that take Cigna insurance. Enrolling in a program that accepts your insurance can significantly lower the cost of care.
This guide will help you understand what Cigna’s behavioral health benefits cover, how to find in-network rehabs, and what you can expect to pay out of pocket. Read on for the most important things to know.
Does Insurance Pay for Rehab?
Yes, insurance does pay for rehab. Insurance providers like Cigna are required to offer the 10 essential health benefits, which include mental health and substance abuse disorder treatment services.
What Substance Use Disorders Does Cigna Cover?
Cigna covers nearly all substance use disorders (SUDs) that are treatable in inpatient or outpatient rehab. This includes the most common SUDs in the US:
- Alcohol use disorder
- Cannabis use disorder
- Prescription opioid use disorder
- Stimulant use disorder
- Illegal opioid use disorder
Individuals can also get coverage for polysubstance use disorders. These are SUDs that feature addiction to more than one substance. More than 32% of people with an SUD have a polysubstance use disorder.
Additionally, Cigna will cover the treatment costs for co-occurring mental health disorders. Sadly, many people with SUDs also suffer from untreated mental health symptoms.
What Substance Abuse Disorder Treatments Does Cigna Cover?
Cigna covers medically necessary substance abuse disorder treatments. The insurance provider may cover all or a portion of the cost, depending on your plan type (more on this in a moment).
The exact services and treatments covered also depend on the plan you are enrolled in. In general, though, Cigna insurance tends to cover the following addiction treatments.
Detoxification is the process of eliminating all traces of drugs or alcohol from your system. During this time, many people experience withdrawal symptoms. These symptoms can be fatal, making medical supervision necessary.
This service is often a requirement for entering an inpatient residential program. People with mild addictions may not experience severe withdrawals. In that case, they may not need detox before starting outpatient treatment.
Inpatient programs are what most people think of when they imagine rehab. They are also known as residential treatment programs since individuals live at the facility while they receive care.
Cigna will cover many of the services received at an inpatient treatment facility. This may include individual, group, and family therapy. Most plans also cover aftercare or the treatments needed to help you stay sober after rehab.
Traditional Outpatient Programs
Traditional outpatient programs are also known as going to therapy. Individuals live at home and commute to treatment sessions once or twice a week for the duration of their program.
Because patients do not live at the treatment facility, outpatient programs are often more affordable than inpatient programs. However, this type of treatment is not suitable for people with moderate to severe SUDs.
Intensive Outpatient Programs
Intensive outpatient programs (IOPs) are a step up from traditional outpatient programs. They are similar in that they allow participants to live at home while receiving care. However, they differ in the number of treatment sessions.
Most IOPs feature two to three weekly therapy sessions lasting one to three hours. These programs are best for people with moderate SUDs or who were recently discharged from an inpatient or partial hospitalization program.
Partial Hospitalization Programs
A partial hospitalization program (PHP) is the most intensive form of outpatient treatment. They still allow patients to live at home, but they spend five days a week in treatment sessions.
PHPs are ideal for people with moderate to severe disorders but who don’t require 24/7 supervision. Usually, these programs require that the person have a strong support system at home to help them avoid temptation.
Mental Health Disorder Treatments
Unfortunately, it is incredibly common for people with SUDs to also have one or more mental health conditions. Also known as co-occurring disorders, they may include anxiety, depression, ADHD, bipolar disorder, and more.
Cigna covers treatments for these disorders, whether they are caused by an SUD or exacerbate the symptoms of an addiction. Treatment may include therapy (e.g., CBT or DBT), medication, or both.
Cigna will cover two types of medication services in rehab. The first is medication needed to manage withdrawal symptoms during detox. These drugs must be administered under a medical professional’s supervision.
The second type of medication is for treatment. Some drugs can treat cravings and other symptoms during addiction recovery. Others can help with symptoms of co-occurring mental health disorders.
How to Find Rehabs That Take Cigna Insurance
Your Cigna insurance policy may not require you to seek treatment from an in-network provider. However, consider finding an in-network provider anyway, as this can substantially lower your treatment costs.
Cigna may not cover the entire cost of in-network rehab. Consult your individual plan to find out which services are covered. Out-of-network care qualifies for even lower coverage, leaving you with high out-of-pocket costs.
But how do you find these elusive in-network providers? Here are three tips for doing just that.
Call Your Benefits Manager
If you are searching for in-network SUD treatment providers, your benefits manager can help you find them. Benefits managers help individuals understand their employer-sponsored insurance policies.
You may be able to connect with your benefits manager one-on-one. Or they may provide a convenient website where you can search for in-network providers that accept your insurance.
Run a Google Search
Didn’t find what you were looking for through your benefits manager? The next best strategy may be to run a Google search. Try search terms like ‘rehabs accepting Cigna near me’ or ‘Cigna rehabs near me.’
Once you find a list of results, check the providers’ websites to verify the types of insurance they accept. Remember, just because a business comes up in your search results does not guarantee that they are in-network.
Verify Your Insurance
Another strategy is to curate a list of local rehabs you love and verify your insurance with each. Many rehab websites offer insurance pre-verification to ensure your benefits will cover treatment.
For example, Altitude Recovery in Camarillo, California offers the option to verify your insurance online. That way, you can find out exactly which services are covered based on your Cigna plan.
What Is the Cost of Rehab With Cigna?
The cost of rehab with Cigna varies based on the plan. Cigna provides a variety of plan options, including but not limited to health maintenance organizations (HMOs) and preferred provider organizations (PPOs).
With HMOs and PPOs, seeking treatment from an in-network provider can substantially lower the total cost of rehab. Again, the exact costs covered by these plan types vary.
EPO and POS plans are also available. These plans are similar, except that EPOs will not cover any of the costs of out-of-network care. POS plans cover a larger portion of in-network care but will also cover some out-of-network costs.
Cigna insurance plans come in four tiers called metal tiers: Bronze, Silver, Gold, and Platinum. See the cost breakdowns for each metal tier below.
Bronze tier plans are the most affordable in terms of monthly premiums. However, that makes for higher out-of-pocket costs at the point of care. Cigna will cover 60% of your rehab costs, and you are responsible for the other 40%.
Silver tier plans have higher monthly premiums but lower out-of-pocket costs at the point of care. In terms of SUD treatment, Cigna will pay for 70% of the total cost while you cover 30%.
Gold tier plans have the second highest premiums of the four Cigna metal tiers. In exchange, your plan will cover more of the cost of rehab. You pay 20%, and Cigna will cover the remaining 80%.
Platinum tier plans are the most expensive in terms of monthly premiums. The good news is that enrollees pay next to nothing for rehab. You only cover 10% of the total cost of treatment, and Cigna will cover the remaining 90%.
Altitude Recovery Community Is In-Network With Cigna
Altitude Recovery Community offers rehab services to the Ventura County, California area. We are also in-network with most Cigna PPO and POS plans, meaning your insurance plan will cover rehab.
We offer the following types of services for a wide range of substance use disorders, including:
- Detoxification and withdrawal management
- Individualized inpatient treatment programs
- Comprehensive aftercare plans
Use the link we provided earlier in this article to verify your benefits. We will let you know which treatments are covered and how much you can expect to pay out of pocket.
Searching for California Rehabs Accepting Cigna?
Cigna provides insurance benefits for substance abuse and mental health treatments. The exact coverage and costs you will pay out of pocket depend on your specific plan, metal tier, and if the provider is in or out-of-network.
Are you looking for ‘rehabs that take Cigna insurance near me’? Altitude Recovery Community offers comprehensive addiction services in beautiful Southern California. Contact Altitude to learn more about our programs.