Cigna insurance plans, available in all 50 states and more than 30 countries, provide coverage for substance abuse treatment in a variety of settings. Cigna offers additional resources, and the company has worked to slow the opioid epidemic in the United States over the past 3 years.1, paragraph 1 They have information on their website to help you if you’re considering whether treatment is right for you. Your Cigna Insurance drug treatment coverage depends on your insurance policy.
When you get health insurance with Cigna, you can choose from 4 tiers: 2, Compare Marketplace Health Plans
- Bronze: You pay about 40% of your medical costs out-of-pocket and Cigna covers the rest. This tier also comes with the lowest premiums of all available options.
- Silver: The Silver tier covers about 70% of your costs with 30% paid out-of-pocket. The premiums are low compared to the following 2 tiers, but higher than Bronze.
- Gold: You only pay 20% of your costs out-of-pocket. However, you also have higher premiums to balance the out-of-pocket costs.
- Platinum: With the highest premiums, Platinum covers almost all of your medical costs, so you only pay about 10% out-of-pocket.
Each tier includes substance use disorder coverage, but the amount of coverage depends on your policy. Make sure you check your specific plan, and not just which tier you have. The percentage changes with the policy, and whether you have an HMO, PPO, or another type of plan may also affect the amount of coverage. To learn more about your coverage, you can call American Addiction Centers, log into your mgCigna account online, or call the number on the back of your insurance card.
What Will Cigna Insurance Cover?
Cigna has several different types of plans, including HMO and PPO policies. The latter gives you more out-of-network options, whereas an HMO plan may make it harder to access out-of-network care should you need it. All Cigna insurance plans cover some level of care for inpatient and outpatient treatment, including intensive outpatient programs (IOPs) and partial hospitalization programs (PHP). However, the amount again depends on your policy and where you seek care.
IOPs often last about 1-3 months with Cigna health insurance. When you seek drug treatment, you can work with the rehab center to determine the specific level of care you need. You and your rehab center will discuss the necessary care and determine what works best for you. That care depends on several factors, including:
- Your living situation.
- Your external support system.
- The severity of your substance use disorder.
You may not need to speak to a representative if you use your myCigna account to check your benefits.3, Access Your Benefits Anytime, Anywhere However, if you can’t find what you’re looking for, call AAC or Cigna. We can give you information about your policy and levels of coverage.
Does Cigna Insurance Cover Mental Health Care?
The Affordable Care Act (ACA) mandates that all health insurance companies offer mental health insurance. Substance use disorder is a mental illness, so it qualifies as part of Cigna mental health coverage. AAC and Cigna both know that everyone’s experience with addiction is unique. People with substance use disorder often have co-occurring disorders that affect their addiction. Cigna offers mental health coverage with all of its plans. The different plans may mean you have access to more specific Cigna mental health benefits, including:4, What Are Mental Health Benefits?
- The network of Cigna behavioral health professionals.
- Follow-up case management.
- Consultation and referrals.
- Outpatient mental health services.
- Referrals to local support and online resources.
Some of these details may also change, depending on the state where you live and your benefits through various employers.
According to the Substance Abuse and Mental Health Service Administration, 64.3% of people with opioid abuse have a co-occurring mental health disorder5, Page 3, graph and 26.9% of those people have a serious mental health disorder. Substance use disorder often happens when people feel they do not have the external support they need. Many situations can make a person feel that drugs are their best or only option at the moment, whether they abuse prescription pain medication or turn to recreational drugs. Treating all parts of a person’s substance use disorder means giving them a complete support system. It offers stability during and after treatment. To neglect co-occurring disorders is to neglect to give someone the best possible care.
At AAC, we work to find the root issues of substance use disorder. We want you to feel comfortable accepting help from us so that we can facilitate your recovery and show you that it’s possible to move past your current situation. We offer resources you can continue to use in the future and give you a community of people who understand what you’re going through. At AAC, we understand how difficult it can be to reach out for help, and we’re here to provide it. Our professionals are trained specifically in processes that aid your recovery every step of the way, through detox and withdrawal, mental health support, emotional support, and general encouragement to keep you on your path to healing.
How Long Does Cigna Insurance Cover Rehab?
The length of your Cigna insurance coverage depends on the care you need. It varies based on each plan, the length of your rehab, the severity of your substance use disorder, and other factors. Cigna has several options with its policies, so check yours to learn more about your specific coverage. According to the National Institute on Drug Abuse, a person’s treatment must last long enough and incorporate strong enough resources to work.6, second full paragraph For many people, that means a longer rehab treatment of 6 months or more. That doesn’t mean shorter treatment times can’t be effective. Many people do well with 3 or fewer months of rehab. However, with more severe substance use disorders, some people require longer treatment.
Detox alone is not treatment for drug addiction. A full course of rehab treatment often includes detox, therapy, counseling, community resources, and much more. It’s about providing a system of support as much as stopping drug use. For treatment to succeed, we need to have enough time to build that system, which shorter treatment courses don’t always allow for. That can lead to people returning to drugs. Recovery is a lifelong process, and at AAC, we want you to have a solid foundation when you start to heal. If you don’t know how long your Cigna insurance benefits will cover treatment, call AAC or Cigna to speak with a representative. We’ll look up your coverage and help you find a rehab center that meets your needs.
What if My Cigna Insurance Policy Does Not Cover Drug Rehab?
Cigna will cover a portion of your care, but the amount varies with the tier and policy. Sometimes, a policy doesn’t cover as much as you need. You might still struggle to pay for rehab. In cases like these, AAC and other rehab centers may offer financing and scholarships for treatment. We want you to get care for your addiction, so we do our best to make financial resources available. With financing, you pay for your rehab in installments. That way, you don’t have to pay upfront, but you still get the care you need. Scholarships and grants are typically non-competitive, so you don’t have to worry about them not being available if you meet the qualifications. To find out if you qualify, talk to us at AAC or contact your chosen rehab center to ask what they offer for financing and scholarships. No matter what, do not delay your treatment. Continued substance abuse can lead to serious conditions, including cancer and heart disease.7, Findings The sooner you stop using, the better chance you have to avoid these complications.
In-Network vs. Out-of-Network Rehab Centers
Cigna insurance covers both in-network and out-of-network rehab centers. With a PPO plan, you have more options, as PPOs typically offer some level of coverage, even with an out-of-network rehab center. HMO plans don’t offer that coverage, so you’re more limited. Cigna in-network providers have agreed to Cigna’s price when charging for care. That price is often lower than what the center would charge if you had no insurance. When you go to rehab, Cigna will then pay part of the cost and you pay the rest. With Gold and Platinum plans, Cigna may cover a significant portion of the cost. Out-of-network providers mean that the center doesn’t agree to Cigna’s payments. Therefore, Cigna cannot cover as much of the cost. This is where PPO plans come in, as they do still help with the cost of care. However, you’ll still pay more than you would with an in-network rehab center.
Check Your Benefits
AAC can help you verify your Cigna insurance coverage for rehab. Use our online form or call us to find out more about your policy coverage. At AAC, we want you to recover, which is why we offer as many resources as possible. We’ll work with you to find the right rehab center for your needs. Contact us today by calling our helpline at1-888-287-0471 and talk to us about how we can help you start your recovery from drug addiction.
- (2018). Cigna intensifies effort to curtail opioid epidemic by confronting opioid addiction and overdose in U.S. communities.
- (2021). Bronze, silver, gold, and platinum health plans.
- (2021). Affordable health insurance plans.
- (2021). Mental health benefits.
- Substance Abuse and Mental Health Services Administration. (2019). Co-occurring substance use and mental disorders among adults with opioid use disorder.
- National Institute on Drug Abuse. (2014). Principles of adolescent substance use disorder treatment: A research-based guide.
- National Institutes of Health. (2014). Substance use and associated health conditions throughout the lifespan.