Cigna Insurance Coverage For Addiction Treatment

The Cigna Group, which is based in Connecticut and incorporated in Delaware, started as a merger between the Connecticut General Life Insurance Company and the INA Corporation.

Cigna offers health insurance marketplace plans, commercial plans, and international insurance plans for employers, individuals, and families.

These plans have many levels, offering options for low premiums and high deductibles, low deductibles and high premiums, and more.

Does Cigna Cover Rehab?

Yes, Cigna insurance covers drug and alcohol rehabilitation services. These include inpatient and outpatient services as well as residential treatment programs.

The most important qualifier for Cigna is medical necessity.

Treatment services or levels of care meet the standard of medical necessity if:

• they are within the accepted standards of addiction medicine
• they are appropriate as clinical approaches
• they are not recommended simply for convenience sake

Substance Abuse Treatment Services Covered By Cigna

Cigna covers a wide range of substance abuse treatment services and settings. Review the table below to see a breakdown of coverage for addiction treatment.

Cigna Coverage By Treatment Type

If you are having trouble keeping all the levels of care straight, take a moment to review the tabs below, which describe coverage at each level in a little more detail.

Cigna Plan Types

Cigna has several different plan types depending on who you are and what you need. This may include commercial insurance plans or Health Insurance Marketplace plans.

For individual and family plans, three basic plan types range from low to high premium costs and low to high deductibles.

The three plan types are:

• Bronze plans, with low premiums and high deductibles
• Silver plans, with a balance of premium and deductible costs
• Gold plans, which have high premiums but low deductibles

How To Use Cigna Coverage For Substance Abuse Treatment

Cigna offers insurance in 13 states, so using this insurance will likely mean going to a treatment center in the state where you are covered by Cigna.

When you begin enrollment, intake specialists at the treatment center will likely talk about payment and insurance. They will need your Cigna plan information to go over the particulars with you.

If you have not met your deductible, you will owe the remaining amount to the treatment center. If you have co-pays for office visits, you will likely need to pay those as well.

Cigna Co-Pays And Deductibles For Addiction Treatment

Co-pays and deductibles for Cigna vary depending on what plan level you have: gold, silver, or bronze.

Bronze plans are going to have higher deductibles and co-pays. These will be lower for gold plans, but there are many options within each level, so expect some variation.

In general, here is the breakdown by plan level for addiction treatment coverage:

• Bronze plans may have a $60 co-pay for office visits with 50% coinsurance for all other outpatient services and a $3,000 co-pay for the first three days of inpatient treatment.
• Silver plans may have a $55 co-pay for office visits with 50% coinsurance for other outpatient services and a $2,500 co-pay for the first three days of inpatient treatment.
• Gold plans may have a $20 co-pay for office visits with no deductible and 20% coinsurance for inpatient treatment.

What Addictions Does Cigna Cover?

Cigna advocates treatment for substance use disorders regardless of diagnosis. This means that treatment for all forms of substance abuse should be covered.

For detox, Cigna does single out a few substance use disorders for medical detox services. They are opioid, alcohol, and benzodiazepine use disorders.

What If My Insurance Plan Doesn’t Cover The Treatment Program I Need?

If your insurance plan does not cover the treatment program that best fits your needs, don’t give up on affording treatment, because you still have options.

These options include help from the government and help from the rehab center itself.

Here are some payment options to consider:

• government grants through the Substance Abuse and Mental Health Services Administration (SAMHSA) or other government agencies
• payment assistance from your rehab center in the form of a sliding fee scale or a payment plan
• government-funded insurance programs such as Medicare, Medicaid, or another form of public health insurance

Finding A Rehab Center That Accepts Cigna

You can take a couple of different routes to find a treatment center that is an in-network provider with Cigna.

One is to contact Cigna by phone or online to learn about in-network treatment centers in your area. This is probably the most efficient way to discover which rehab programs accept Cigna.

The other way is to contact the treatment centers near you that you are interested in. They often have insurance verification forms on their websites to help you determine whether they accept Cigna.

Or you can call and start a conversation with an intake specialist.

Find Substance Use Disorder Treatment Today

If you or a loved one is facing a substance use disorder, call us today. We have more information about the treatment process, recovery options, and how to get started.

Written by the Addiction Resource Editorial Staff