How to Pay for Drug Rehab With Cigna Insurance?
How Does Cigna Rehab Coverage Work?The level of coverage you receive from Cigna for substance use treatment will vary based on your plan and the state you live in.
Preauthorization is usually required for treatment of substance use disorders. Preauthorization, also known as prior authorization or prior approval, is when your health insurer determines that a treatment or equipment is medically necessary for your condition.2 Those who require preauthorization for substance use disorder services and fail to obtain it may be responsible for paying the full cost of treatment.
You may also be required to meet a deductible and/or pay a copayment or coinsurance if the services you receive are not fully covered. A copayment is a flat amount you pay for the services; coinsurance is a percentage of the costs that you pay. A deductible is the amount you pay for covered services before Cigna will pay for services.3,4
Receiving drug rehab treatment from an in-network provider may help you avoid paying the full cost of treatment. In-network providers have negotiated an agreed-upon price for services with the health plan, which are generally at a lower cost than for someone without insurance or through a plan in which the provider is not in-network. Out-of-network providers have not negotiated set prices, and you will likely be charged more to use these providers.5
Cigna offers an employee assistance program (EAP) that gives you access to licensed clinicians who can talk to you about your drug and alcohol use. The EAP is available with health care plans purchased through an employer. This program allows you to meet in person with a licensed counselor, speak with a consultant on the phone, or chat with a consultant through live chat.6
What Will Cigna Insurance Cover?
Depending on the plan, Cigna may cover a range of treatments and services for substance use disorders, including inpatient and outpatient rehab programs. The following services may be covered by your Cigna plan.
Outpatient rehab takes place in clinics at hospitals, mental health facilities, counselors’ offices, and local health department offices. Treatment sessions at outpatient rehab may take place once or twice per week for up to 1 or more years.7
Outpatient rehab allows you to live at home and continue going to work or school while receiving treatment.7
Intensive outpatient programs (IOPs) typically meet on 3 days per week for a total of between 10 and 20 hours of therapy. IOPs may last for between 1 and 3 months and may include individual counseling and group therapy sessions. At an outpatient program, patients do not stay at the treatment facility overnight.7 However, American Addiction Centers may have housing available for clients who do not live in the local area.
Partial hospitalization programs (PHPs) usually meet 5 days per week for most of the day. PHPs allow you to receive day treatment while living at home. They may be good fits for people who struggle with more severe substance use disorders but who can safely remain in their home environments.7,8
In an inpatient program, you live at the treatment facility while receiving care.
In an inpatient program, you live at the treatment facility while receiving care. The program may provide a wide range of therapies including counseling, medical care, and 12-step groups. Inpatient treatment might be a good choice for those who also need treatment for co-occurring physical or mental health problems, who need a safe environment in which to recover from drug and alcohol use, who have not had success with outpatient programs, and who don’t live near an outpatient center. Inpatient programs often last between 1 and 6 weeks. Residential rehab is a type of inpatient treatment and may involve staying at the facility for months.7
After completing inpatient, it is recommended that you attend outpatient counseling, which can provide support as you adjust to your new sober lifestyle.7
Drug rehab centers, including American Addiction Centers, are generally not allowed to tell a person outside the rehab center that you are a patient or disclose any information about your treatment. This is prohibited by law. Your identifiable health care information is strictly confidential and usually cannot be disclosed to any outside party unless you give your written consent. Examples of exceptions include when disclosure is required by court order, disclosure is made to medical staff to help treat you in a medical emergency, or the information is requested for the purpose of a program evaluation.Learn more about the privacy of your treatment information.
Types of Addictions Cigna Typically Covers
Cigna plans that cover substance use disorder treatment cover most major addictions. Most drug rehab centers that accept Cigna can treat nearly any addiction. They often offer a range of services that can be customized for your needs.
Cigna may offer treatment coverage for the following addictions:
- Prescription opioids
- Prescription stimulants
- Sleep aids/sedatives
- Other drugs
Cigna Types of PlansCigna offers plans to individuals, families, and employers. Types of plans include health maintenance organization (HMO), exclusive provider organization (EPO), point-of-service (POS), and preferred provider organization (PPO).9
HMOs require you to choose a primary care provider from a local network of health care providers. The costs of HMOs are generally lower than most other health insurance plans, if you receive care within the network. EPOs allow you to choose from a network of participating providers, and they may require you to choose a primary care provider. If you seek treatment out of network with an EPO plan, it will likely not be covered.9
A POS plan offers in-network care at a low cost, requires you to choose a primary care provider, and requires you to receive referrals for specialists. With a POS plan, you can see in- or out-of-network specialists but will likely pay higher costs for out-of-network care. PPOs offer you a large network of health care providers and do not require you to choose a primary care provider. With a PPO, you can see specialists without obtaining a referral.9
How Do I Get Started?
First, contact us for a screening to make sure we can meet your needs. We will review your benefits and help you choose a treatment center that accepts your health insurance plan if possible and provides the services you need to safely recover from your substance use disorder. We understand how overwhelming it can be to find the right treatment center and are committed to connecting you with high-quality, affordable addiction treatment.
To verify your benefits, you can call an admissions navigator, chat with a live agent on our site, or use the verification form on this page. There is no obligation to use our services, and all your information will be kept strictly confidential.
Contact us today at 888-966-8152 to learn more about using Cigna to receive treatment with American Addiction Centers.
- Cigna. Facts about Cigna.
- Healthcare.gov. Preauthorization.
- Cigna. (2019). Terms and definitions FAQs.
- Bankrate. Deductible.
- Centers for Medicare & Medicaid Services. (2017). What You Should Know About Provider Networks.
- Cigna. Licensed clinicians available through EAP.
- Cigna. Inpatient and outpatient treatment for substance use problems.
- National Institute on Drug Abuse. (2014). Treatment settings.
- Cigna. (2018). Types of health insurance.
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