Cigna Insurance Detox & Rehab Benefits Guide
Cigna is a private health insurance company that has been in business for over 225 years.1 Cigna provides health insurance coverage to 17 million people and offers various Medicare plans throughout the United States.1 Despite companies like Cigna being around for a while, there’s still a great deal of confusion about what health insurance plans cover, especially in regards to detox and rehab. It’s important to understand what is covered if you plan on using Cigna insurance for detox and rehab.
Types of Cigna Insurance Plans
Cigna offers providers that are in-network to help save you money when accessing care. Insurance plans through Cigna are available in three tiers:3, 4, 5, 6, 7, 8, 9, 10, 11, 12
- Bronze plans have the lowest premiums, but the highest out-of-pocket costs, deductibles, and co-pays. These plans are best for people who can’t afford high premiums or don’t go to the doctor frequently.
- Silver plans have higher premiums than bronze plans, but lower out-of-pocket costs, deductibles, and co-pays. These plans are best for people with families or those who go to the doctor regularly.
- Gold plans have the highest premiums but the lowest out-of-pocket costs, deductibles, and co-pays. These plans are best for people who visit the doctor often, have a chronic illness, and are prescribed several medications.
Cigna insurance plans are currently offered in the following 10 states: Arizona, Colorado, Florida, Illinois, Kansas, Missouri, North Carolina, Tennessee, Utah, and Virginia. Although coverage is offered in these states, plans & benefits can vary depending on where you live. 2
Online therapy covered by Cigna is available in most states as well. This includes the above-mentioned state of, Colorado, Florida, Illinois, Kansas, Missouri, North Carolina, Tennessee, Utah, and Virginia. This makes it easier to access care when you need it most, no matter where you are. You can learn more about Cigna health insurance plans in your area here.
Cigna and Medicare
Medicare is a federal program that provides health insurance to people aged 65 or older, as well as people with specific disabilities.13 There are different types of Medicare plans, some of which are available through Cigna.1,13 Medicare Advantage (Part C) plans are available through private insurance companies and offer medical and hospital coverage as well as other benefits including prescription medication benefits, depending on the plan that you choose.13, 14 These plans commonly include a deductible and set copay amounts for doctor visits and maximum out-of-pocket limits.14
Medicare prescription drug plans (Part D) are offered through private insurance companies to provide coverage for prescription medications.13 Cigna administers Medicare prescription drug plans throughout the US and Medicare Advantage Plans in 16 US states and Washington, D.C.1 Some Medicare Advantage Plans require you to access care within a network of providers that are contracted with Medicare, while others allow you to see any provider you wish, although this may cost you more.14 To learn more about Cigna Medicare Advantage Plans, click here.
Medicaid is a federal program that provides health insurance to people with disabilities, children, and low-income individuals.15 (about Medicaid) Cigna offers Medicaid managed care plans in Texas through a program known as STAR+PLUS.15 You can learn more about STAR+PLUS and how to apply here.
Cigna also offers a range of health insurance plans for federal employees and retirees, depending on employer and location.16 Plan types include:
- Open Access Plus (OAP) plans, which include a large network of providers, clinics, rehabs, and hospitals across the country that you can access without a referral and the option to choose your primary care doctor to coordinate your medical care.16
- Preferred Provider Organization plans, which are similar to OAP plans but that allow additional flexibility by offering the option to choose care from providers that are out of network.16
- LocalPlus plans, which offer a limited network of providers and facilities close to where you live and also offer the safety net of care when you are out of the area.16
- Health Maintenance Organization (HMO) plans, which offer a network of providers, clinics, rehabs, and hospitals within a set area to meet your treatment needs.16
How to Check Your Cigna Benefits
If you have Cigna Insurance, you may be wondering “How do I check my Cigna coverage?” The first way is to call the phone number for member services on the back of your insurance card. This will connect you to someone who can guide you through your benefits and answer any questions you may have. Some things to ask about may include:
- What does Cigna health insurance cover when it comes to substance use disorder treatment?
- Which facilities are in the Cigna rehab provider network?
- Do I need a preauthorization or a referral to get treatment?
- What types of treatment are covered under my Cigna rehab insurance benefits?
- Are there any limits on my Cigna therapy coverage benefits?
Alternatively, you can check your insurance benefits online. Cigna has a website where you can create and access an online account here. This account allows you to check your benefits, find in-network providers, and estimate costs. You can also access this information through a phone-based app called myCigna.
Cigna Insurance For Cover Detox & Rehab?
Once you’ve verified your benefits and determined the level of Cigna rehab coverage your plan provides, the next step is finding Cigna alcohol rehab centers or drug rehab centers that accept your insurance or are in-network if your plan requires it. This ensures that your insurance plan will cover the majority of the financial responsibility for your treatment, leaving you with a co-pay rather than the full cost of care.
Cigna insurance plans may cover a range of substance use disorder treatments, including:
- Detox, which offers around-the-clock medical care and monitoring during the withdrawal process.17 Medication-assisted treatment is commonly used during detox, meaning that medications can be prescribed to relieve the uncomfortable, painful, and potentially life-threatening symptoms of withdrawal that can occur.17, 18 Detox is only the first step on the road to recovery, and for best results, it should be followed with an additional form of treatment.18
- Inpatient treatment, which involves staying at a facility for the duration of treatment and can be up to 6 weeks in duration.17, 18, 19 This type of care includes group, individual, and family therapy sessions, and may also include psychiatric care for people who have co-occurring mental health disorders.17, 19
- Partial hospitalization programs (PHPs), a step down in intensity from inpatient care. PHPs involve spending around 6-8 hours a day, 5-7 days a week in group and individual counseling sessions.17
- Intensive outpatient treatment, which is a step down from a PHP. This type of treatment provides intensive care while allowing you to continue functioning in daily activities outside of treatment.17, 18, 19 Treatment generally involves around 3-4 hours of group and individual sessions each day for approximately 3-5 days a week and often tapers down as people progress through the program. Attendance and participation in self-help meetings is strongly encouraged.
- Standard outpatient treatment, which involves receiving less intensive care while participating in your usual daily activities.19 Treatment is provided in group and individual sessions on a regular schedule and facilities commonly offer the services of a psychiatrist who may provide medication to manage cravings and co-occurring mental illness.17, 18, 19 Sessions may occur once or twice a week for around a year or longer.
See If Your Cigna Plan Covers Detox Now
American Addiction Centers is one of the largest networks of substance use disorder treatment providers in the United States, with facilities located across the country. One way that American Addiction Centers helps people to access treatment is by working with a variety of insurance companies. Cigna is one of them. For more information about whether your insurance plan is accepted at American Addiction Centers, call our confidential helpline at 1-888-935-1318.
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- (2020). Medicare Advantage plans (Part C) FAQs.
- (2020). Cigna STAR+PLUS.
- (2020). Group health insurance plans.
- (2011). Levels of substance abuse care descriptions (lowest to highest).
- National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (3rd edition).
- (2020). Inpatient and outpatient treatment for substance use disorder.