Cigna Drug & Alcohol Rehab Coverage | Treatment Solutions

Cigna Insurance for Drug Rehab and Alcohol Addiction Treatment

Cigna is a worldwide health insurance company with over 18 million Cigna Insurance customers.1 The specific coverage for drug treatment depends on many factors, including:2

  • The state where you live.
  • Whether your plan is employer-sponsored or government-sponsored (Medicaid/Medicare).
  • If your plan was purchased on the Healthcare Marketplace under the Affordable Care Act (ACA).
  • Whether your plan is a health maintenance organization (HMO), exclusive provider organization (EPO), or preferred provider organization (PPO) plan.
  • Your policy’s behavioral health deductibles.

Deciding to seek treatment for drug addiction can be very challenging. One reason is the cost associated with drug addiction treatment. The goal of this guide is to make the decision to seek drug addiction treatment for you or your loved one easier by offering detailed information about the drug treatment coverages offered by Cigna Insurance.

Does Cigna Insurance Cover Drug Treatment?

Cigna Insurance provides group health insurance plans through an employer. Plans include:3

  • Cigna Open Access Plus (OAP) offers a national network of doctors and hospitals, discounts, the option to select a primary care provider (PCP), and no referral requirements.
  • Cigna HMO requires you to use doctors and hospitals only within a specified network. An HMO often has lower monthly premiums, but higher deductibles. Under an HMO, you will choose a primary care physician (PCP) who will assist with coordinating your care.
  • Cigna PPO offers a large network of doctors and hospitals you are required to use. The policy premiums of a PPO are typically higher than an HMO, but your deductibles may be lower or higher.
  • Cigna LocalPlus® provides employees with a limited network of doctors and hospitals plus access to Away from Home Care.
  • Cigna SureFit® is a customizable plan for employers and employees and is available only in certain service areas.
  • Cigna Indemnity Plans (Network Savings Program) allow employees to see any doctor, use any hospital, and visit any specialist without a referral.
  • Cigna Network provides a list of doctors and hospitals you must use within a service area.
  • Cigna Group Medicare plans are designed to meet the specific needs of retired employees.

Cigna also offers individual and family plans that may be purchased on the Healthcare Marketplace. A Managed Medical Assistance (MMA) program is offered via Medicaid or may be selected as a Medicare supplemental insurance policy.3Cigna individual and family insurance plans include:4

  • Cigna HMO requires you to use only the doctors and hospitals within a specified network. An HMO often has lower monthly premiums, but higher deductibles. Under an HMO, you will choose a primary care physician who will assist with coordinating your care.
  • Cigna EPO offers a specific network of doctors and hospitals you must use. While the premiums for an EPO may be lower than an HMO, the deductibles may be higher, and services received from doctors and hospitals outside of the network will not be covered unless it is an emergency.
  • Cigna PPO offers a large network of doctors and hospitals you are required to use. The policy premiums of a PPO are typically higher than an HMO, but your deductibles may be lower or higher.

Cigna Insurance is currently available in Arizona, Colorado, Florida, Illinois, Kansas, Missouri, North Carolina, Tennessee, Utah, and Virginia.5

There are several drug rehabs in the Cigna network. A rehab facility can help you check your insurance coverage. For example, American Addiction Centers (AAC), which accepts Cigna, has a webpage where you can enter your policy number to instantly verify your drug rehab coverage.6 You can also call the telephone number listed on the back of your Cigna insurance card to verify coverage.

What will Cigna Insurance Cover?

Drug treatment coverages differ across Cigna’s plans. Your plan may cover the following services for the treatment of alcohol, heroin, prescription opioid, marijuana, methamphetamine, cocaine, benzodiazepine, prescription stimulant, and sedative addiction:7

  • Outpatient rehab/therapy
  • Intensive outpatient programs (IOPs)
  • Partial hospitalization programs (PHPs)
  • Inpatient/residential rehab

Specific Cigna Insurance plans offer coverage as follows:7

  • Cigna PPO covers outpatient rehab services, IOP, PHP, and inpatient/residential rehab services, but prior authorization is required. In-network services are covered at higher amounts, but out-of-network services may be covered in part.
  • Cigna LocalPlus® covers in-network outpatient and inpatient rehab services without limitations. Out-of-network services are not covered.
  • Cigna Connect Flex covers in-network outpatient services without limitations. Inpatient services require prior authorization.
  • Cigna LocalPlus HSA has higher coverage for in-network outpatient services than out-of-network services. A prior authorization is required for inpatient services.

Cigna health insurance plans may also provide coverage for outpatient and inpatient drug rehab treatments such as medical detox, counseling/therapy, community-based programs, support group meetings, medication management, psychosocial rehabilitation, relapse prevention, and holistic methods.7; 9

You will likely need to pay a copayment to receive drug rehab treatment of any type. The amount you pay will depend on the type of Cigna Insurance plan you have. To check your Cigna Insurance drug treatment coverage, call 1 (888) 270-7346 to speak with an AAC Admissions Navigator.

Does Cigna Insurance Cover Mental Health Care?

The ACA requires all insurance policies to provide coverage for mental health care and treatment.9 Some people have co-occurring disorders—drug addiction and mental health disorders—requiring simultaneous treatment for both.9 Many drug rehab programs are available to assist people with co-occurring disorders.

Cigna Insurance plans provide coverage for the treatment of co-occurring mental health and substance abuse issues.9 To check your specific drug treatment coverage under Cigna, speak with an AAC Admissions Navigator at 1 (888) 270-7346.

How Long Does Cigna Insurance Cover Rehab?

Drug rehab services often include a combination of inpatient and residential rehab, outpatient rehab and therapy, and/or intensive outpatient rehab and therapy. These services are described in more detail as follows:10

  • Inpatient and residential rehab—Inpatient/residential rehab may require you to stay at a rehab center for 30-120 days, depending on your needs. After the inpatient portion of treatment is complete, you will likely be required to have outpatient rehab and therapy as part of your aftercare plan. Outpatient rehab and therapy may continue for months.
  • Outpatient rehab therapy—Outpatient rehab therapy often involves 1 or 2 group therapy sessions per week in settings such as a community behavioral health clinic, therapy office, hospital, clinic, or health department. Treatment may continue for months or even years.
  • Intensive Outpatient Programs—IOPs require you to complete 10-20 hours of individual counseling and/or group counseling. Attendance is usually 3 days a week for up to 3 months.

The length of drug rehab treatment varies from person to person. The type of drug or drugs abused and frequency of use can determine the length of required treatment.10; 11; 12; 13

The drug rehab services covered by Cigna Insurance will depend on the type of plan you have. There are several ways to determine what your plan will cover:

  • Call the member information number on the back of your card.
  • Call AAC at 877-640-1943 and speak with an Admissions Navigator.
  • Fill out the insurance verification form underneath by entering your insurance carrier (Cigna) and policy membership identification number (located on the front of your card)

What if My Cigna Insurance Policy Does Not Cover Drug Rehab?

If your Cigna Insurance plan does not cover drug rehab services, know that some drug rehab centers, including American Addiction Centers, offer scholarships or payment plans. Call 877-640-1943 to discuss flexible payment plans at AAC. Some nonprofit organizations also offer scholarships for both inpatient and outpatient drug rehab services.14

While drug treatment may require some out-of-pocket expenses, the price for not seeking treatment may be greater. According to long-term research on people in drug rehab treatment, most people stopped using drugs, engaged in less criminal activity, and increased their social, work, school, and psychological functioning.9 Without drug rehab treatment, drug use and criminal activity increased and functioning decreased.9

In-Network vs. Out-of-Network Rehab Centers

Cigna Insurance maintains an extensive list of in-network doctors, hospitals, and facilities.1 In-network refers to a professional relationship that exists between Cigna and the doctor, hospital, and facility. While some Cigna Insurance plans allow for out-of-network care, there may be additional out-of-pocket expenses.1

AAC is an in-network provider under Cigna Insurance. To find out if another doctor, hospital, or facility is an in-network provider under Cigna Insurance, visit https://www.cigna.com/hcpdirectory/search-tool/.

Check Your Benefits

Navigating through the many parts of drug treatment coverage under Cigna can be difficult. AAC can help you with this process. You have a few options to get this assistance:1; 16; 17

  • Fill out the underneath insurance verification form by entering your insurance carrier (Cigna) and policy membership identification number (located on the front of your Cigna Insurance card)
  • Call the AAC at 877-640-1943 and speak with an Admissions Navigator.
  1. American Addiction Centers: National Rehabs Directory. (2021). Does Cigna cover drug and alcohol rehab?
  2. (2021). Group health insurance plans.
  3. (2021). What’s the difference between an HMO, EPO, and PPO?
  4. (2021). 2021 Cigna health plan information.
  5. American Addictions Center. (2021). Instantly check your insurance coverage.
  6. (2021). How to pay for drug rehab with Cigna Insurance?
  7. American Addiction Centers. (2021). Verify your insurance.
  8. gov. (2021). Mental health & substance abuse coverage.
  9. Cigna (2021). Inpatient and outpatient treatment for substance abuse disorder.
  10. Manuel, J., Yuan, Y., Herman, D., Svikis, D., Nichols, O., Deren, S. (2017). Barriers and facilitators to successful transition from long-term residential substance abuse treatment. Journal of Substance Abuse Treatment, 74(1), 16.22.
  11. Kelly, P., Kyngdon, F., Ingram, I., Deane, F., Baker, A., & Osborne, B. (2018). The Client Satisfaction Questionnaire – 8: Psychometric properties in a cross-sectional survey of people attending residential substance abuse treatment.Drug and Alcohol Review, 37(1), 79 – 86.
  12. Ali, B., Green, K., Daughters, S., & Lejuez, C. (2017). Distress tolerance interacts with circumstances, motivation, and readiness to predict substance abuse treatment retention. Addictive Behaviors, 73(1), 99 – 104.
  13. National Institute on Drug Abuse (2021). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). How effective is drug addiction treatment?
  14. American Addiction Centers. (2021). How to pay for drug rehab with Cigna Insurance?