Cigna Rehab Coverage for Drugs & Alcohol

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Cigna Rehab Coverage

Cigna Healthcare is a health insurance provider headquartered in Bloomfield, CT, that provides healthcare coverage for millions of people around the world, including those suffering from substance abuse, substance use disorder (SUD), and other behavioral and mental health conditions. Since the inception of the Affordable Care Act (ACA) in 2010, all health insurance companies are required to cover at least a portion of the costs of essential care, including drug abuse addiction treatment and recovery services. 

If you or a loved one is suffering from addiction and ready to make the first step towards a life of sobriety, we can help. If you’re unsure about the specifics of your insurance coverage for drug and alcohol rehabcontact Zinnia Health at (855) 430-9439 to speak to a compassionate treatment specialist. With your permission, we can contact Cigna on your behalf to learn what your policy covers.

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Does Cigna Insurance Cover Alcohol Rehab?

Yes. Cigna Insurance (and all public insurance companies since the introduction of the Affordable Care Act) offers coverage for alcohol rehab, but your specific level of coverage depends on your unique policy and other factors, such as:

  • Your state of residence.
  • Whether you have an employer-, state-, or federal-sponsored policy.
  • If you purchased a Marketplace policy under the umbrella of the ACA.
  • Your plan’s healthcare deductibles for mental and behavioral health services.
  • Drug and alcohol treatment, such as inpatient rehab, must be deemed medically necessary and recommended by a board-certified, licensed healthcare provider.

How much Cigna covers for alcohol treatments or other inpatient rehab services also depends on the type of plan you’re enrolled in. Coverages vary between health maintenance organization (HMO), exclusive provider organization (EPO), and preferred provider organization (PPO) policies.

Does Cigna Insurance Cover Substance Abuse Treatment?

Yes, Cigna insurance plans offer insurance benefits to cover both inpatient and outpatient substance abuse treatment programs. Substance abuse treatment is often done with an inpatient program, but it’s important to consider exclusions and restrictions. For instance, the rehab center may need to request prior authorization before providing services.

Actual coverage can be as much as 90% of total treatment costs, but vary by plan.

Addiction treatments your Cigna Insurance may cover include (but aren’t limited to):

  • Detox
  • Counseling programs
  • Inpatient care and outpatient treatments
  • Medication-assisted treatment and therapy

Your policy’s provisions depend on many variables, such as where you live, what your specific policy covers, where you obtained your policy, the intensity of the treatment plan you require, how long your treatment may take, and where you’ll receive treatment.

Cigna’s preventive care appointments are of no-cost to policyholders, but for visits considered non-preventive, you may need to:

  • See only in-network doctors.
  • Obtain a referral from your primary physician.
  • Receive treatment from hospitals or other facilities considered in-network.
  • Set up appointments with in-network specialists when required or recommended.
  • If you have coinsurance, obtain a statement of payments/coverage.
  • Calculate how much you’ve paid towards your deductible for the policy period (typically 12 months), then if you have a portion of your deductible remaining unpaid, you must pay this amount before Cigna pay their portion for your treatment.

Cigna Insurance benefits offer coverage to begin the treatment process, and your employer’s plan might also include benefits such as:

  • Confidential counseling or therapy sessions.
  • Multiple substance abuse treatment options.
  • Ongoing access to recovery treatment specialists, outpatient rehab, and aftercare programs.
  • Personalized life skills coaching or support that can work around your personal schedule and unique challenges.

Does Cigna Cover Mental Health Treatment?

Yes, Cigna Healthcare, in partnership with Evernorth Health, offers coverage for mental health services and treatment for policyholders. Your benefits may vary depending on whether employer-sponsored or self-purchased.

Your policy may provide access to:

  • Referral services, including:
    • 12-step programs for substance abuse and alcohol addiction
    • Online resources
    • Life skills coaching
    • Community support and outreach programs
  • Outpatient programs
  • Initial consultations
  • Case management and follow-up
  • Provision of mental health treatment
  • A network of licensed behavioral and mental health services providers

Cigna Inpatient Coverage

Cigna provides inpatient Hospital Care coverage according to each policy. The injury or illness that caused the policyholder to submit to hospitalization must be on Cigna’s list of covered injuries and illnesses.

Cigna Outpatient Coverage

Cigna Insurance offers healthcare coverage for outpatient visits at clinics, urgent care locations, and other medical facilities that don’t require overnight stays in a hospital, such as:

  • Physical therapy
  • Counseling sessions
  • Weight-loss support programs
  • Drug rehab and alcohol rehab services
  • Preventive and wellness checkups
  • Lab tests, MRIs, and other diagnostics
  • Surgery, chemotherapy, and other outpatient treatments

Rehabs That Accept Cigna Insurance Near You

Zinnia Health has locations across the United States to provide addiction recovery services and give a helping hand on the road to recovery.

We accept Cigna Healthcare insurance alongside many other health insurance plans at our locations.

Start your journey to healing at one of these in-network Zinnia Health locations:

If you or a loved one has been diagnosed with a co-occurring disorder, such as a drug addiction paired with depression or anxiety, Zinnia Health can help. From residential inpatient treatments to convenient outpatient programs and group therapy, our treatment specialists can jumpstart your recovery. Contact Zinnia Health at (855) 430-9439 to learn how you can live a life of sobriety.

How to Check Your Cigna Coverage

To check your Cigna Healthcare coverage:

  1. Gather necessary information. Write down your policy ID number, along with any other information you might need, such as doctor’s name and location, and any prescriptions you’re currently taking in the event you have to answer any questions requesting personally identifiable information — having it handy will make the process smoother.
  2. Request a myCigna account. On your myCigna account, all of your policy information, including past doctor office visits, copays, and deductible amounts paid for the period is easy to find. The myCigna account is relatively user-friendly with easily navigable pages and tabs to find the information you’re looking for.

Note: You cannot navigate to certain Cigna Healthcare information without a myCigna account.

Alternatively, you can:

  1. Call Zinnia Health at (855) 430-9439.
  2. Speak to one of our caring admissions specialists.
  3. Provide the insurance information (policy number, plan type, etc.) that you wrote down earlier.
  4. Zinnia Health will contact Cigna Healthcare for you and find out exactly what your policy covers and let you know your out-of-pocket costs for substance abuse treatment if your policy doesn’t cover the entire amount.

Navigating the many nuances of your Cigna Healthcare policy is challenging. Obtaining a ‘medically necessary’ judgment and knowing exactly what your policy covers and for how long is essential. While most facilities offer payment options and can put you in touch with assistance programs, it’s still important to understand your coverage, how much assistance you might need, and your total out-of-pocket costs.

Types of Cigna Plans that Cover Addiction Treatment

Many pages on the Cigna site are only visible to members with current policies. You can, however, enter your zip code to see plans, prices, and availability in your state on the ShopCigna page.

As an example, if you have the Cigna Healthcare | Cigna Connect 6500 Individual & Family policy as part of an EPO plan and you live in Kansas:

  • You’d likely need to obtain a referral from your primary healthcare provider to access benefits to cover substance abuse treatment, such as a partial hospitalization or intensive outpatient program.
  • Cigna Healthcare would not cover mental or behavioral health services or substance abuse treatment provided by a physician or facility that’s out-of-network.
  • Cigna Healthcare would cover 50% of the total costs of mental health issues, behavioral health services, and/or substance abuse treatment if the medical professionals or rehab center is in-network.
  • If you haven’t yet met your deductible, you must pay the remainder of your deductible plus 50% of the total cost of treatment, and then Cigna pays their portion (the other 50%).

Frequently Asked Questions

What Length of Stay Will Cigna Cover?

There’s no limit on coverage for substance abuse and mental health treatments as long as a policyholder has met their out-of-pocket maximum and, if the preapproved length of stay (typically 30 to 90 days) has elapsed and the individual still requires care, they must submit to a reevaluation.

If the policyholder is a single individual with no dependents, they must pay their individual out-of-pocket maximum and then Cigna covers 100% of treatment costs. If the policyholder is part of a family plan policy, the individual must meet their out-of-pocket maximum obligation and all other individuals on the policy must also have met their out-of-pocket maximum for the policy period before Cigna will cover the treatment costs.

How to Pay for Costs Cigna Doesn’t Cover?

If your policy doesn’t cover all the costs of inpatient rehab, there are state- and federally-funded assistance programs that can help you cover treatment costs, in addition to sliding fee scales and payment plans.

What to Do if Cigna Doesn’t Cover Rehab?

Most Cigna plans cover all or a portion of rehab treatment services.

Do Rehab Facilities Need to Be In-Network?

Cigna Healthcare doesn’t require treatment facilities to be in-network — however, for inpatient substance abuse treatment and inpatient mental health services, the in-network deductible per stay (not the same as your policy deductible) is $250 for in-network treatment centers and $500 per stay for out-of-network treatment centers (all else equal). 

Choose a treatment center that’s in-network, like Zinnia Health. Our caring treatment professionals are available 24/7 to answer questions, verify insurance coverage, or just lend an ear if you need someone to talk to. Contact Zinnia Health at (855) 430-9439.

Call us
Ready to get help?
(855) 430-9439
Why call us? Why call us