Does Cigna Insurance Cover Alcohol and Drug Rehab?

In the United States, almost all health plans are required to provide some level of coverage for essential health benefits, which includes treatment for substance use disorders.¹ As such, your Cigna health insurance plan may provide coverage for alcohol and drug rehab.

Due to the vast number of different plans that may be offered through Cigna, it’s important to learn more about your specific health plan to understand the breadth of coverage it may offer.

What Is Cigna Insurance?

Cigna is an international health insurance company, providing healthcare solutions in 30 different countries, including the United States of America.² Cigna has been providing insurance solutions for more than 225 years through a variety of plans and coverage options.³

Cigna Health InsurancePlans

Cigna offers a variety of different plans across the many countries and markets it covers. All in all, Cigna serves 190 million customers in 30 different countries.² In the United States, Cigna offers a variety of plans in different markets.⁴ “^{Shop plans” tab}

Individuals and families may purchase plans on the Health Insurance Marketplace Exchange through Cigna, which are the Affordable Care Act (ACA) Marketplace plans, annually from November 1 through December 15 each year.⁵ Each state may have different requirements surrounding plan types and costs, but typically, they follow the metals level of coverage structure as offered through HealthCare.gov.⁵

Cigna also offers group health plans, which are plans offered through your employer.⁶ Most plans are subject to the ACA’s mandates but may also be subject to various state-issued regulations and mandates.⁶

Plans issued by your employer will vary, as employers typically have options to choose from in plan design and construction, but Cigna offers a variety of different plan designs, including:⁶

• Cigna Open Access Plus (OAP)
• Preferred Provider Organization (PPO)
• LocalPlus
• Health Maintenance Organization (HMO).
• Exclusive Provider Organization (EPO)
• Medical Indemnity
• Medical Network Plans.
• SureFit Plans.

You can generally only sign up for plans through your employer during the annual open enrollment, or outside of that if you qualify for a special enrollment period, such as starting a new job, expanding your family, or experiencing another qualifying life event.⁶

Finally, Cigna also facilitates plans for the Medicare Advantage market in 26 states and Washington, D.C., and Medicare prescription drug plans (Medicare Part D) in all 50 states, Puerto Rico, and Washington, D.C.² 

Outside of medical plan coverage, Cigna also offers dental insurance plans and other supplementary insurance plans.

What Types of Drug Rehab Will Cigna Insurance Cover?

Every Cigna plan will provide varying types of coverage regarding healthcare services, including addiction treatment. Regardless of what your plan may cover, your provider may recommend 4 types of addiction treatment for your path to recovery. These types of treatment are:⁷

• Inpatient or residential rehab. If you’re in an inpatient or residential rehab program, you will live at the facility for the duration of your care, where you will receive round-the-clock, medically supervised care.
• Outpatient rehab or therapy. If you’re in an outpatient rehab program, you will go to a facility 1 or 2 times weekly, or less frequently, where you’ll receive therapy or counseling. You do not stay overnight with this type of program.
• Intensive outpatient programs (IOPs). If you’re in an IOP, you’ll go to a facility for outpatient care (e.g., therapy or counseling) for a minimum number of hours each week, which is usually 9 hours of care. No overnight stay is required with this type of treatment.
• Partial hospitalization programs (PHPs). If you’re in a PHP, which is commonly known as a day program, you’ll generally attend 4–8 hours of care per day, multiple days a week. No overnight stay is required with PHPs.

Does Cigna Insurance Cover Inpatient Mental Health Treatment?

The Affordable Care Act (ACA), which is a federal healthcare reform law, requires almost all health plans in the United States, which may include some plans offered by Cigna, to provide coverage in some capacity for mental and behavioral health services.¹

What this means for you is that no matter what type of treatment you may need, including treatment at an inpatient mental health treatment facility, your plan may be required to provide coverage in some capacity. So, whether you may need stand-alone heroin rehab or treatment for a co-occurring disorder, you may be able to have some coverage for such services.

To find out how your plan provides coverage for dual diagnosis, which is another name for a co-occurring disorder, you can use our free online insurance verification tool.

How Long Does Cigna Insurance Cover Rehab?

The length of time that Cigna will cover rehab or mental health treatment  will depend on your specific policy. Every plan will cover treatment and lengths of treatment differently, and your plan may include cost-sharing elements such as deductibles, copays, and coinsurance which can affect coverage and out-of-pocket costs.

Every person is different, but most experts agree that remaining in treatment for at least 90 days improves overall outcomes.⁹ Longer treatment times tend to prove more effective, but every person is different. Your provider may recommend shorter or longer times of treatment, depending on your situation. Work with your provider to determine what is best for you.

What if My Cigna Policy Does Not Cover Rehab?

Your Cigna policy may not fully cover the costs associated with rehab. If this is the case for your treatment journey, you need to know your options for how to pay for rehab.

Depending on the rehab facility you choose to attend, there may be financing or scholarship opportunities available to you. These options may be able to help you offset some of the out-of-pocket costs associated with treatment. Regardless, be sure to prioritize getting the treatment you need today rather than pushing it down the road.

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

Knowing the difference between in- and out-of-network providers is a key component in keeping your healthcare costs as low as possible. Depending on the health plan that you have, you may be limited to receiving coverage for your treatment if you attend an in-network provider.

• In-network providers are those who agree to accept pre-negotiated rates for covered services under your specific Cigna plan.¹⁰
• Out-of-network providers are not contracted with your plan and, as such, can charge you the full price, which tends to be higher than the in-network discounted rate.¹⁰

Staying in-network tends to be more affordable than seeing out-of-network providers, which underscores the importance of finding a covered provider whenever possible. To do this, you can call the number on the back of your card, use the Cigna Find a Doctor tool, or work with rehab facilities directly.

Check Cigna Insurance Coverage for Addiction Treatment

Rehab centers can often check your coverage for you based on basic insurance information that you provide to them, which could include your or the subscriber’s personal information, your plan type, policy number, and group or member ID. You can also call the number on the back of your insurance card for more information about your specific health plan and to find covered facilities near you.

Cigna Approved Rehab Centers 

American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have a Cigna insurance plan, the following AAC facilities accept Cigna for drug and alcohol addiction rehab.

• AdCare Rhode Island: With various facilities located in Rhode Island, AdCare provides innovative, quality, and cost-efficient addiction treatment. Its integrated system of care offers an inpatient treatment center in North Kingstown and a network of outpatient offices throughout Rhode Island. AdCare’s continuum of care includes detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, inpatient and outpatient services, and tele-health.
• Recovery First. Located in South Florida, Recovery First provides multiple levels of addiction treatment, including detox, residential care,  partial hospitalization (day treatment), intensive outpatient care, and aftercare planning.
• Laguna. Laguna Treatment Center in Southern California provides detox and residential care. There are several specialized treatment tracks available, including a Veteran’s program, a program for people who have relapsed multiple times, and a young adults’ program.
• Desert Hope. Located in Las Vegas, Nevada, Desert Hope Treatment Center is equipped to provide evidence-based care and supplemental therapeutic programs through many levels of care, including detox, residential treatment, and multiple levels of outpatient treatment.
• Greenhouse. Greenhouse Treatment Center operates a residential treatment center, outpatient center, and sober living program in the Dallas-Ft. Worth metropolitan area. Patients at Greenhouse benefit from specialized treatment programs, evidence-based care, and comfortable amenities.
• Oxford. AAC’s Oxford Treatment Center in Etta, Mississippi provides a full continuum of detox, residential, and outpatient care as well as multiple specialized treatment tracks for Veterans, first responders, Christians, couples, and survivors of trauma.

There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Cigna insurance.

Getting Addiction Treatment with Cigna Insurance

If you or a loved one requires addiction treatment, and you have Cigna insurance, you may be wondering how to check your coverage. American Addiction Centers is here to simplify the process. If you call our confidential helpline, you can speak to a real live person who can help you check your benefits right while you’re on the phone. You can also enter your information in the form below to instantly verify your benefits.

In addition to helping you learn more about your plan, the AAC staff can help you find out whether your Cigna plan is accepted at any of the AAC facilities across the country. They can also help you find a local, covered, in-network facility to help you get the addiction treatment you need.