Does Cigna Cover Opioid Detox and Rehab Centers?
Cigna is a global health services company that has over 190 million customer and patient relationships in more than 30 countries and jurisdictions.1 This company has provided several different health plans in order to service its many members. Many of these health plans encompass coverage for opioid treatment and rehab. These types of opioid coverages fall under mental and behavioral health services, which cover the following:2
- Behavioral health treatment, such as psychotherapy and counseling
- Mental and behavioral health inpatient services
- Substance use disorder (commonly known as substance abuse) treatment
Each of the aforementioned outlines the services that are available for Cigna customers seeking opioid treatment.
Cigna has several group health plans. The plans that are listed below include the option for opioid treatment coverage:3
- Open Access Plus: A large, seamless national network of quality providers and facilities with competitive network discounts.
- Cigna PPO Medical Plans: A large, national network similar to OAP but with more choice and flexibility for out-of-network care.
- Cigna LocalPlus® Plans: Plans that give employees access to a focused, limited network of quality and cost-effective providers and facilities, while still providing the security of having access to Away from Home Care.
- Cigna SureFit Medical Plans: Customizable plans to meet the needs of each employee and employer in very select service areas.
- Cigna Health Maintenance Organization (HMO) Medical Plans: Designed around a focused set of quality, cost-effective providers and facilities in certain local service areas.
- Cigna Medical Network Plans: Designed around a focused set of quality, cost-effective providers and facilities in certain local service areas.
American Addiction Centers (AAC) has several drug addiction rehabilitation centers, including AdCare Rhode Island, which is in-network with Cigna insurance for opioid treatment.
What Does Cigna Insurance Cover for Opioid Treatment?
Cigna insurance coverage varies per the person and plan that they choose. Treatment for opioid abuse can be done either with inpatient care or outpatient care. Inpatient care is provided in a hospital or other inpatient facility, whereas outpatient care typically involves traveling to a facility several times per week but continuing to live at home.4 The specifics of each type of care and programs found under these care types are outlined below:5
- Outpatient Care:
- 12-Step programs
- Routine outpatient care (ROC)
- Substance use disorder intensive outpatient program (IOP)
- Substance use disorder partial hospitalization
- Ambulatory detox
- Inpatient Care:
- Inpatient detox
- Inpatient acute care
- Inpatient residential
Overall, Cigna coverage for opioid treatment varies according to a person’s selected plan. However, an example of what is covered under the 2022 Cigna Individual Family EPO Plan Type is below:6
- Outpatient service coverage (network provider)
- $75 Copayment/Visit
- Deductible does not apply
- 40% Coinsurance on all other services
- Inpatient service coverage (network provider)
- 40% Coinsurance on all services
What Cigna does not cover for Opioid Treatment?
Cigna does not cover the following for opioid treatment: food delivery, recreation programs, holistic care services, recreation programs, private treatment services, or alternative therapies.7
How Much Does Opioid Rehab Cost?
Opioid rehabilitation costs vary according to the treatment center one chooses. The average cost of rehabilitation per person is $13,475.00.8 In addition, the type of treatments that the person chooses influences the overall costs. Potential treatments include, but are not limited to, the following: inpatient treatment, outpatient treatment, opioid partial hospitalization programs (PHP), and medication-assisted treatment (MAT).
Cost of Inpatient Opioid Rehab
The cost of inpatient opioid care varies according to the length of stay, care plan, and other factors. It was found that the average cost for inpatient opioid rehab for a 30-day stay is $12,500.8
Cost of Outpatient Opioid Rehab
The average cost of outpatient opioid rehabilitation is $5,700 a month.8 This treatment is far less than inpatient treatment because its services are less extensive.
Cost of Opioid Partial Hospitalization Programs (PHP)
Opioid PHP averages about $350 per day.8
Cost of Medication-Assisted Treatment (MAT)
MAT costs about $8,836.00 overall.8
Opioid Rehab vs. the Cost of Opioid Addiction
The benefits of opioid rehabilitation far outweigh the costs and consequences of having an opioid addiction. Opioid addiction affects over 2.1 million in the United States (and over 16 million people globally), and there are over 120,000 deaths worldwide annually attributed to opioids.9
Based on the aforementioned statistics, we can see that the cost of opioid addiction affects one’s health and income. If one does not seek treatment for opioid addiction, the future costs associated will be many. It is important to note that costs, both material and abstract, associated with non-treatment are:10
- Potential issues with the law (e.g., arrests, convictions, etc.) due to someone who might be behaving in a certain manner while taking drugs.
- Treating babies born dependent on opioids.
- Greater transmission of infectious diseases.
- Treating overdoses.
- Injuries associated with intoxication (e.g., drugged driving).
- Lost productivity.
What Length of Opioid Rehab Does Cigna Cover?
Research by the National Institute on Drug Abuse (NIDA) indicates that most of those with a substance use disorder need at least 3 months of treatment to significantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment.11
Cigna provides varies coverage amounts for the plans and treatments that one utilizes. In order to find out what your specific plan will cover for opioid treatment, you should look up the plan information on the back of your Cigna insurance card.
Choosing between Cigna Inpatient vs. Outpatient Opioid Rehab Centers
In seeking opioid rehabilitation treatment, you must choose which type of center, outpatient or inpatient, is better suited for your needs. Inpatient rehabilitation will be the most effective because it is more thorough and comprehensive than outpatient rehabilitation. The benefits of inpatient care is as follows:4
- You are under the care of doctors, nurses, and other types of healthcare professionals within a hospital.
- You are in need of medicine, care, monitoring, and medical treatment—the kind that’s provided by around-the-clock medical staff.
The benefits of inpatient care are:5
- Licensed residential treatment facilities offer 24-hour structured and intensive care
- The person has access to housing and medical attention.
- Residential treatment facilities may use a variety of therapeutic approaches
- Residential treatment facilities are also generally aimed at helping the patient live a drug-free, crime-free lifestyle after treatment.
How to Use Cigna Insurance for Opioid Rehab?
Cigna insurance can be used in several ways for opioid rehabilitation. You can consult with a doctor to determine the best form of treatment for your unique needs. Cigna has a portal where you can look up physicians in your specified area. Secondly, staff are on hand to find suitable programs, whether inpatient or outpatient, for you. Thirdly, someone will determine your eligibility according to your selected Cigna insurance plan. Lastly, the chosen rehabilitation center can determine your coverage.
How to Find Opioid Rehabs That Accept Cigna Insurance
Cigna provides some of the most all-inclusive plans for the treatment of opioid addiction. As stated, they have many benefits and policies that provide people with the best possible coverage for their money. Coverage for treatment can range from full coverage to partial coverage, all depending on your specific plan.
In order to verify your specific insurance coverage, AAC can assist. AAC has helped countless numbers of people get their lives back on the right path. Consumers are encouraged to call the AAC helpline to further discuss treatment options. The helpline is open 24/7, and the telephone number is .
What Rehab Centers Take Cigna Insurance?
American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have an 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.
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.
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