Cigna is a global health service company that provides healthcare coverage to 17 million people around the world.1, “Our Strength” In addition to its private insurance plans, Cigna insurance offers Medicare Advantage plans in 16 states and the District of Columbia and Medicare prescription drug plans in every US state.1
Like other large insurance companies, Cigna works closely with providers across the world to secure contracts, enabling access to affordable and quality care for its covered members. The company has grown its mental and behavioral health networks by 70% since 2016 and now has connections with more than 175,000 providers.1, “Our Connections”
If you have a Cigna insurance plan and are wondering whether Cigna insurance covers drug treatment or rehab, the answer is: yes, in some capacity. Its wide mental health provider network means you may be able to receive rehab services at an American Addiction Centers-accredited facility at little to no cost. Please note that all plans vary in how much or which facilities they cover; always call the number on the back of your insurance card for more information about your specific plan.
What Will Cigna Insurance Cover?
Cigna health insurance covers a variety of health issues, including mental and behavioral health services. The extent to which a particular service is covered will depend on your specific health plan and location. It’s crucial that you check and confirm your benefits before entering a care facility to avoid surprise expenses or high out-of-pocket costs.
The most common rehab treatments for drug addiction include the following:2
- Inpatient or residential rehab: You or your loved one receives medical attention and care in a treatment facility. You would stay there for a set period of time and be monitored and counseled through recovery.2, “How are behavioral therapies used to treat drug addiction?” In most cases, Cigna insurance plans will provide coverage in some capacity for inpatient or residential rehab.
- Outpatient rehab or therapy: You or your loved one would receive medical attention and counseling within a facility and be permitted to leave after treatment sessions are complete.2, “How are behavioral therapies used to treat drug addiction?” In most cases, Cigna will cover outpatient programs and intensive outpatient programs in some capacity.
- Partial hospitalization programs: You or your loved one would attend a structured day program for treatment and then go home at night.3 It is an alternative to full inpatient psychiatric care. In most cases, Cigna insurance will cover this treatment type in some capacity.
This list is not exhaustive and doesn’t guarantee that your insurance will cover these treatment types in their entirety. Please check and verify your benefits with your insurer before seeking treatment.
Does Cigna Insurance Cover Mental Health Care?
Under the Affordable Care Act (ACA), which became law in 2010, all health plans must provide coverage in some capacity for mental health care services, which are considered essential health benefits.4 These services include behavioral treatment, mental and behavioral inpatient care, and treatment for substance use disorders.4 Plans must also provide coverage for treatment of co-occurring disorders and stand-alone drug rehabilitation.
This coverage mandate helps millions of people in America get the help they need. According to data from the National Institute of Drug Abuse, 7.7 million American adults have a co-occurring mental disorder and substance use disorder; 20.3 million have a substance use disorder, and 42.1 million have a mental illness.5
How Long Does Cigna Insurance Cover Rehab?
Every person’s rehabilitation journey varies, as does insurance coverage. You will need to work with doctors to determine how long your treatment may need to be. You can then contact your Cigna representative to determine the extent to which your plan will issue coverage for treatment.
The length of time covered by your Cigna insurance plan will depend on your specific plan and policy. Be sure to review your Cigna plan’s Summary of Benefits and Coverage (SBC) and call the number on the back of your Cigna insurance card to review coverage.
What If My Cigna Insurance Policy Does Not Cover Drug Rehab?
In some cases, your Cigna insurance policy may cover only a portion of your drug rehab. It may not cover care at your desired American Addiction Centers-accredited facility. If that is the case, you are not out of luck.
It may be possible to submit your rehab costs to your Cigna plan to seek out-of-network reimbursement. While this is typically a low level of reimbursement, it may help you recoup some of your costs. Additionally, you should check to see whether your chosen facility offers financing or scholarship options.
Don’t delay getting the care you or a loved one needs due to insurance complications. Getting appropriate care today rather than putting it off is critical to your long-term health. Be sure to discuss what your options may be by calling our AAC customer service line.
Cigna In-Network vs. Out-of-Network Rehab Centers
It’s important to know the difference between in-network and out-of-network rehab centers. In-network rehab centers are those with which Cigna has entered a contractual agreement.6 Cigna pre-negotiates rates with these in-network centers to offer better reimbursement and coverage rates. In some cases, you may only be responsible for co-pays for visits to in-network facilities.
Out-of-network rehab facilities exist outside of Cigna’s network of approved mental and behavioral health providers. Your plan may provide limited coverage for out-of-network providers, but some plans offer no coverage at all for these providers. This will result in high out-of-pocket costs for you.
You can check whether a facility is an in- or out-of-network provider by contacting the facility directly. You can also call the number on the back of your insurance card.
Check Cigna Coverage for Addiction Treatment
Cigna insurance plans can help people experiencing substance use disorders or co-occurring illnesses get the care they need. Additionally, most Cigna plans cover AAC facilities, meaning you may be able to obtain treatment at little to no cost to you.
AAC can help you easily check your benefits and verify coverage. Fill out the form below to immediately see whether an AAC facility is in-network or out-of-network. You can also call our helpline anytime to speak with someone who can help you check your benefits.
- Company Profile.
- National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. (2019). Treatment Approaches for Drug Addiction DrugFacts.
- Mental health care (partial hospitalization).
- Gov. Mental health & substance abuse coverage.
- National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. (2018). Comorbidity: Substance Use and Other Mental Disorders.
- In-Network vs. Out-of-Network Providers.