Cigna started out as the Insurance Company of North America, selling policies to insure the cargo carried on ships. ICNA eventually combined its operations with Connecticut General Corporation, evolving into Cigna, a company offering health and dental insurance to millions of American consumers.

Cigna rehab coverage helps pay for addiction treatment in inpatient and outpatient settings, which can help you avoid the most severe physical and emotional consequences of drug or alcohol addiction.

Cigna Insurance Coverage for Addiction Treatment

Like many insurance companies, Cigna now covers several types of addiction treatment for its plan members. Prior to the passage of the Patient Protection and Affordable Care Act in 2010, many private insurance companies refused to cover treatment for substance abuse problems. Even companies that covered some type of substance addiction treatment offered limited benefits, making it difficult for people struggling with substance abuse to seek treatment for drug and alcohol addiction.

Thanks to the ACA, health insurance companies are now required to offer at least some type of coverage for drug addiction treatment and alcohol addiction treatment, making it easier to access the care you need. Cigna covers inpatient and outpatient treatment, but the type of treatment you need will depend on the following factors:

  • The severity of your addiction
  • Whether you have another mental health disorder that needs to be addressed, such as post-traumatic stress disorder or generalized anxiety disorder
  • The strength of your support network
  • How much you can afford to pay for your treatment
  • Your current living situation

Cigna rehab coverage varies from plan to plan, with some plans covering more services or paying a greater percentage of your treatment costs than others. Depending on the terms of your Cigna health insurance plan, you may be able to get help paying for medical detox, intensive outpatient programs, inpatient treatment, behavioral therapy or medication-assisted treatment for substance use disorder. Cigna also covers medical care related to alcohol and drug abuse, such as treatment for a medical emergency caused by taking illicit drugs or consuming too much alcohol.

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Cigna Rehab Coverage for Outpatient Rehab

Outpatient treatment is an option if you have a strong support network at home and can’t take a leave of absence from work to participate in a residential treatment program. Cigna rehab coverage pays for many outpatient services, including individual therapy and group therapy. Your out-of-pocket costs will depend on the exact terms of your plan as each Cigna insurance plan has different rules regarding deductibles, coinsurance and covered services.

Cigna Rehab Coverage for Inpatient Programs

Cigna covers at least some of the costs of inpatient or residential treatment for substance use disorders. Residential treatment is ideal if you lack support at home, have a co-occurring disorder that makes it more difficult to manage your addiction or have a home situation that makes it difficult to avoid alcohol, prescription medications or illicit substances. Once you complete residential treatment, you typically continue with outpatient treatment to make your recovery as successful as possible.

Seeking Addiction Treatment With Cigna Rehab Coverage

Whether you need inpatient or outpatient treatment, your Cigna coverage will only pay for it if you can demonstrate that it’s medically necessary. Cigna uses the following criteria to determine the medical necessity of each treatment option:

  • The treatment must be delivered according to accepted standards of practice.
  • The treatment must be considered clinically appropriate based on your illness or injury.
  • The treatment can’t be performed primarily for the convenience of the patient or the care provider, and it must be at least as likely as an alternative service to produce equivalent therapeutic results.

When determining the medical necessity of drug rehab and alcohol rehab services, Cigna uses The ASAM Criteria, Third Edition: Treatment Criteria for Addictive, Substance-Related and Co-Occurring Conditions. ASAM Criteria are objective guidelines for planning care for patients with substance use disorders. Under these criteria, substance abuse treatment should be individualized for each patient, take the whole person’s needs into account and provide a range of services based on the patient’s progress.

Addictions Covered by Cigna

Cigna typically covers substance abuse treatment for three main types of addictions: alcohol, prescription medications and illicit substances. Although prescription medications help millions of people manage acute and chronic health conditions, some of them have addictive properties, including sedatives and opioids used for pain management. If you have an addiction to one of these medications, your Cigna insurance plan should cover at least some of the costs of getting treatment.

Illicit substances are drugs that aren’t legal to possess or use. Cocaine, methamphetamine and heroin are some of the most common. In states that haven’t legalized marijuana use, cannabis is also considered an illicit substance. If you’re addicted to one of these substances, you can use your Cigna benefits to get treatment.

Mental Health Coverage

Many people with addictions have co-occurring disorders, or mental health conditions that can make it more difficult to treat an addiction. For example, many veterans who struggle with alcohol or drug use also have post-traumatic stress disorder related to their military service. Cigna plans include mental health benefits, ensuring you can get some coverage for therapy and other mental health treatments.

Coverage for Treatment Medications

Some people benefit from medication-assisted treatment, or the use of certain medications to help people break addictions to harmful drugs. Suboxone and methadone are commonly used to treat opioid addictions, but how they’re covered by your insurance plan depends on where they’re administered. Suboxone is typically taken on an outpatient basis, so it would likely be covered under your Cigna pharmacy benefits. Depending on the terms of your plan, you may need to pay a co-pay every time you fill your Suboxone prescription. Methadone is typically given at a clinic, so it would be covered by your Cigna medical benefits instead.

Verify Your Cigna Benefits Today

Because one Cigna plan can vary significantly from the next, it’s important to understand what your specific plan covers in terms of medications, therapy and other forms of substance abuse treatment. If you’re ready to start your recovery, call Virtue Recovery Center at (866) 461-3339 to have one of our admissions coordinators verify your benefits and discuss your payment options.

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