People who suffer from addictions require treatment. While it can be tempting to try to manage a substance use disorder on one’s own, individual willpower is rarely sufficient for combating this serious mental health condition. Enrolling in a quality drug and alcohol addiction rehab can help people address underlying issues, learn new coping tools, and rebuild their lives in recovery. Fortunately, people who are covered by Cigna health insurance plans are covered for a wide variety of outpatient rehabs, including NuView Treatment Center.
Cigna’s Behavioral Health division is designed to help people recover from alcohol or drug addiction, as well as co-occurring mental health disorders. However, the level of coverage and the out-of-pocket expenses will differ from plan to plan. Understanding how your specific policy and your state of residence impact your addiction treatment coverage with Cigna is essential to getting the care you need.
Cigna Health Insurance
Cigna is a health insurance company based in Connecticut whose reach extends around the world. With more than 86 million customers, Cigna has enormous resources at its disposal to help cover the health needs of its clients. In addition to other basic health needs, Cigna is notable for the quality of its addiction treatment coverage.
The type of coverage a person can expect to receive from Cigna differs from plan to plan. However, in most cases it is normal to expect a wide variety of recovery services, including:
- Alcohol rehab
- Drug rehab
- Outpatient rehab
- Counseling and therapeutic interventions
- Aftercare services
Cigna Recovery Resources
In an effort to help tackle substance addiction more effectively, Cigna has actually created an entire division designed to support individuals suffering from addiction. Cigna’s Behavioral Health division offers a wide variety of resources at no cost to policyholders. These include podcasts, articles, and other tools designed to support individuals suffering from addiction as well as their family members and loved ones.
Cigna Behavioral Health also offers an educational series that is intended to provide information about the mental, physical, and emotional consequences of addiction. These lessons provide actionable advice for family members and people in recovery.
However, these resources are merely a starting point. Cigna recognizes that the vast majority of people with substance addictions need professional help. The educational resources they offer are designed to support people in recovery, not replace the care of an outpatient program or doctor.
Cigna Substance Abuse Treatment Coverage
The type of coverage you can expect depends upon your specific Cigna health plan. Coverage levels vary from plan to plan, and they are also partly determined by the policyholder’s state of residence. Plans with more comprehensive coverage, including Cigna’s gold and platinum plans, have lower deductibles and other out-of-pocket expenses, but they tend to have higher monthly premiums. More economical plans, such as Cigna’s bronze plans, have significantly lower monthly premiums, but clients often have to pay more out-of-pocket expenses when they receive treatment.
When it comes to substance abuse treatment, individuals often need to make use of a wide variety of treatment services. While all of Cigna’s policies cover addiction treatment to some extent, the specific services that are covered and the quantity of out-of-pocket expenses depends upon the specific plan and the policyholder’s state of residence.
Does Cigna Cover Outpatient Treatment for Addiction?
In general, Cigna is more than willing to cover a large portion — or the entirety — of the costs associated with outpatient addiction treatment. Outpatient treatment programs are considered effective evidence-based treatment programs. They are regarded as just as effective as inpatient treatment programs, but they are more cost-effective for insurance companies — as well as being more flexible for clients.
Outpatient rehabs are treatment programs that individuals attend on a regular basis while residing at home. Outpatient programs offer a wide variety of levels of care, including partial hospitalization programs (PHPs), intensive outpatient programs (IOPs), outpatient programs (OPs), and aftercare services. It is common for clients to progress from a more acute level of care to a less acute one as they progress in their recovery journeys. Cigna offers coverage throughout this process, as long-term outpatient treatment is associated with lower rates of relapse.
Outpatient programs covered by Cigna are designed to help people recover from substance use disorders using a wide variety of therapeutic modalities. Clients address underlying issues, including mental health disorders and interpersonal conflict. They also learn new coping strategies for managing triggers and cravings. Meanwhile, quality outpatient programs help clients develop new lives in sobriety.
The vast majority of Cigna plans cover outpatient treatment programs. However, the type of coverage varies from plan to plan. Even when outpatient rehabs are covered, there is no guarantee that a specific outpatient facility will be considered in-network. If you are seeking information about your coverage levels, you can reach out to NuView Treatment Center, an in-network outpatient rehab. Our staff members will be happy to research your specific policy and determine your coverage options.
Cigna Coverage Levels for Outpatient Rehab
Cigna plans cover a wide variety of outpatient addiction treatment services. These include:
- Partial hospitalization programs (PHPs)
- Intensive outpatient programs (IOPs)
- Outpatient programs (OPs)
- Aftercare services
- Individual, family, and group therapy
- Medication-assisted treatment (MAT)
The out-of-pocket expenses that a policyholder is responsible for depend upon their level of coverage. While Cigna offers countless unique plans, the vast majority of them can be broadly divided up into four distinct categories.
Cigna Bronze Plans
Cigna’s lowest level of care is also its most economical. Coinsurance for the bronze plan generally is between 0% and 50%. These plans have limited out-of-network coverage.
Ciga Silver Plans
Cigna’s silver plans have broader coverage and somewhat higher monthly premiums than the bronze plans. Outpatient services that are in-network sometimes have a coinsurance percentage, but in some cases clients are merely responsible for a copay. Not all out-of-network providers are covered.
Cigna Gold Plans
Cigna gold plans offer more comprehensive coverage. While policyholders pay somewhat higher monthly premiums, outpatient rehabs that are in-network have fewer out-of-pocket expenses. Clients may be required to pay a small coinsurance percentage or copay per visit. Out-of-network providers are more broadly covered, but not in all cases.
Cigna Platinum Plans
Cigna platinum plans have the most comprehensive coverage. Clients are responsible for minimal copay or coinsurance requirements at in-network outpatient facilities. Platinum plans often have out-of-network coverage, though clients may be responsible for paying higher coinsurance rates if they choose to use an out-of-network facility.
Cigna Health Insurance and the Affordable Care Act
The Affordable Care Act, also known as the ACA, has completely changed the way health insurance companies handle addiction treatment. Not only has the ACA resulted in more Americans than ever before having access to health insurance, but it also has set new rules for managing the treatment of addiction. Under the Affordable Care Act, addiction treatment is considered an “essential health benefit.” As such, health insurance companies, such as Cigna, are legally obligated to cover people who suffer from substance use disorders.
The Affordable Care Act also stipulates that addictions cannot be considered pre-existing conditions. For this reason, health insurance companies cannot deny people coverage just because they have an addiction. Anyone, no matter how severe their substance use disorder is, can have access to health insurance coverage for their addiction treatment.
Dual Diagnosis Treatment with Cigna Health Insurance
The Affordable Care Act classifies addiction treatment as an essential health benefit, and it does the same for mental health services. It also implements a policy known as “parity.” Parity means that mental health treatment cannot cost more than equivalent treatments for physical health conditions. If the copay for seeing a doctor about a cold is $50, for instance, then seeing a doctor about depression or anxiety cannot cost more than $50.
Individuals who suffer from addiction and mental health disorders are known as dual diagnosis. Comorbid mental health conditions are highly common among people with drug and alcohol use disorders. In fact, roughly 50% of people with addictions suffer from one or more mental health disorders as well. Similarly, half of people with mental illness also develop a substance abuse problem — often as a way of obtaining relief from their symptoms.
Cigna health insurance policies cover outpatient treatment for individuals with comorbid mental health disorders. Outpatient rehabs offer integrated treatment to help people tackle both conditions simultaneously. Integrated treatment is essential, since a relapse with one condition can trigger a relapse with the other quite easily. As such, it is both in the client’s best interest and in Cigna’s best interests to ensure long-term recovery by covering comprehensive and integrated treatment for dual diagnosis patients.
What Is My Coverage with Cigna?
Individuals who are covered by any of Cigna’s health insurance policies are likely able to attend an outpatient rehab. NuView Treatment Center is in-network for Cigna policyholders. However, not all outpatient treatment centers are considered in-network. Additionally, policies vary considerably in terms of their benefits, copays, and deductibles. It is important to understand what your level of care is and what kinds of out-of-pocket costs to expect.
It can be difficult and confusing navigating the details of your health insurance plan on your own. It is possible to get some basic answers by calling your health insurance representative. You can usually find their number on the back of your Cigna policy card.
If you know you want treatment for addiction, however, it is often best to reach out to a treatment facility directly. Staff members at NuView Treatment Center are more than willing to look into your specific Cigna policy and determine your coverage levels. Even if our outpatient program is not covered or considered in-network, we will work with you to evaluate your options and get you connected to the services you need. Contact us at (323) 307-7997 for a free confidential evaluation.
Addiction Treatment at NuView Treatment Center
NuView Treatment Center is the preeminent outpatient rehab located in West Los Angeles. At our modern facility, clients can take part in a range of evidence-based treatment programs. We offer every level of outpatient care, including partial hospitalization programs, intensive outpatient programs, outpatient programs, and aftercare planning. More importantly, clients can benefit from addiction treatment without breaking the bank. NuView Treatment Center is covered by the vast majority of Cigna health insurance policies, as well as a wide range of other health insurance plans.
It is our philosophy that addiction recovery involves more than just quitting drugs and alcohol. Clients in our outpatient addiction treatment programs work daily to rebuild their lives from the ground up, creating a lasting foundation for long term sobriety. Staff members at NuView Treatment Center are highly trained and professional, but they emphasize compassion above all. We believe that addiction treatment cannot be one-size-fits-all. As such, our individualized treatment plans are holistic and comprehensive. We work with clients to help them address underlying issues, rebuild their lives in recovery, and learn new coping techniques for mitigating the potential for relapse.
If you are ready to put down your substance of choice and begin a new life, reach out to NuView Treatment Center today. Our staff will help you navigate your Cigna insurance plan to ensure that your out-of-pocket expenses are minimal.
Frequently Asked Questions
Yes, preauthorization is required for treatment with Cigna coverage at drug and alcohol rehab. Preauthorization is a process in which Cigna reviews specific medical treatments or services requested by your provider to ensure that the care you are receiving or seeking meets certain criteria.
For your treatment to be covered under your plan, it must meet Cigna's criteria for medically necessary services. The preauthorization process also helps to make sure you are receiving the most cost-effective care possible.
Steps to get preauthorization
- Your provider submits a preauthorization request to Cigna
- Cigna reviews the request and determines if it meets their criteria for medically necessary services
- You or your doctor will receive a response from Cigna regarding the preauthorization status
- If necessary, you may reach out to Cigna customer service representatives for more information
Cigna requires that addiction treatment must be medically necessary and performed by a licensed provider to be covered under your plan. Additionally, treatments must be consistent with Cigna's standard of care guidelines and approved for coverage through the preauthorization process.
Yes, you can get addiction treatment through your Cigna insurance policy even if you don't have a doctor's referral. This is because some Cigna plans offer out-of-network benefits for addiction treatment. Out-of-network benefits give you the freedom to work with any qualified provider without needing a referral from your doctor. However, if your plan only offers in-network benefits for addiction treatment, then a doctor's referral is required. It's important to contact Cigna directly to determine what type of coverage you have and whether or not you need a referral.
Yes, many addiction treatment centers have a case manager whose job is to help clients understand their insurance coverage and how it applies to their situation. Case managers typically work with clients and their families to determine if they qualify for Cigna coverage and what type of treatments or services are covered under the plan.
You can request a case manager to review your Cigna coverage and create a plan that fits within the policy's limits. They can also explain any out-of-pocket costs, such as copays or coinsurance, you may need to pay for services. By clearly understanding what is covered and what is not, clients are better informed and can make decisions accordingly.
The answer depends on your specific plan and benefits. Cigna offers a range of health plans that provide coverage for medication-assisted treatment, including those for opioid addiction and other substance use disorders. To find out if you have coverage, contact your employer or the phone number on your Cigna ID card to talk to a customer service representative. They can help you understand your coverage and how it applies to the cost of medication-assisted treatment.
At NuView Treatment Center, we accept most major health insurance plans. To find out if your specific Cigna Health Plan is accepted, please call our office at 323-307-7997. Additionally, you can fill out this verification of insurance benefits form. Our staff will be more than happy to answer any questions you may have and help determine the best plan for your treatment.
