Data shows that overdose deaths in the US increased 28.5% in 12 months ending in April 2021. With more than 100,000 people dying in a single year from opioids alone, the crisis is at its worst.
For those that struggle with drug or alcohol addiction, there is help available. This article will specifically discuss the support available for people with Cigna health insurance. So if you’ve been wondering, “Does Cigna cover inpatient rehab?” keep reading to get the answer to this question and more.
Cigna is one of the largest insurance providers in the US and worldwide. The company has more than 180 million customer and patient relations globally.
Its mission is to provide affordable healthcare for basic needs. Cigna offers different types of health insurance plans like:
Also, the company partnered with more than 1 million prescribing providers to reduce opioid use amongst its customers. In addition, Cigna created its Behavioral Health Division to support further people who face drug or alcohol addiction. The division offers mental health care in addition to educational materials.
The Affordable Care Act (ACA) requires insurance companies to provide some coverage for mental health treatment. Mental health treatment includes treating substance use disorder (SUD).
Cigna offers several different substance abuse treatments for members. Cigna is partners with addiction rehab facilities around the US to provide programs like:
To seek substance abuse treatment, you want to research Cigna-approved rehab centers near you. Fortunately, not all Cigna plans require you to visit an in-network center. Yet, if you use an out-of-network center, you will have higher out-of-pocket expenses to pay.
Yes, Cigna insurance policies will cover at least some of the costs of inpatient treatment or residential services for substance abuse. Some programs they may cover are:
A Detox Program allow you to withdraw from drugs and alcohol with 24/7 medical supervision safely. Inpatient programs require you to live at the treatment facility while receiving care. Programs usually provide different therapies like counseling and medical care.
Partial hospitalization programs (PHPs) allow you to receive daily treatment while living at home. This type of treatment usually meets five days per week for most of the day.
Your insurance coverage and out-of-pocket expenses will depend on your specific plan and location. However, you can get a basic idea of your financial responsibilities by assessing what plan you have.
Those holding a bronze policy usually have 0% coinsurance for in-network providers. Cigna will pay the treatment costs after you pay your deductible in full. If you wish to see an out-of-network service, some plans may help cover the costs. But, some plans won't cover any of the fees for out-of-network services.
Silver plans usually have 30-50% coinsurance for in-network programs after you meet the deductible. Sometimes the policy covers out-of-network services. This depends on the state you live in.
Gold plans are very similar to silver plans. The difference is that the coinsurance range for in-network treatment is 20-50% after the deductible.
You can expect a 10-30% coinsurance after meeting the deductible if you have a platinum plan. In addition, some platinum plans cover out-of-network treatments at a higher coinsurance percentage.
Yes, Cigna insurance also overs outpatient rehab. However, not everyone requires inpatient treatment. You can discuss this with your doctor.
Additionally, many patients attend outpatient counseling after completing an inpatient program. Outpatient rehab services include:
Outpatient treatment allows you to live at home and continue your daily life while receiving care.
As with inpatient treatment options, your coverage and out-of-pocket expenses will depend on your specific plan and location. Let’s break down the costs of outpatient services with the different Cigna plans.
Cigna bases the coinsurance for bronze plans on the state of residence. The coinsurance rate will be between 0-50%. Bronze plans may or may not cover out-of-network services.
Some in-network outpatient services will have a coinsurance percentage, while others will have a copay per visit. Silver plans may or may not cover out-of-network services.
You may need to pay a small coinsurance percentage or copay for in-network services with a gold plan. This will depend on the service you need. Again, gold plans may or may not cover out-of-network services.
Platinum plan holders will have minimal coinsurance or copay for in-network services. Some platinum policies have out-of-network coverage. The coinsurance rates for out-of-network services are higher.
Because Cigna drug rehab coverage differs between people and policies, it’s important to check your insurance benefits before entering a rehab program. This way, you will understand the costs you are responsible for before treatment.
You can log into your Cigna portal or contact a customer service representative at Cigna to check your coverage.
Cigna often requires preauthorization or prior approval before entering a substance abuse program. This means Cigna needs to determine the treatment is medically necessary for your condition. Failing to obtain preauthorization could result in you bearing responsibility for the total cost of treatment.
It is best to contact Cigna directly to identify if you need drug rehab preauthorization and review your policy. This way, it’s clear what Cigna will cover and what you will be responsible for.
We’ve answered the question, “Does Cigna cover inpatient rehab?” and much more. You can get some coverage when receiving treatment for addiction or substance abuse with Cigna insurance.
To explore your treatment options, contact us at Sober Partners. We offer a wide variety of services to help those suffering from drug and alcohol addiction.
Please fill out the following form to contact Sober Partners® by email, immediately!
