Cigna Rehab Coverage
The great news about having Cigna insurance is that it’s a major provider with a number of coverage options. Finding a detox that accepts Cigna or a rehab program that takes Cigna is usually straightforward as a result. Thankfully, Solution Based Treatment is In-Network with Cigna. That means it’s easy to check your coverage see if Cigna will cover your care at Solution Based Treatment.
When looking for a detox or rehab program Cigna insurance covers, it’s important to contact the rehabilitation or detox clinic and your insurance provider as well as to determine your coverage before you begin. Some facilities and treatments require pre-authorization, and some insurance plans require you to stay in-network for full coverage.
Cigna Insurance Plan Options
Cigna is a large insurance company with many different plans. It has:
- Open Access Plus (OAP) plans that cover in-network care
- Preferred provider organization (PPO) plans that have a large network of providers
- LocalPlus plans for those seeing local network providers
- Health maintenance organization (HMO) plans with a local network of doctors and hospitals you can choose from
- Cigna SureFit plans, which work within a local community of care network
- Medical Network plans that are limited to local doctors and providers
- Medical indemnity plans that give you choice when choosing the providers and facilities you’ll go to
- Exclusive provider organization (EPO) plans that let you choose from national networks of providers or facilities.
Addiction Treatment Options
Cigna believes that seeking treatment for substance use disorder is an important part of recovery and does cover it based on the plan. The exact cost for a detox program Cigna insurance takes or for rehabs that take Cigna will depend on the policy you hold as well as if you choose an in-network or out-of-network provider.
Cigna for Medical Detox
Cigna covers ambulatory and inpatient detox. Ambulatory detox is provided on an outpatient basis, while inpatient provides 24-hour medical care. Both require pre-authorization. Solution Based Treatment is in-network with Cigna so it will cover alcohol detox, prescription drug detox, benzo detox and other detox programs.
Cigna Coverage for Residential Treatment
Cigna covers two kinds of residential treatment: Inpatient acute care and inpatient residential care. Inpatient acute care is normally offered after inpatient detox and is a short-term treatment. On the other hand, inpatient residential treatment may last for 28 days or longer. Both of these services require pre-authorization.
Cigna Coverage for Outpatient Treatment
Cigna does cover outpatient treatment. Please see your member benefits handbook for a full breakdown of your co-payments, deductible, and in-network provider services.
Partial Hospitalization Programs (PHP)
Cigna recognizes partial hospitalization programs (PHP) as outpatient care and does cover them (depending on the plan you hold). Partial hospitalization also requires a face-to-face assessment prior to authorization.
Outpatient Treatment
According to Cigna, outpatient care coverage is available for 12-step programs, partial hospitalization, support groups, and therapy. Routine outpatient care, including time with a trained therapist, addictionologist, or psychiatrist, may also be available. However, Cigna states that ROC doesn’t include medical treatment for complex withdrawal symptoms.
Cigna Rehab Coverage FAQs
Yes. However, the exact amount of coverage you’ll receive depends on the specific types of Cigna insurance coverage you have.
To verify your insurance benefits and check your coverage, you can call Solution Based Treatment at (833) 999-1941 or log into your Cigna Healthcare account online.
Yes. Cigna covers several kinds of outpatient treatment including partial hospitalization and intensive outpatient programs. You will need pre-authorization for some services.
Yes. Cigna does cover inpatient mental health care. Depending on your policy, you may need to go to an in-network provider and have pre-authorization.
Some Cigna plans require you to go to an in-network provider for care. Others will allow you to seek care from an out-of-network provider with pre-authorization, but the cost is typically higher. Luckily, Solution Based Treatment is in-network with Cigna.
Cigna has many different plans, and your exact deductible and/or copay will depend on the benefits you or an employer pay for. Cigna offers coverage on most services requested within its network (and some outside of its network) with pre-authorization. Contact us to determine how much Cigna will cover.
To cover costs not paid by Cigna, you will need to make an out-of-pocket payment. Some rehabilitation and detoxification programs offer sliding-scale services or financial support. Other ways to pay include using a credit card or paying with cash.
Cigna’s HMO, or health maintenance organization, is different from its preferred provider organization (PPO) due to cost and access to medical care. The HMO requires you to have an in-network primary care provider and only covers out-of-network emergencies. In comparison, Cigna’s PPO allows you to seek care from an out-of-network provider and will cover some of that care, though it will cost more than in-network care.
Depending on the plan you have enrolled in, you may be able to get a single-case agreement with Cigna. Some plans are more flexible than others, so you should reach out to member services to learn more about your options based on your specific plan.
Solution Based Treatment serves inpatient clients from all over the United States. We also offer outpatient and day treatment programs for residents in the following areas: Temecula, CA, Murrieta, CA, Menifee, CA, Wildomar, CA, French Valley, CA, Lake Elsinore, CA, Canyon Lake, CA, French Valley, CA, Corona, CA, Vista, CA, Escondido, CA, San Marcos, CA and Fallbrook, CA.
Sources:
- https://www.cigna.com/individuals-families/member-guide
- https://www.cigna.com/individuals-families/shop-plans/plans-through-employer/medical-indemnity
- https://www.cigna.com/individuals-families/shop-plans/plans-through-employer/medical-network
- https://www.cigna.com/individuals-families/shop-plans/plans-through-employer/surefit
- https://www.cigna.com/individuals-families/shop-plans/plans-through-employer/hmo
- https://www.cigna.com/individuals-families/shop-plans/plans-through-employer/localplus
- https://www.cigna.com/individuals-families/shop-plans/plans-through-employer
- https://www.cigna.com/individuals-families/shop-plans/plans-through-employer/ppo
- https://www.cigna.com/individuals-families/shop-plans/plans-through-employer/open-access-plus
