Cigna Insurance For Addiction Treatment

Does Cigna Healthcare Cover Alcohol Rehab?

Like all health insurance providers, the Affordable Care Act (ACA) requires Cigna to cover behavioral health treatment. This refers both to substance abuse treatment for drugs and alcohol, as well as mental health treatment. 

Every Cigna insurance plan includes mental health and substance abuse coverage. This includes inpatient and outpatient treatment. 

The extent of your Cigna rehab coverage, however, will depend on several factors, including:

• Which state you live in
• Whether or not the provider is in-network
• Which treatment provider you choose
• Treatment length
• The specifics of your individual policy

The most significant factor of coverage is your specific Cigna health insurance plan. 

Every Cigna health plan covers substance abuse and mental illness, but plans differ on the extent of coverage they provide. 

For example, certain Cigna exclusive provider organization (EPO) plans in North Carolina exclude non-injectable prescription drugs or any type of holistic therapy from coverage.⁵ 

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Cigna Health Plans

The following is a list of the different types of Cigna health insurance plans:

• Open Access Plus (OAP): You choose your health care providers.
• LocalPlus: This includes a budget plan with a network of providers limited to your immediate area. You don’t need referrals for specialists, but Cigna may need to pre-certify outpatient treatment and hospitalization.
• Preferred Provider Organization (PPO): You don’t need a referral to see a specialist. You also don’t need to choose a primary care provider (PCP), and you will have some coverage for an out-of-network provider. Out-of-pocket expenses are typically higher, though.
• Exclusive Provider Organization (EPO): These plans have lower monthly premiums. Insurance won’t cover you if you go outside your network unless it’s a medical emergency. Like PPOs, you don’t need referrals to see specialists.
• Account-Based Plans: These include employer-based health savings accounts, including HSA, HRA, and FSA.
• Medical Network: Cigna pre-certifies hospitalizations and outpatient treatment, but there’s no paperwork for using in-network providers. These plans include global emergency and urgent care coverage 24 hours a day, seven days a week.
• Cigna Health Maintenance Organization (HMO): You need to choose a PCP to coordinate your care. However, monthly premiums are lower than EPO or PPO plans. Only in-network providers are covered.
• Cigna SureFit: This plan includes a budget plan with a network limited to your immediate area. You need to choose a PCP.
• Medical Indemnity: This allows you to choose any provider or treatment facility, but you pay up front for services. Then you’ll need to file a claim for reimbursement after.

It’s essential to check the details of your plan when considering treatment. Log into the Cigna customer portal to obtain more information about your rehab coverage. 

You can check whether a treatment provider is in your network by visiting the Find a Doctor page on Cigna’s website.

Cost of Alcohol Rehab

The cost of alcohol addiction treatment can vary widely based on two main factors:

1. Type of Facility

There are two basic types of alcohol rehab treatment facilities: for-profit and non-profit.

For-profit facilities usually have more and higher-quality amenities, like pools or saunas. They are also often located in desirable locations, like in the mountains or on the beach. 

For this reason, they tend to be more expensive. They’re usually marketed toward wealthier clients or even celebrities. Many of them have longer, extended treatment lengths.

Insurance providers rarely cover treatment at for-profit facilities.

Non-profit treatment facilities, meanwhile, generally only offer the basics: a room with a bed, a bathroom, a place to store your possessions, and sometimes a television. Insurance providers are typically more likely to cover treatment at these facilities.

A for-profit treatment facility may cost twice as much as a non-profit facility. One study of residential treatment programs found the average difference in monthly fees between the two was $17,434 to $5,712, respectively.¹

Aside from choosing a non-profit facility that’s in-network, another way to minimize treatment cost for alcohol abuse is to choose a program with a large enrollment. Studies show treatment centers with large enrollment numbers tend to charge less per person.¹⁶

2. Type of Treatment

Whether you receive inpatient or outpatient treatment also has a large impact on cost:

• Outpatient treatment costs $32 to $385 per week, on average.¹⁴
• Inpatient treatment costs $3,000 to $4,000 per week, on average.¹⁴ But it can cost up to $10,000 a week (luxury programs). 

Inpatient treatment involves 24/7 medical support, meaning it’s usually more expensive than outpatient treatment. 

If treatment involves medication, it will also likely cost more. For example, medication-assisted treatment (MAT) with naltrexone costs up to $14,000 per year.¹⁵

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Which Treatments Does Cigna Cover?

Cigna insurance provides coverage for a wide variety of drug and alcohol addiction treatment services.

These include:

Detoxification

Detoxification is the first step in drug and alcohol rehab. It’s also often the most dangerous and frightening step.

Also known as detoxing, this process involves stopping all drinking so the body can return to normal. Due to alcohol dependence, this often leads to withdrawal symptoms. 

Alcohol withdrawal can be deadly. Those undergoing withdrawal often require medical care.

Inpatient Treatment

Inpatient alcohol rehab centers provide round-the-clock treatment for people struggling with alcohol addiction. Those with severe alcoholism usually begin treatment here and move to outpatient care later. 

Inpatient treatment is best for those with unstable home environments that aren’t supportive of recovery and abstinence. It is very difficult to abstain from alcohol or drugs if the people they live with use regularly, or if they don’t have a safe space to sleep and eat. 

Cigna may cover inpatient treatment for between 1 to 6 weeks.⁷

Outpatient Treatment

Outpatient treatment programs are usually less intensive than inpatient care. They’re typically for people with less severe addictions and those transitioning from initial detox in inpatient care.

People in these programs may attend treatment services just a few times a week and go home when they’re done.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) involves taking medication to manage cravings, prevent relapse, or address mental illness. 

Three drugs are FDA-approved for MAT to treat alcohol abuse:

• Acamprosate (Campral)
• Disulfiram (Antabuse) 
• Naltrexone (Vivitrol)

Health professionals implement MAT during detox or as part of ongoing treatment. It’s often combined with mental health counseling.

Mental Health Treatment

Mental health rehabilitation is often an important part of substance abuse treatment. 

Substance addiction can be either a cause or a product of mental health problems. This complex relationship is known as a dual diagnosis.

All Cigna healthcare plans cover mental health treatment.

Some mental health problems linked to alcohol addiction include:

• Depression
• Anxiety
• Bipolar disorder 

Any dual diagnosis of addiction and mental illness needs to be treated concurrently. This is known as integrated treatment.  

Integrated treatment combines counseling with medication-assisted treatment. 

 Mental health treatment approaches for alcohol addiction include:

• Cognitive behavioral therapy (CBT)
• Multisystemic therapy
• Alcohol counseling
• Holistic treatment
• Contingency management
• Motivational enhancement

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How to Check Your Cigna Healthcare Coverage