While it is true that Rehabs That Take Cigna can make the treatment process more affordable, it is important to keep in mind that coverage will vary depending on your individual plan, medical need requirements, benefits, and whether the facility is a part of Cigna’s network. Cigna might cover the following types of substance use treatment: outpatient, intensive outpatient, partial hospitalization, detox, and inpatient treatment.
When looking for rehabs that take Cigna, you are likely seeking to answer two vital questions: “Does my insurance coverage cover treatments?” and “Where do I find treatments?” Luckily, many plans cover behavioral health services, which Cigna offers; however, the coverage extent and its nature may vary. At Florida Atlantic Coast Treatment Solutions, they can guide you through your options and help you make the next move in getting clean.
Key Takeaways
- Depending on the plan you have with Cigna, you may be covered for different types of care for a substance use disorder.
- This may encompass outpatient care, intensive outpatient treatment, partial hospitalization, detox and inpatient care.
- A clinical evaluation will support identification of the level of care that might be appropriate.
- Some services may be subject to authorization before being covered.
- The cost of your out-of-pocket may decrease with in-network treatment; however, these benefits will vary with your specific policy.
- It is important to check Cigna benefits before you start a treatment program at a treatment center that accepts Cigna insurance.
- Just having a Cigna insurance card does not mean that any rehab program or services are covered.
Does Cigna Insurance Work for Rehab?
Cigna might cover treatment for a substance use disorder, but this is dependent on your health plan. According to Cigna, based on an evaluation of a person’s substance use, treatment history, physical health, social situation, and treatment goals, treatment recommendations can include inpatient or outpatient care.
By implication, there’s no one-size-fits-all solution for those who have Cigna insurance coverage.
Requirements may include some authorization or medical necessity requirements, deductibles, co-payment, co-insurance, network status, etc., that can apply to your plan. Also, according to Cigna, the plan requires a face-to-face evaluation and authorization before determining the appropriate level of care at certain levels of care.
That is why it is essential to check benefits prior to admission.
What Types of Treatment Can Cigna Help Cover?
It is common to think that “rehab” is synonymous with residential treatment. In fact, alcohol and drug addiction therapy can take place in a number of levels.
Cigna outlines outpatient and inpatient treatment for substance abuse. Outpatient care can be determined by outpatient detox, partial hospitalization, ambulatory detox, and intensive outpatient care. Inpatient choices can include inpatient detox, acute care, and residential treatment.
Outpatient Treatment
Outpatient treatment will allow a person to be treated without moving to a different location. Programs can help with individual counseling, addiction education, both support and medication, and recovery planning.
Intensive Outpatient Program
Outpatient therapy is less structured than intensive outpatient programs (IOPs). Cigna defines IOP as an outpatient treatment program with more frequent visits, and which still permits individuals to engage in many of their day-to-day routines.
Partial Hospitalization
Partial hospitalization offers a greater level of structure. According to Cigna, this type of treatment means getting a lot of treatment, several days a week for several hours a day.
Detox and Inpatient Treatment
Medical assistance may be needed for some to get them through withdrawal. If withdrawal or other medical issues require more intensive supervision, inpatient detox may offer 24-hour medical supervision.
Residential treatment is another type of care that may be considered if other proposed levels of care have been unsuccessful. The length of time in, or out, of residential treatment is not set by a predetermined number and might be extended to 28 days or longer, according to Cigna.
How to Find Rehabs That Take Cigna Insurance
When looking for rehabs that accept Cigna insurance, it’s not just a matter of locating a facility that has the insurance company’s name.
Firstly, inquire if the facility accepts your particular Cigna plan. Next, inquire if this doctor bills in- or out-of-network and what services they accept insurance for.
Currently, Recovery.com maintains a list of treatment centers that state they accept Cigna, stating that coverage and provider policies may vary from center to center.
Making this process easier with Florida Atlantic Coast Treatment Solutions was the goal. As they make a selection of whatever insurance coverage is readily available they’d consider for coverage in an action step for substance use and withdrawal, the anxieties they’re having around family members, work, and entering treatment, and also the worries they might be having about their very own drug use is overwhelming them.
Questions to Ask Before Choosing a Rehab
Before you choose a rehab, you should ask yourself these questions:
If you are looking for a rehab center that accepts Cigna, you may want to ask:
- Does the facility take my specific Cigna plan?
- Does the facility participate in the program?
- Does my plan give benefits out of network?
- Does Cigna have a “prior authorization” policy?
- How can I utilize the services at a certain level of care?
- What services do you get?
- What will be my deductibles, copays, or coinsurance?
- So if other treatments are recommended, what do you do?
- Is the facility able to check my benefits before admission?
Having clear answers can make a difference, so you can avoid taking on anything extra that you wouldn’t need to incur and choose the care you would.
How Cigna Determines the Appropriate Level of Care
Having an addiction isn’t the only criterion covered by insurance. Based on a clinical evaluation, you may get a recommendation for treatment.
Current substance use, past substance use and treatment history, physical health, social circumstances, and treatment goals are some factors that can be incorporated into an evaluation, according to Cigna. Then a treatment suggestion is issued upon an appropriate level of care.
This is critical since it is not the only treatment option for an individual.
People who require medically supervised withdrawal might require a different environment than those who are medically stable but do require structured counselling. Similarly, if someone has been continuing to use despite attending treatment, they may require a higher level of care.
Safety, clinical needs, recovery goals, and long-term support should be the emphasis of the right treatment plan.
Call (844) 643-2287 so that a caring specialist can guide you through the different steps that you should follow to go through with recovery.
Can Cigna Pay for Inpatient Rehab?
Cigna may cover inpatient substance abuse treatment as long as it meets specific requirements of the member’s plan and criteria.
At inpatient detox, people receive 24/7 medical care, and people with continuing symptoms from medical or psychiatric issues may receive inpatient acute care, according to Cigna. Some people who don’t need medical supervision are referred to another level of care, residential treatment.
But it is important to remember that having Cigna doesn’t necessarily mean that you have inpatient coverage.
This plan “makes a decision about the level of care needed based on medical-necessity guidelines after the facility provides it with clinical info,” Cigna says, but authorization may be required.
Get Help Verifying Your Cigna Rehab Benefits
Finding out insurance coverage is not the person’s responsibility alone; the person who is ready for treatment and we can help them either.
What Should You Look for in Treatment Centers That Take Cigna?
One of the factors in choosing an insurance company should not be the only factor used in your decision.
Any treatment facility worth its salt is going to provide you with treatment suitable for your clinical requirements. Think about the experience of treatment staff, the levels of care available, specific treatment plans, family included, continuity of care, and care of co-occurring mental health issues.
Cigna emphasizes that people with substance use disorders have different needs and responses to treatment. Ongoing support, changes in lifestyle, healthier coping mechanisms, and a solid sober support system may be necessary for recovery.
But you don’t always have to pick the facility that states Cigna accepted. It’s the only program to offer proper care and educate you on how your insurer will and will not pay them.
Take the Next Step Toward Recovery
Finding the rehabilitation center that accepts Cigna might be the first step towards a drug user’s quest for help. However, there is more to choosing treatment than insurance acceptance. Deserves to be cared for as an individual with a substance use history, physical and emotional health, circumstances, and recovery goals.
To help you understand your treatment options and the insurance process, Florida Atlantic Coast Treatment Solutions is here for you.
Contact us today to find out if your Cigna policy could assist you with treatment costs and what you can do next.
Frequently Asked Questions
What rehab takes Cigna insurance?
Many treatment facilities accept Cigna, but acceptance varies by plan and provider. Recovery.com lists thousands of treatment centers associated with Cigna coverage. Always verify your specific plan, network status, benefits, and authorization requirements before admission.
How to get insurance to pay for inpatient rehab?
Start with a clinical assessment and insurance benefits verification. Cigna states that certain levels of care require authorization after facility staff submit clinical information. Coverage ultimately depends on your plan and medical-necessity requirements.
What types of therapy does Cigna cover?
Cigna describes substance use treatment that may include individual counseling, intensive outpatient treatment, partial hospitalization, detox, acute inpatient care, and residential treatment. The specific services covered depend on your individual health plan and clinical needs.
What states are covered by Cigna?
Cigna offers health plans in multiple states, but coverage and plan availability vary. The important question is whether your particular Cigna plan provides benefits for the treatment facility and services you need in your location.
What is not covered by Cigna?
There is no single list that applies to every Cigna member. Plans contain exclusions and limitations, and services may require authorization. Review your specific policy and confirm benefits directly with Cigna before beginning treatment.
How long will insurance pay for rehab?
There is no universal number of days that applies to every Cigna plan. Treatment length depends on the person’s clinical needs, level of care, plan benefits, and authorization. Cigna notes residential treatment may last 28 days or more.
What are the 13 qualifying conditions for inpatient rehab?
The supplied Cigna and Recovery.com references do not identify a universal list of 13 qualifying conditions for inpatient rehab. Eligibility depends on the person’s clinical needs, treatment assessment, plan benefits, and medical-necessity criteria rather than one universal checklist.
What is the 60% rule in rehab?
The supplied references do not establish a universal Cigna “60% rule” for rehab coverage. Insurance requirements can differ by plan and level of care. Before relying on this rule, confirm the requirement directly with your Cigna plan or treatment provider.
Why do insurance companies deny rehab?
Coverage can be denied when a requested service does not meet the plan’s requirements, lacks authorization, or does not meet applicable medical-necessity criteria. A denial does not necessarily mean treatment is inappropriate, so ask about review or appeal options.
Disclaimer
This blog is for general educational and informational purposes only and is not medical, psychological, legal, financial, or insurance advice. Cigna benefits, exclusions, authorization requirements, network status, and out-of-pocket costs vary by individual plan. Coverage is not guaranteed based solely on having Cigna insurance. Speak with Cigna, your plan administrator, and qualified treatment professionals for information specific to your situation. If you are experiencing a medical emergency or an immediate safety crisis, call 911 or seek emergency medical care.
