Cigna Insurance Coverage For Substance Abuse Treatment
Those who have a substance abuse problem require help. Unfortunately, too few of them actually get the help that they need. Those who do get help start with a period of detox, after which they attend rehab. During rehab, they are equipped with the necessary strategies to live a sober life in the future. While this treatment is not free, if you have Cigna insurance, depending on your plan, some or all of this treatment may be covered. The list of services that they cover, however, constantly changes, which is something that most insurance companies do. Hence, while this information was correct at the time of this writing, it is important that you check your summary and benefits book as well.
Inpatient and Outpatient Coverage
When having an intake conversation about the necessary rehab treatment, patients are advised on whether to use inpatient or outpatient facilities. This mainly depends on the severity of the addiction. In an inpatient facility, patients are required to stay at the rehab center for a certain period of time, which is recommended for long term, serious addiction problems. At an outpatient facility, patients still live at home and simply go for treatment several times per week. This is often provided for patients with short term, less serious addictions.
What If Your Insurance Doesn’t Cover Everything?
If your Cigna insurance policy doesn’t cover all of your treatment, there are options available to you. A number of government programs exist to ensure you can receive treatment. The Substance Abuse and Mental Health Administration also offers grants to specific types of people. As such, there should be nothing standing in your way to receive treatment.
Cigna and Alcohol Abuse Treatment
Recent statistics show that 53% of people in this country have a close relative who they believe has a drinking problem. Thus, alcohol rehab is one of the most sought after substance abuse treatment types. All insurance carriers now cover this kind of treatment to a certain degree, because it has been proven to help people remain sober and avoid relapse. While all insurance companies, including Cigna, are offering cover, the amount of cover varies greatly. This means that you have to put in the effort to find out exactly what kind of help you will be able to receive. Cigna has released a wealth of information in terms of its coverage for alcohol treatment, and this can be quite overwhelming to go through. One of the reasons for this is that the company has a range of plans, each of which has different types of coverage.
The Kinds of Rehab Covered by Cigna
In terms of alcohol addiction treatment, Cigna covers all traditional in-network rehab facilities. This means that, so long as the facility is part of the Cigna network, it will be covered. However, some of the treatments are usually excluded, such as:
- Private and luxury treatment (with exceptions)
- Over the counter medication
- Alternative therapy, such as acupuncture, massage, and yoga
- Out of network facilities
What this demonstrates is that you should not just research the facilities that are available to you, but the treatment types that they offer as well.
The Cost of Rehab that Cigna Covers
The plan that you have will determine how much of your rehab is covered. Every plan has a deductible, which means you will have to pay something before your plan kicks in. Once you exceed this deductible, a percentage of the cost will be paid by Cigna. It should be noted, however, that this is not always 100%.
Coverage for Inpatient and Outpatient Treatment
Cigna does cover both inpatient and outpatient alcohol addiction treatment. Hence, when you start to choose between those two, coverage shouldn’t be a determining factor. You need to find out which type of treatment is most suitable to you, which will depend on factors such as living conditions, genetics, severity of the addiction, and so on. Outpatient treatment is usually only suitable for those who only have a short term dependency and haven’t become truly addicted yet.
It is important to note that each individual has different needs. For instance, you may simply be unable to take time away from your personal or professional life to attend inpatient treatment. Thus, it is important to consult with a doctor.
Local or Out of State Rehab
Some patients prefer to go to an out of state rehab facility because it removes them from the environment that facilitated their alcohol abuse. Cigna does cover out of state rehab as well, but only if it is within their network. Hence, you must look into this.
Private or Luxury Treatment Excluded
Cigna does not cover treatment in luxury, private, or executive facilities. This is because the services offered in these facilities are above and beyond what people need. All carriers take this approach so if you do want to receive this type of treatment, you will need to pay for it yourself. You may, for instance, require executive treatment so that you can continue to remain in touch with clients and work, even if you are in an inpatient facility. These facilities offer customized treatment plans so you can meet your career needs, allowances for outside contact, and guaranteed privacy.
The Length of Treatment
Importantly, Cigna will pay for treatment of any length. If the medical professional recommends a lengthy stay in rehab, they will cover this. Usually, alcohol rehab lasts for around one month, but it can also be as long as three months or even more. Exactly what will be covered will depend on what is recommended by the medical professional.
Frequently Asked Questions about Cigna Insurance for Alcohol Treatment
Q. Will multiple stays be covered by Cigna?
A. Yes, so long as multiple stays are recommended by a medical professional.
Q. Will Cigna pay for aftercare?
Q. Will going to rehab increase my premium?
A. No, it is against the law to do this.
Q. How has Obamacare (the Affordable Care Act) affected rehab coverage?
A. Obamacare has required insurance carriers to cover addiction treatment. How they cover this, however, depends on the carrier.
II. Cigna and Drug Abuse Treatment
Cigna also covers treatment for opiate or opioid addictions. Again, how much they cover and the type of facilities they cover will depend on your personal plan. It is important, therefore, to contact them to make sure you have the correct information.
Types of Rehab Covered
The type of treatment covered depends on your plan, but in general, Cigna covers:
• Long term residential treatment
• Short term sober living treatment
• Substance abuse day treatment
• Outpatient drug rehab
The Cost of Rehab that Is Covered
How much coverage you will receive through Cigna depends on your policy. The Cigna Insurance California Bronze Standard Plan tends to be the baseline coverage for all their other plans. Under this plan, they cover inpatient rehab services for both participating and nonparticipating facilities. However, there are exceptions and limitations. For instance, the plans usually only offer between 30% and 50% co-insurance, although this will depend on your plan. If you were to use a participating provider, the co-pay usually is around $60.
Cigna understands the lifesaving services that rehab facilities offer, which is why they regularly add more options and services that they cover. Those who have an opiate addiction may therefore receive partial payment for their treatment. Cigna is not a treatment provider, however, so it is important to speak to a representative of the rehab center as well. Cigna may cover up to 100% of the treatment.
Inpatient and Outpatient Treatment
There is a significant difference between inpatient and outpatient treatment, which is mainly because the latter doesn’t require hospitalization. For outpatients, Cigna covers physical and psychological care. During inpatient treatment, people are supported through their withdrawal, which is often done through medication. It is important to check whether or not the medication is covered by Cigna, although most prescription medications are.
The easiest way to decide which center to go to is by looking at the summary benefits highlighted in your Cigna plan. This will ensure that you know what type of treatment is and isn’t covered, and you can then decide which type of treatment will be most suitable to help you recover. Do ask questions about what each type of therapy is and does as well, how long you will have to stay in treatment, and what type of medications will be provided.
Local and Out of State Treatment
As with alcohol rehab, some people prefer to receive treatment out of state. Cigna is only available in a few states, and each state has different Cigna benefits. Generally speaking, however, Cigna will cover out of state coverage, although the co-pay and coinsurance will be different.
Private and Luxury Treatment May Be Included
Cigna does cover some private and luxury opioid treatment, but only if the facility is included in their network. Usually, there will also be a 50% co-pay requirement. Cigna regularly updates both their benefits and their participating providers, so make sure that you look into this. The same is true for executive rehab centers, which is designed for those who are working professionals, including celebrity types.
The Length of Treatment
As a rule of thumb, three types of residential rehab programs exist:
1. 28 to 30 day inpatient programs
2. 60 day inpatient programs
3. 90 day inpatient programs
How long you have to stay depends on the severity of your opiate addiction. A 28 to 30 day program may be fine for you, but most are advised to stay for at least 60 days. In more severe cases, 90 days is usually recommended. This is not solely for those who have multiple addictions. Cigna will cover all length of treatments, depending on your plan, so long as it is recommended by a medical professional.
There are some other options available as well depending on your personal benefit summary and plan. Through Cigna, you should be able to receive at least some coverage for opiates and opioid treatment, but you should check their website, your personal benefits summary, and speak to a customer service representative. There are significant differences between group and individual plans as well. This means that, if your plan is employer provider, you will have to discuss this with your human resources department to find out what sort of coverage you have.
Frequently Asked Questions about Cigna Insurance for Opioid and Opiates Treatment
Q. What if I don’t have insurance?
A. The majority of rehab centers that are included in the Cigna network for opiate addiction treatment also offer services for those without insurance. Every center usually has their own policies and procedures in place to deal with people who are underinsured or not insured at all.
Q. Will I be covered if I need multiple stays in rehab?
A. This depends on your personal Cigna insurance plan, although generally speaking, multiple stays are covered. Check your summary benefits package to find out whether you are covered or not.
Q. Is aftercare covered under my Cigna plan?
A. Cigna offers a huge variety or plans, each of them with different policies. These will determine whether or not aftercare is included. While aftercare is usually paid for, there are generally exceptions and limitations.
Q. Will going to rehab increase the price of my insurance?
A. Absolutely not. There is no penalty for using specific types of benefits. As always, there are exceptions, but this will depend on your individual case. All the terms and conditions that are applicable to you are highlighted in your summary benefits.
Q. How has Obamacare affected payment for mental health and opiate addiction treatment?
A. The Affordable Care Act continues to grow. Mental health treatment is now part of it, and drug addiction treatment is classed as a mental health issue. Exactly how it is covered, however, will vary depending on the insurance provider and the plan.
What to Do If You Don’t Have Insurance
If you don’t have insurance at all, there are four options available to you. Two of these options are suitable for those on a low income, and the other two for those on a higher income. Those on a low income can go to public rehab, or they can apply for Medicare. Those on a higher income must wait for the next enrollment, or they must pay for treatment themselves.