Cigna Insurance Coverage for Drug & Alcohol Rehab Centers Near Me

If you are covered through Cigna insurance, you will likely have some form of healthcare coverage for drug and alcohol rehab. Addiction treatment coverage will vary depending on which Cigna insurance health plan you have.

Cigna has several different types of plans, including HMO and PPO policies. The latter gives you more out-of-network options, whereas an HMO plan may make it harder to access out-of-network care should you need it. All Cigna insurance plans cover some level of care for inpatient and outpatient treatment, including intensive outpatient programs (IOPs) and partial hospitalization programs (PHP). However, the amount again depends on your policy and where you seek care.

IOPs often last about 1-3 months with Cigna health insurance. When you seek drug treatment, you can work with the rehab center to determine the specific level of care you need. You and your rehab center will discuss the necessary care and determine what works best for you. That care depends on several factors, including:

• Your living situation.
• Your external support system.
• The severity of your substance use disorder.

You may not need to speak to a representative if you use your myCigna account to check your benefits.³

The Affordable Care Act (ACA) mandates that all health insurance companies offer mental health insurance. Substance use disorder is a mental illness, so it qualifies as part of Cigna mental health coverage. People with substance use disorder often have co-occurring disorders that affect their addiction. Cigna offers mental health coverage with all of its plans. The different plans may mean you have access to more specific Cigna mental health benefits, including:⁴

• The network of Cigna behavioral health professionals.
• Follow-up case management.
• Consultation and referrals.
• Outpatient mental health services.
• Referrals to local support and online resources.

Some of these details may also change, depending on the state where you live and your benefits through various employers.

According to the Substance Abuse and Mental Health Service Administration, 64.3% of people with opioid abuse have a co-occurring mental health disorder and 26.9% of those people have a serious mental health disorder.⁵ Substance use disorder often happens when people feel they do not have the external support they need. Many situations can make a person feel that drugs are their best or only option at the moment, whether they abuse prescription pain medication or turn to recreational drugs. Treating all parts of a person’s substance use disorder means giving them a complete support system. It offers stability during and after treatment. To neglect co-occurring disorders is to neglect to give someone the best possible care.

The length of your Cigna insurance coverage depends on the care you need. It varies based on each plan, the length of your rehab, the severity of your substance use disorder, and other factors. Cigna has several options with its policies, so check yours to learn more about your specific coverage. According to the National Institute on Drug Abuse, a person’s treatment must last long enough and incorporate strong enough resources to work.⁶ For many people, that means a longer rehab treatment of 6 months or more. That doesn’t mean shorter treatment times can’t be effective. Many people do well with 3 or fewer months of rehab. However, with more severe substance use disorders, some people require longer treatment.

Detox alone is not treatment for drug addiction. A full course of rehab treatment often includes detox, therapy, counseling, community resources, and much more. It’s about providing a system of support as much as stopping drug use. For treatment to succeed, we need to have enough time to build that system, which shorter treatment courses don’t always allow for. That can lead to people returning to drugs. If you don’t know how long your Cigna insurance benefits will cover treatment, call Cigna to speak with a representative.

What if My Cigna Insurance Policy Does Not Cover Alcohol & Drug Rehab Facilities?

Cigna will cover a portion of your care, but the amount varies with the tier and policy. Sometimes, a policy doesn’t cover as much as you need. You might still struggle to pay for rehab. With financing, you pay for your rehab in installments. That way, you don’t have to pay upfront, but you still get the care you need. Scholarships and grants are typically non-competitive, so you don’t have to worry about them not being available if you meet the qualifications. No matter what, do not delay your treatment. Continued substance abuse can lead to serious conditions, including cancer and heart disease.⁷ The sooner you stop using, the better chance you have to avoid these complications.

Cigna insurance covers both in-network and out-of-network rehab centers. With a PPO plan, you have more options, as PPOs typically offer some level of coverage, even with an out-of-network rehab center. HMO plans don’t offer that coverage, so you’re more limited. Cigna in-network providers have agreed to Cigna’s price when charging for care. That price is often lower than what the center would charge if you had no insurance. When you go to rehab, Cigna will then pay part of the cost and you pay the rest. With Gold and Platinum plans, Cigna may cover a significant portion of the cost. Out-of-network providers mean that the center doesn’t agree to Cigna’s payments. Therefore, Cigna cannot cover as much of the cost. This is where PPO plans come in, as they do still help with the cost of care. However, you’ll still pay more than you would with an in-network rehab center.

If you or a loved one are struggling, know that you are not alone. Get started on your recovery right now with our free rehab locator tool, where you can find addiction treatment facilities that take insurance, inpatient detox, outpatient detox, and much more.

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1. (2018). Cigna intensifies effort to curtail opioid epidemic by confronting opioid addiction and overdose in U.S. communities.
2. (2021). Bronze, silver, gold, and platinum health plans.
3. (2021). Affordable health insurance plans.
4. (2021). Mental health benefits.
5. Substance Abuse and Mental Health Services Administration. (2019). Co-occurring substance use and mental disorders among adults with opioid use disorder.
6. National Institute on Drug Abuse. (2014). Principles of adolescent substance use disorder treatment: A research-based guide.
7. National Institutes of Health. (2014). Substance use and associated health conditions throughout the lifespan.
8. Cigna. Licensed Clinicians Available Through EAP. 
9. Cigna. Designated Substance Use Treatment.
10. Medicaid.gov. Substance Use Disorders.
11. Medicare.gov. Mental Health & Substance Use Disorder Services.
12. Humana. Don’t Let Substance Use Disorders Have the Last Word.
13. Aetna. Support System: Behavioral Health Provider Manual.
14. Cigna. Mental Health Care
15. HealthCare.gov. Affordable Care Act (ACA).
16. The Office of National Drug Control Policy. Substance Abuse and the Affordable Care Act.
17. Department of Health and Human Services. (2019). Implementation of Section 5052 of the SUPPORT for Patients and Communities Act – State Plan Option under Section 1915(l) of the Social Security Act.