Can Cigna Insurance Plan Cover Opioid Addiction Treatment Nationwide?
Cigna is a global health insurance company that provides health care coverage to individuals and businesses in over 30 countries. They offer a variety of health insurance plans and dental, vision, and prescription drug coverage. Cigna also offers a range of wellness and personal protection products and services, as well as alcohol and drug addiction treatment.1
Opioid addiction treatment is also typically included in Cigna healthcare plans nationwide. In fact, under the Mental Health Parity and Addiction Equity Act passed in 2008, all health insurance providers are required to treat addiction recovery the same as they would any other medical or surgical treatment or service.2
Nearly 50,000 people annually lose their lives to opioid overdose, while over 10 million misuse them. Between almost 72% and up to 80% of deaths by overdose involve opioids.3
For hundreds of millions of patients wondering “does Cigna cover drug rehab” the answer is yes. In fact, there are over 175,000 mental and behavioral health care providers in their network, ready to help people struggling with opioid addiction find the help they need.1
What’s Included in Cigna’s Opioid Insurance Coverage?
Most Cigna healthcare plans cover a variety of mental health and addiction services. Depending on the plan, this may include the following:4
Interventions & Screenings
Screenings and interventions are important for the early detection and treatment of addiction. Early detection can help prevent addiction from developing into a more serious issue. Interventions can provide people with the resources they need to get treatment for addiction.4
Medical Detoxification
Detoxification is often one of the first steps in addiction treatment following intake. It’s a process that helps rid the body of toxins that have built up over time. Detox can be dangerous due to the withdrawal symptoms that manifest when a patient stops using, so it’s important to undergo it under the supervision of a professional.4
Inpatient Treatment
Inpatient opioid addiction treatment is a vital part of the recovery process for many people. It provides a safe and supportive environment where people can focus on their recovery without the distractions of daily life. Inpatient treatment also allows people to get the help they need while avoiding potential triggers.4
Outpatient Treatment
Outpatient treatment for addiction typically includes a combination of counseling and behavioral therapies. Unlike inpatient treatment, you do not stay in a facility, only visit for your scheduled treatment.4
Behavioral Therapies
Behavioral therapies can help patients understand and change the behaviors that contribute to their addiction. Behavioral therapies can also help patients learn how to cope with stress and temptation without using drugs or alcohol.4
Treatment for Co-Occurring Disorders
Co-occurring disorders are often treated in conjunction with addiction treatment. Following an assessment and dual diagnosis, the patient will receive appropriate treatment for both issues. This can involve a variety of different therapies, depending on the individual’s needs. Some common treatment options for co-occurring disorders include medication, therapy, and education.4
Is There Something Cigna Won’t Cover for Addiction Treatment?
While addiction treatment is typically covered by Cigna rehab coverage, there are a number of elements that are not, including:5
- Non-medical amenities such as private rooms, private nurses, and access to private phone or TV.
- Holistic care services such as acupuncture and massage.
- Recreation programs such as horseback riding or golf.
- Food delivery services.
- Alternative treatments such as yoga or meditation.
How’s the Cost of Opioid Rehab Determined?
The cost of opioid rehab is determined by several factors, including:2
- The services provided and their intensity/frequency.
- The duration of rehab.
- Additional services provided.
The price of opioid treatment may vary based on a number of elements, but recent initial cost estimates for treatment in a certified opioid treatment program (OTP) offer a solid foundation for comparison. Based on the type of treatment provided, the annual prices for opioid treatment can range from $6,552 to $14,112. Fortunately, Cigna insurance substance abuse treatment coverage can help patients with at least some of these costs.6
Inpatient Opioid Rehab Costs
Inpatient opioid treatment is a necessary step for those struggling with opioid addiction. It provides a safe and secure environment for detox and rehabilitation and gives patients the time and support they need to get their lives back on track. Inpatient treatment costs can vary, but this program is often the best option for those who are unable to overcome addiction on their own.4
There are a number of factors that contribute to the cost of inpatient drug rehab. The most obvious factors are the location and length of the program. Treatment lengths can vary anywhere from 30 to 90 or more days.4
Inpatient opioid treatment at a certified facility gives patients a safe place to reside in, continuous access to medical and psychosocial services, including group therapies, counselor meetings, and drug administration around the clock.4
Outpatient Opioid Rehab Costs
Outpatient drug rehab is a form of addiction treatment that does not require the patient to live in a rehab facility. The patient continues to live at home and attends treatment sessions at a treatment center. This type of rehab is often less expensive than inpatient rehab, and it may be more appropriate for people who have jobs or families.4
Outpatient drug rehab typically includes individual counseling, group counseling, and sometimes medication therapy. The cost of rehab depends on the frequency and type of services provided.4
Partial Hospitalization Program Costs
A partial hospitalization program (PHP) for opioid addiction treatment provides structured, intensive treatment on a daily basis, but allows patients to live at home. Patients attend the PHP program for several hours each day with all the services such as group and individual therapies, counselor meetings, and drug testing.7
The cost of the treatment is determined by the location, services offered, length of treatment, and type of insurance coverage for addiction rehab. The cost is usually lower than inpatient treatment, but higher than standard outpatient treatment.7
Medication-Assisted Treatment Costs
Cigna insurance coverage for drug treatment programs may also include the cost of MAT or medication-assisted treatment. The most common type of opioid treatment, methadone maintenance therapy, costs an average of $126 per week. Buprenorphine maintenance therapy provided in a certified opioid treatment program costs an average of $115 per week. Finally, Naltrexone maintenance therapy costs an average of $1,176 per week. This price includes the cost of the drug and any associated services, such as medical support, counseling, therapy, or drug administration.6
It’s important to note that the annual prices listed above are averages. The actual price that a patient pays for opioid treatment will vary depending on the type of treatment, the provider, and the location.6
How Does the Price of Opioid Treatment Compare to the Costs of Addiction?
Opioid treatment can be expensive, but it’s important to remember that the cost of not receiving treatment can be even higher. The costs of untreated opioid abuse are broader than just personal finances and may also include:6
- Criminal justice costs.
- Treatment for infants born with opioid dependence.
- An increased risk of infectious disease transmission and the costs of treating them.
- Treating opioid overdose.
- Casualties related to substance abuse (driving under influence).
- Work inefficacy costs.
The amount of money that is spent on the treatment of substance use disorders is only a fraction of the costs these disorders generate. In 2013, the sum of all costs linked to opioid use disorders and overdoses in the U.S. was $78 billion, and only $2.8 billion or 3.6% of those costs were treatment-related.6
The Duration of Cigna Coverage for Opioid Treatment
Addiction treatment is tailored to the individual, taking into account the severity of their opioid addiction. Every patient progresses at a different pace during treatment, so no one-size-fits-all approach can be applied. However, a positive treatment outcome is more likely if the treatment is of adequate length.5
The best outcomes for struggling individuals coincide with longer durations of treatment, typically around 90 days. However, some may need longer to significantly reduce or treat their opioid addiction.5
Different policies cover different lengths of stay, which is why you should contact your insurance provider by calling the number on the back of your insurance card and inquire about your benefits. Calling the Cigna helpline will connect you with operators who will assist you with determining your coverage benefits and help you locate the nearest in-network rehab facility.2
Should I Opt for an Inpatient or Outpatient Treatment Program?
The length of treatment at inpatient or outpatient facilities varies depending on the program. Inpatient facilities require you to stay overnight, while outpatient facilities allow you to come during the day for scheduled treatment and activities. Your doctor will typically suggest wha type of treatment may be best for your needs.8
Both programs can include some common components, such as the 12-step program and behavioral treatment, individual and group therapy, education, family therapy, and medical care. Choosing between inpatient and outpatient treatment depends on various factors, including:8
- The severity of your opioid use disorder.
- The support your receive from your environment.
- Your housing conditions.
- Your mental and emotional health.
There are benefits to both treatment programs, but generally, inpatient treatment offers additional benefits that might play a pivotal role in recovery and relapse prevention, including:5
- Access to better care.
- Same-day admittance if necessary
- A healthy treatment-focused, accountable environment.
- Monitored progress.
- Professional and peer support.
How to Use Cigna Insurance to Cover Opioid Treatment
If you or your loved one are struggling with opioid addiction, a visit to the doctor will help you determine the severity of SUD and whether treatment is required or not.5
If you have any of the Cigna healthcare plans, the first thing you should do is contact the company via the Cigna helpline using the number on the back of your insurance card or any of the official contacts provided. You can also call a dedicated local addiction hotline for any treatment-related information.2
You may or may not be assigned a case manager who can give you additional details on the initial deductible, available Cigna-covered inpatient rehab centers nationwide or in your area, and help you find a program that’s financially and medically most applicable for you.2
Additionally, you can get in touch with your preferred rehab center directly to find out whether they accept your Cigna addiction treatment insurance and to check whether your coverage is accepted.
For instance, American Addiction Centers has a team of admissions navigators who will help you confirm your insurance coverage, offer additional payment options, talk to you about financing options, and provide any information on the treatment you require via a phone call, email, or their website form. Then, following an initial case assessment, they will be able to suggest the best course of treatment.
Where Can I Find Opioid Rehabs in Network With Cigna Insurance?
American Addiction Centers is committed to providing affordable, high-quality treatment for those suffering from addiction. They understand that paying for treatment can be a challenge, which is why they work with most major insurance providers to verify coverage and help you get the care you need at a local treatment facility. Call them today to learn more about how American Addiction Centers can help you or your loved one recover from addiction.
The AAC hotline provides a great resource for people who are looking for assistance with their private pay benefits. The helpline is staffed by trained admissions navigators who can help people check their benefits, present them with various payment options, and get them closer to the help that they need.
With over 1.5 million relationships with facilities, clinics, and health care providers and over 17 million global customers, Cigna has many in-network substance abuse treatment facilities equipped to help people dealing with opioid use disorder, including AAC.1
AAC has a number of leading treatment centers nationwide that provide prime quality opioid treatment programs. AAC centers are staffed with experienced and licensed professionals who provide evidence-based treatment, so feel free to reach out.
