Cigna Insurance Coverage for Drug and Alcohol Addiction Rehab

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Provider Overview
Cigna is a “global health services company” that serves more than 180 million people worldwide. With a focus on addressing whole-person health, Cigna is “dedicated to improving the health, well-being and peace of mind” of the people they serve.1 This page should help you understand what type of drug and alcohol rehab treatment is and isn’t covered by Cigna insurance.
Please note: This page is simply a brief guide to how Cigna health plan benefits work with regard to substance abuse, mental health, and behavioral health treatment. This is not a comprehensive guide. Call or reach out to a Cigna representative to confirm your coverage benefits or with specific questions about your health plan.
Cigna insurance plans offer many different types of coverage, which include:
If you or a loved one are struggling with a substance use disorder (SUD), Cigna may cover various forms of treatment, therapy and support, depending on your plan. Substance addiction treatment services may include:10
Cigna health plans can be broken down into several different categories. However, the specifics of Cigna insurance plans may vary based on:
Like many other health insurance companies, Cigna insurance plans fit into several main categories:4
Cigna also provides other options:
Inpatient rehabilitation is one of the addiction treatment methods covered by Cigna insurance. Coverage may vary depending on the state you live in and the types of services you require, so it’s important to contact a Cigna representative for more information.7
If you go outside the Cigna network for an inpatient treatment facility, it may result in no coverage.7
Another common form of addiction treatment covered by Cigna health insurance is outpatient rehabilitation in which a person visits a facility to receive treatment rather than stay overnight. Outpatient treatment can vary in intensity levels and include a range of services to help a person recover.
Like inpatient treatment, outpatient programs that are outside the Cigna OAP network may not be covered.8
Mental health, behavioral health, and substance abuse treatments are all categorized together within Cigna health plans. For both the examples outlined in the sections above, the coverage for mental health treatment in inpatient or outpatient treatment for mental health would be the same as it is for substance use.7, 8
Out-of-pocket coverage means that after you meet your yearly out-of-pocket maximum, insurance will cover any costs above the maximum amount set by your plan. Out-of-pocket costs can include copayments, deductibles and coinsurance.
Some plans are required to meet standards set by the Affordable Care Act (ACA), which calls for out-of-pocket maximums. If you have a plan through the ACA, be sure to check your coverage for the specific out-of-pocket maximum.11
Mental health and substance abuse coverage is a part of Cigna medical plans acquired through an employer and does not have a separate deductible to be met.10 If you buy your own health plan, there may be different premiums and rules regarding out-of-pocket maximums, such as not being able to apply your deductible to the out-of-pocket maximum.11
It’s always important to check the details of your plan to confirm coverage. There may be some expenses that don’t count toward your out-of-pocket maximum, including:11
Out-of-state rehab coverage may depend on your specific Cigna health plan and which treatment providers are considered in-network or out-of-network. Make sure to check your plan details for information about receiving addiction treatment that’s out of your plan’s local service area.
The length of treatment for substance misuse covered by Cigna (e.g. 28-30 days or more long-term programs e.g. 60 days/ 90 days) will depend on what is deemed medically necessary. Cigna will work with treatment providers to assess and find the appropriate level of care for a person who needs treatment for substance misuse. This could include the length of treatment, types of treatment, services and level of care, in addition to milestones to be met during treatment.13
If you have Cigna but you are unsure about which plan you have or what it covers, there are a few different ways to check your benefits. You can:
All the options above should be able to provide you with specific information about your Cigna plan. If you are considering treatment at an American Addiction Centers (AAC) facility and are unsure whether Cigna contracts with AAC directly, you can use the Verify Your Insurance portal, call one of our admissions navigators, who can assist you for free in making sense of the health insurance coverage for addiction treatment, or fill out the form below.
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