Cigna

Cigna

It can be very daunting to admit that you need help for a drug, alcohol, or behavior addiction. Cigna is one of the leading insurance companies in the world providing 95 million people with insurance. Thanks to the Affordable Care Act of 2010, also known as Obamacare, all health insurance companies are required to provide at least some coverage for mental health disorders including substance use disorders. Cigna is one of the top providers of quality, affordable, addiction care. 

 

What Does the Affordable Care Act Mean?

The Affordable Care Act also stops insurance companies from denying you treatment due to preexisting conditions. This means that even if you struggled with addiction before 2010 you still  have a good chance that your insurance will still cover you.

 

What Type of Healthcare Plans Does Cigna Offer?

Depending on your location, and your needs, Cigna offers different plans, and depending on your policy, the benefits and coverage will vary. The policy’s available through Cigna are bronze, silver, platinum, and gold. 

Cigna Bronze Plan

This is the most affordable plan but it also offers the fewest benefits. It does often provide at least some addiction recovery insurance but it does not always cover all of the costs. Usually, the Bronze Plan does not offer any coverage for out of network health providers.

 

Cigna Silver Plan

The Silver Plan is the plan right after the Bronze Plan. It is still one of the more affordable healthcare plans. The Silver Plan offers some more benefits than the Bronze Plan and some out-of-network health providers might be covered.

 

Cigna Gold Plan

The Gold Plan offers more coverage than the Bronze Plan or the Silver plan. There is also a greater chance that an out-of-network provider will be covered than there is in the Bronze or Silver plans.

 

Cigna Platinum Plan

This plan offers the most coverage of any of Cigna’s health care plans. Out of all plans, this one provides the greatest chance of coverage for treatment by an out-of-network health care provider.

Do Insurance Companies Cover All Addiction Conditions?

 Many health insurance plans do not cover clinical recovery from all substances. Here are some of the substances that Cigna might cover:

  • Alcohol
  • Heroin
  • Opioids
  • Marijuana
  • Methamphetamine
  • Cocaine
  • Prescription Opioids
  • Benzodiazepines
  • Prescription stimulants
  • Sleep aids/sedatives
  • Other drugs
  • Addictive behavior like gambling

 

Does Cigna Cover Treatment for Co-occurring Disorders?

Cigna might also provide extra coverage for the treatment of dual diagnosis. A dual diagnosis is also known as co-occurring disorders. A dual diagnosis is simply the name given to co-occurring disorders once they are diagnosed. Co-occurring disorders are when an addiction disorder and another mental health disorder occur in the same person and during the same period of time. Someone can have several co-occurring disorders at once. Some of the most common co-occurring disorders are:

  • Anxiety
  • Depression
  • PTSD
  • Bipolar

 

What Sorts of Therapy Does Cigna Cover?

Certain services needed to maintain mental health independent of the substance abuse treatment might be offered to people who have certain Cigna plans. Some services that might be needed by someone to maintain their mental health are:

  • Psychotherapy
  • Group therapy
  • Cognitive Behavioral Therapy (CBT)
  • Medication

 

What Parts of the Addiction Recover Process Does Cigna Cover?

Depending on your location, and your needs, Cigna offers different plans, and depending on your policy, the benefits and coverage will vary. Some parts of the clinical recovery process that Cigna might cover are:

 

Detox

Detoxification is a necessary step in all substance recovery programs. During detox, your body naturally purges itself of dangerous levels of drugs. There are two types of detox. In the first type, the body detoxifies by itself. 

In the second the process is assisted by medical tapering. During medical tapering medications such as methadone are introduced into the patient’s system to help the patient gradually wean off of the drugs and/or alcohol they are addicted to. 

It is important to note, that not all Cigna plans cover detox and the ones that do cover detox do not always cover medical tapering.

 

Residential Treatment

This is usually the next step after detox. During residential treatment, the patient lives at the clinic. At the clinic, they continue to rehabilitate by going to group therapy, therapy, and other treatments including physical training, and much more.

 Partial Hospitalization Program (PHP)

A PHP is similar to a residential treatment program and it is usually the next step after residential treatment for most patients. During the PHP patients continue to undergo therapy and other therapeutic activities. The PHP also focuses on preparing the patient to readjust to day to day life. They will work further on this during the intensive outpatient program.

Intensive Outpatient Program (IOP)

IOP is the last step in the clinical recovery process for patients. Some patients go straight from detox to the IOP. Whether you can go straight from detox to an IOP depends on what substances you had been abusing and for how long.

 

Aftercare

Some Cigna insurance plans might offer their aftercare services and in-network therapists who specialize in addiction and practice in your area. Some insurance companies offer social events, group therapy programs,

 

Can Cigna Help Me Find a 12 Step Program

Cigna is also likely to help you find a local 12 step program in your area such as Alcoholics Anonymous (AA) Narcotics Anonymous (NA) and/or Gamblers Anonymous (GA). These 12 step programs are nationwide and there is likely to be one in your area.

 

What Do I Do If There Is Not A 12 Step Program in My Area?

If there is not there may be a local therapy group that Cigna and Granite Mountain can help you find. Some therapy groups might be private and only the people involved in the group and the related health care professionals are aware of it. Your recovery clinic and Cigna can help you find and participate in these groups.

 

Can Cigna Help Me Get Help for My Addiction Privately?

With the help of Cigna, Granite Mountain, and your company’s Human Resources department you can find help for your addiction quickly and anonymously. Human Resources departments are required to keep your disorder(s) private if you so choose. There is nothing shameful about having an addiction disorder, but as with every condition from the flu to cancer some people prefer to deal with their health concerns in private.

 

What is Preauthorization?

When you are going to enter an addiction recovery clinic it is important to find out if you need a pre-authorization or prior approval. The preauthorization process is a way for your insurance company, in this case, Cigna, to determine that you do need clinical addiction recovery help.

 

What is Prior Authorization?

While your need for help might be easy for most people to assess, please remember that these insurance companies do not know you personally and they rely on medical professionals to make judgments for them instead of insurance company employees. Prior authorization is just another phrase for preauthorization. If you do not get preauthorization before beginning treatment at your clinic of choice your insurance might not cover your treatment.

 

Will Cigna Cover My Travel Expenses to My Addiction Clinic?

Cigna offers many benefits to their customers. While private travel expenses might fall out of the scope of your insurance plan, it is always a good question to ask. It is especially important to ask this if you have to go to your recovery clinic in an ambulance or in any other medically supervised way.

 

Does Cigna Cover My Addiction Recovery Housing?

Some addiction recovery clinics offer their own off-campus housing programs. Cigna insurance might help you afford this housing if it is directly related to your recovery treatment if you are staying in their housing during your IOP or PHP for example. They may not help you pay for the housing if you choose to stay in the area after clinical treatment.

 

Can Insurance Cover My Expenses While I am at Drug and Alcohol Rehab?

While is unlikely that Cigna will cover your day to day expenses while you are at your addiction clinic, you can always ask. Many policies provide additional benefits to standard care programs. However, Cigna might cover day to day expenses that are related to your addiction recovery, such as work out equipment that might be required for health care classes.

 

How do I Find Out if My Insurance Covers Addiction Recovery Treatment?

The best way to go about finding out if your insurance covers your clinical addiction recovery treatment is to contact your clinic of choice. Clinics like Granite Mountain know what questions to ask the insurance company about your policy and what information the insurance company needs to know so that you can get help quickly.

 

What Therapies Does Insurance Cover?

There are many programs that make up clinical addiction recovery treatment. Some of these are:

  • Psychotherapy
  • Family Therapy
  • Cognitive Behavioral Therapy (CBT)
  • Group Therapy

  

Will My Insurance Cover My Whole Addiction Recovery Treatment?

Not all policies will cover your entire stay at an addiction treatment clinic. Some policies limit the amount of time you can spend on each step of your clinical recovery treatment and still be covered. Fortunately, in the end, the health professionals at the clinic are the ones that determine how long you stay at each stage and the insurance company usually does not try to push you forward when you are not ready.

 

You are the only one that can decide that you are ready to get help, is you. When you are ready to get help you help can call us at: (877)338-6287

 

References: 

https://www.cigna.com/individuals-families/health-wellness/hw/medical-topics/inpatient-and-outpatient-treatment-for-substance-ad1101

https://www.healthcare.gov/health-care-law-protections/

Article Reviewed by Rob Heinrich, LPC

Rob Heinrich, LPCRob is our Clinical Director and brings years of various expertise to Granite Mountain Behavioral Healthcare. He graduated with a Masters in Counseling in 1992 from Denver Seminary and has decades of hands-on experience with providing treatment for substance abuse and eating disorders. Rob oversees the entire clinical team and treatment programming for our clients. He is also an active group therapist in our outpatient program.