Cigna Drug & Alcohol Rehab Coverage in Ohio

Will Cigna Pay For Rehab?

Generally, yes, Cigna will pay at least a portion of drug and alcohol rehab. Any potential out-of-pocket costs will depend on the specifics of your plan. You may be responsible for copays, co-insurance, or deductibles.

For those whose annual deductible is already satisfied, the entirety of addiction treatment could be 100% covered by Cigna. 

The types of services covered by Cigna will also be dependent on the severity of addiction and may require pre-authorization. For example, Cigna will only cover medical detox if it is medically indicated. Not all individuals with a substance use disorder require medical detox. In this scenario, Cigna may approve another level of care, such as residential treatment.

Types of Cigna Plans

Like other insurance companies, Cigna has different plan types that will affect your upfront costs for drug and alcohol rehab and which providers your plan will cover. If you aren’t sure which plan you or a loved one has, your insurance card should offer you insight. Popular Cigna plans include:

Cigna HMO

Cigna HMO, or Health Maintenance Organization, is a popular plan that gives you a local network of facilities that you are required to choose from in order to receive coverage. HMO plans sometimes require a referral from your primary care physician to see a specialist.

Cigna EPO

Similarly as an HMO, EPO plans, or Exclusive Provider Organizations, offer a network of providers to choose from. EPO plans generally do not offer out-of-network coverage, however, they usually have a larger network of providers than other plans. EPO plans can be thought of as a premium HMO plan.

Cigna PPO

PPO plans, or preferred provider organizations, give members the most flexibility when choosing providers at the cost of higher premiums. PPO plans offer both in and out-of-network coverage and do not require a primary care doctor or referrals to see a specialist. Like other plans, out-of-pocket costs are lowest when you choose a facility that is in-network with Cigna.

Cigna POS

Cigna POS, or point-of-service, is a plan that combines features of HMO and PPO plans. Like a PPO plan, POS plans offer both in and out-of-network coverage. However, costs will be lower when you see providers that are in-network. Like an HMO plan, you may be required to have a referral from your primary care doctor for certain services.

Medical Detox Centers That Accept Cigna

Medical detox is an inpatient level of care that specializes in the management of drug and alcohol withdrawal with medications and therapy. Our medical detox center in Columbus, Ohio is in-network with all commercial Cigna plans. Unlike a hospital, our detox center is a comfortable residential environment with a variety of amenities.

Medical detox is not always medically indicated, so it’s important to first get an assessment and authorize your claim with Cigna prior to admitting to a detox center. Cigna most often covers detox for substances that cause physical dependence. This includes:

• Alcohol abuse
• Heroin or prescription opioid addiction
• Fentanyl addiction
• Benzodiazepine addiction, such as Xanax, Ativan, Klonopin, and others

If medical detox is not medically indicated, Cigna may instead cover an alternative level of care, such as residential treatment.

Residential Rehabs That Accept Cigna

Ohio Addiction Recovery Center is one of several residential rehabs that accept Cigna in Ohio. Because we are in-network with Cigna, your Cigna plan should offer coverage at our facility with lower out-of-pocket costs compared to other programs. Our residential program is 30-45 days and treats the underlying causes of substance use disorder with evidence-based therapies, education, relapse prevention strategies, aftercare planning, and more.

Learn more about our residential rehab in Ohio and the included amenities. 

Cigna Outpatient Rehab Coverage

At OARC, we also have various outpatient programs that are in-network with Cigna. These include:

Partial Hospitalization Program (PHP): PHP is technically an outpatient level of care, though you may find it closely resembles our residential program. The primary difference is that clients do not reside at our facility. Instead, they attend groups during the day. PHP is an intensive level of care that still requires full-time attention to treatment.

Intensive Outpatient Program (IOP): At OARC, IOP is a level of aftercare that offers more freedom than residential treatment or PHP. Clients attend groups and therapy in the evenings 3 days per week. This allows clients to begin their transition back to school or work while maintaining accountability and structure. Most clients first complete residential treatment prior to IOP.

Addiction Counseling: When clients complete IOP, they may choose to continue sessions with their primary counselor on a custom cadence. It’s common for individuals to continue counseling for their first year of recovery. 

Cigna Mental Health Coverage

Cigna also offers coverage for mental health treatment and psychiatry. At OARC, we’re a dual diagnosis facility, which means we also treat any co-occurring mental health conditions. It’s estimated that 50% of individuals with a substance use disorder also have a co-occurring mental health condition, which is why we strongly believe in treating other possible conditions hand-in-hand. We may utilize your Cigna coverage for psychiatry or prescriptions related to other mental health disorders.

Cigna Employee Assistance Program For Substance Use

Your Cigna plan may also include their Employee Assistance Program (EAP). This is an optional service that may be added to your group plan by your employer. If your employer has Cigna EAP, anyone in your household will have access to addiction resources and licensed clinicians. You may be able to receive telehealth counseling or help with referrals for addiction treatment. To access EAP resources, you can log in to your Cigna member portal.

Understanding Your Cigna Coverage

We understand insurance can be confusing. We’re committed to helping anyone who reaches out. Even if you are on the fence about addiction treatment, our specialists can help verify your benefits and walk you through your coverage at no cost, pressure, or obligation. You can reach us at 800-481-8457 or use our instant chat in the right corner of the screen.

• Sources
  1. Cigna – Types of Insurance
  2. Cigna – Preferred Provider Organization (PPO)
  3. Cigna – Health Maintenance Organization (HMO)
  4. Cigna – What is Point of Service (POS) Health Insurance?
  5. Cigna – Exclusive Provider Organization (EPO) Plans
  6. Cigna – Employee Assistance Program