Cigna insurance plans cover drug rehab to some degree. Depending on the plan you have, your level of coverage will vary. Some plans offer much more extensive coverage than others.
Cigna is a global provider of healthcare services, headquartered in Enfield, Connecticut. The company employs individuals in over 30 countries, has annual revenue exceeding $32 billion, and is a publicly traded company on the New York Stock Exchange.
Cigna offers numerous insurance plans for employers and private individuals. The basic major plans provided include two preferred provider organization plans (PPO) and a health maintenance organization plan (HMO).
A PPO is a managed care network of health care providers that have agreed to provide health care at reduced rates for individuals who go to the specific providers.
Cigna offers two major PPO plans.
Their HMO plan covers health care provider services only within the recognized network. There is a $20 copay for most services and a $30 copay for specialists.
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Under the specifications of the Affordable Care Act, insurance providers must offer the same services for the treatment of substance use disorders as they do for other medical conditions. Thus, the above specifications would apply to the treatment of substance abuse given the policy the individual has.
The rehab services covered include:
Medicaid is a government-funded insurance program that is available to individuals with very low-income levels. The guidelines for Medicaid eligibility are set by each state.
Medicaid coverage is typically comprehensive, but not all facilities and providers accept it.
Cigna appears to offer comprehensive Medicaid services in some states, such as Texas. To find out if Cigna has a Medicaid program in a particular state, contact them through their website.
Medicare is a government-funded form of insurance that is available for individuals 65 years and older and some people with disabilities. Premiums are based on a person’s income and are designed to be affordable.
Contact Cigna directly to learn about the availability of these programs in your area.
The notion of medical necessity —that the service is relevant to the problem being addressed by research studies and is not being used merely for convenience purposes — is generally specified by statutes from Medicare. Most rehab services must be deemed medically necessary to be covered by insurance.
Physician referrals may be required for inpatient rehab. Sometimes, it’s specified that a client must first be unsuccessful with outpatient treatment before inpatient rehab is covered.
Cigna is very thorough in describing the types of services it does not fully cover. These services are not included, but they may be part of substance use disorder treatment in some rehab facilities in some instances.
When it comes to using Cigna insurance for drug rehab, call a Cigna representative to pinpoint your exact coverage levels. Confirm this coverage with a representative from your chosen drug rehab to ensure there are no hidden costs.
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(2019) Insurance is complicated. We’re here to help. Cigna. from https://www.cigna.com/individuals-families/
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(December 2018) Medical Necessity Definition in Health Insurance. Verywell Health. from https://www.verywellhealth.com/medical-necessity-1738748