Knowing the do’s and dont’s of insurance can be very difficult. Along with mental illness, substance use disorder, or other health concerns; you do not want insurance to throw more stress into the mix. We at AKUA have a team of people dedicated to this very task. Give us a call and we can help you decide what your insurance does, or does not, cover.
A global health organization, Cigna has more than 86 million customer relationships around the world. Along with their mission to provide affordable healthcare for basic needs, the company helps its members with addiction treatment.
Cigna supports those who are looking to recover from a drug or alcohol addiction. Cigna works with an individual’s needs to find nearby treatment services. Cigna insurance policies have different options for Detox, Inpatient and Outpatient rehab, as well as other mental health services to help on your path to recovery. Depending on your individual Cigna insurance plan, your inpatient and outpatient rehab coverage will vary.
Cigna works with an individual’s needs to find nearby treatment for drug or alcohol addictions. Cigna insurance policies have different options for inpatient and outpatient rehab, as well as other services to help on your path to recovery.
• Drug rehabilitation
• Alcohol rehabilitation
• Detoxification
• Counseling for addiction treatment
To better support those who face drug or alcohol addiction, Cigna started a Behavioral Health division. In addition to providing articles, tools and podcasts for individuals and family members, the division now includes an education series.
Depending on your Cigna plan, your benefits and coverage will vary. For instance, Cigna’s lowest plan – bronze – offers lower premiums, but individuals may face higher deductibles and out-of-pocket expenses. But for those with gold or platinum plans, you receive more comprehensive coverage with lower deductibles.
In regards to substance abuse treatment, the services insurance covers and the expenses you will be responsible for depend greatly on the type of plan and the state you reside in. Contact your health insurance provider to review your policy and determine the types of treatment services that are covered by your plan. In addition to your health insurance provider, you can contact a treatment provider to discuss financial assistance options for treatment.
Mental illness affects millions of Americans and is common among those with substance abuse issues. Insurance providers are legally required to cover mental health services. In many cases, mental health problems can co-occur with substance use, so it is important to address mental health concerns if you are seeking care for substance misuse and addiction.
Cigna typically covers individual therapy sessions for people with substance abuse issues and other mental health conditions. Cigna may cover therapy fully or partially depending upon the member’s plan.
Inpatient substance abuse treatment programs that Cigna may cover include:
• Acute Inpatient Substance and Drug Detoxification.
• Inpatient Treatment for Substance and Drug Disorders.
• Partial Hospitalization for Substance and Drug Disorders.
Insurance coverage and out-of-pocket expenses may fluctuate depending on your specific plan and where you’re located. Here are several estimates for inpatient rehab costs broke down by plans.
Bronze Plans
Typically have 0% coinsurance for in-network providers which means Cigna will pick up the costs after you pay your plan’s deductible in full. For out-of-network services, some plans will help cover costs while others may not.
Silver plans
In-network programs coinsurance usually falls between 30 to 50% after the deductible is met. Out-of-network services may or not be covered, depending on the state you reside in.
Gold plans
Coinsurance for in-network plans can range from 20 to 50% after the deductible. Similar to the other plans, out-of-network providers may or may not be covered depending on the state in which the policy was issued.
Platinum plans
10 to 30% coinsurance after meeting the plan’s deductible. Some plans may cover out-of-network programs at a higher coinsurance percentage.
Outpatient rehab services that are usually covered by your Cigna plan include:
• Individual, Family and Group Therapy
• Intensive Outpatient Treatment
• Substance and Drug Detoxification Medication Management
• Anti-Craving Medication Management
Bronze Plans
Coinsurance based on the state of residence and may fall between zero to 50%. Out-of-network may or may not be covered in these plans.
Silver plans
Several outpatient services that are in-network may have a coinsurance percentage, while others have a copay per visit. Out-of-network providers may or may not be covered.
Gold plans
Depending on the service provided, there may be a small coinsurance percentage or copay required per visit for in-network. Out-of-network services may or may not be covered.
Platinum plans
Minimal coinsurance or copay requirements for in-network providers. Some policies may have out-of-network coverage, but coinsurance rates are generally higher for these services.
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While not all Cigna plans require your treatment center to be in-network, it’s important to note that using an out-of-network provider usually increases your out-of-pocket expenses.
Many out-of-network treatment options require a pre-certification. This involves Cigna reviewing the request against nationally recognized guidelines.
In cases that require pre-certification, Cigna will determine what services are covered based on your plan. Refer to your policy or call the number on the back of your insurance card to find out what treatment options are available to you.
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It’s important not to let the costs of treatment deter you from getting the help you deserve. There’s a wide range of alternative methods to help with addiction treatment expenses outside of what your insurance will cover.
It’s important not to let costs of treatment deter you from getting help you need. Many alternative methods are available to help with addiction treatment expenses.
Akua Behavioral Health offers addiction treatment programs in a residential, community-based setting. Our clients stay in our home-like program, with 24-hour supervision to ensure their safety and comfort. Inpatient drug rehab gives clients the best chance at lasting recovery through highly-structured care for those struggling with drug, alcohol and/or their mental health.
Many clients stop experiencing withdrawal symptoms 3 to 7 days after starting our detox program. While the experience may vary due to various factors, Akua Behavioral Health is committed to providing our clients with safe and comfortable detox.
Akua Behavioral Health works with most major insurance plans to ensure quality addiction treatment is accessible for our clients.
Speak with your insurance provider to get more information. Cigna’s 24-hour phone line allows customers to connect with a member services professional who can provide the answers you need about your policy’s coverage.
AKUA works closely with most HMO, EPO and PPO insurance plans including AmeriHealth, Humana, Allcare Health, Highmark, UPMC Health Plan, and are In-Network with Anthem Blue Cross, Aetna, Cigna, HealthNet, Blue Cross/Blue Shield, Magellen, HMC Health Works, Tricare, Western Health Advantage, Prime, Multi Plan, Triwest, and more.