Cigna Insurance Coverage for Drug and Alcohol Rehabilitation

Cigna is one of the most common insurances used at rehabilitation centers nationwide. There are many different aspects to work through as you navigate how to find the best possible treatment, at the lowest price. That’s where we come in. Although becoming familiar with insurance policies and benefits may come across as confusing at first, it’s quite simple with the right experts to walk you through your benefits. We have a team of people ready to help you and guide you through the entire process. Keep reading to learn more about what your Cigna insurance covers for drug and alcohol rehabilitation. 

Does Your Policy Cover Rehab?

Our team of specialists are ready to walk you through every step of the way. Cigna insurance will help you pay for a variety of costs associated with you or a loved one’s drug and alcohol treatment program. Often, mental health concerns are also a part of the equation. When it comes to drug and alcohol addiction, there is often a mental health disorder that gets diagnosed as well. This is also known as a dual-diagnosis. Your insurance will cover different parts of treatment depending on your policy. 

Cigna Insurance for Drug and Alcohol Treatment

Coverage for drug and alcohol treatment varies based on the policy. Cigna’s lowest plan – bronze – provides lower premiums, however, individuals may have to account for deductibles and out-of-pocket expenses. When it comes to gold or platinum plans, you receive more comprehensive coverage with lower deductibles.

In concerns to substance abuse treatment, the services insurance covers and the expenses you will be accountable for are reliant on the type of plan and the state you live in. You can talk to one of our specialists today to go over exactly what your plan covers. 

Policy Coverage for Substance Abuse with Cigna Insurance

In the majority of situations, Cigna will need prior approval, or pre-authorization, for substance use treatment. Without this prior approval, patients may need to pay the entire cost of treatment out-of-pocket. That’s why it’s important to make sure that the treatment center you’ve selected is pre-authorized by Cigna. Fortunately, here at Amethyst, we are authorized by Cigna. Keep in mind that individuals may also be required to pay a deductible.

Typically, Cigna offers coverage for outpatient and intensive outpatient programs, residential (inpatient) programs, and partial hospitalization programs (PHPs).

Cigna Policies Work for Addiction Treatment Centers

Our in-depth view of your policy and the benefits it covers will include:

  • What kind of rehabilitation you’re eligible for
  • Length of program that you’ll be able to attend
  • Level of Care

By allowing us to provide you with a thorough review of your Cigna coverage, we can make the most of your benefits. A lot of the people we assist in this review had no idea of the potential their Cigna drug rehab coverage had for alcohol and drug rehab because of what they were told by Cigna directly or any other misconceptions about their benefits. 

Unfortunately, we have seen people check into a drug abuse treatment program because they were told that their Cigna insurance covers the addiction program, only to see the individual become responsible for claims that were not approved by the insurer. With us, you’ll know all of your options with full transparency. 

Cigna Covers Inpatient and Outpatient Treatment

Addiction treatment is often considered as a residential or inpatient process. However, you or a loved one can also go through an outpatient program for addiction rehabilitation. The choice between an inpatient or outpatient treatment will depend on the unique situation. For example, an individual who lives in a home where drugs or alcohol are constantly present may find it more helpful to go to a residential facility. An individual who has outside obligations such as taking care of a child or school may be better suited for an outpatient program.

Cigna plans may provide coverage for both inpatient and outpatient treatment programs. However, pre-authorization may be a requirement to ensure that the company will account for the cost of treatment.

Costs and Services at Inpatient Rehab

Inpatient programs provide the highest level of treatment care, with medically supervised detoxification and 24/7 supervision. Below are some of the typical terms used when becoming familiar with your health plan coverage:


Your health insurance plan premium is the payment you make to your health insurance company that keeps your coverage active.

Out-of-Pocket Maximum

The largest amount you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan will take care of 100% of the costs of covered benefits. The out-of-pocket limit doesn’t include your monthly premiums.

Policy Effective Date

This is the day your insurance company starts to help you take care of your health care expenses. Open enrollment period is typically a set amount of time that occurs once a year, or during a special enrollment period. Your policy effective date is agreed upon after you’ve enrolled, and generally takes place a few weeks or months after the date of your official enrollment. 


This is the amount you pay for covered health care services in a given plan year before when your insurance will start to pay for them. Let’s say you have a $2,000 deductible. In this case, you pay the first $2,000 of covered services yourself. After you pay your deductible, your provider will typically pay for the remaining costs.


A copayment is a cost that your health insurance plan requires you to pay to receive a specific medical service or supply. For example, your health insurance plan may require a $15 copayment for pharmaceutical medicine. 

Below are the plans available with Cigna – the benefits vary within each one:

  • Bronze Plan – Holds the minimum deductible amount for in-network providers. Out-of-network Providers tend not to be covered.
  • Silver Plan – In most cases, a coinsurance percentage in addition to the deductible for in-network. Coverage is generally not included for out-of-network.
  • Gold Plan – Theses plans also require a coinsurance percentage (generally this is a lesser amount than that of the lower level plans), as well as a deductible. As the plans above, out-of-network providers are also not covered.
  • Platinum Plans – Any in-network provider services will have one or the other- copay per day (with a maximum daily amount) or coinsurance percentage. There are some instances in which out-of-network services are covered. If out-of-network is covered, it will include a higher coinsurance percentage including the deductible.

Cigna Coverage for Mental Health Treatment

Addiction and mental illness go hand in hand most of the time. Although some may think that an addiction is merely a physical pain, the truth is that users are often struggling with their emotional and mental well-being. The mental illness can take over, making you or a loved one feel like there is no hope. Many times, these co-occurring disorders can even turn into severe issues in the lives of those close to them. Fortunately, there are dual diagnosis treatment programs that offer help to those who have co-occurring disorders.

Clinical professionals can help patients safely detox from drug or alcohol use, walking them through the withdrawal process with expertise. However, those who are suffering from a substance use disorder combined with a mental health concern should undergo treatment that focuses on both issues. Dual diagnosis treatment offers individuals professional care that deals with substance abuse including mental health.

Cigna is here for you and your loved ones when it comes to mental health. Once we do a thorough review of your policy, we’ll see what the best treatment program for you can offer. You must get a review from us because our team of specialists has gone over hundreds of different patient’s insurances. This means that we know how to make sure you get the most out of your benefits. Sometimes going through insurance can be misleading, which we like to avoid upfront.

Walking You Through Your Cigna Benefits

Here are some other benefits as a Cigna policyholder with our facility:

  • We’ll do an in-depth review and take you through your Cigna health insurance plan.
  • We’ll help you determine if you are covered for substance abuse treatment.
  • We’ll help decide what kind of treatment and how much is covered.
  • Cigna health insurance is accepted by almost every treatment center in the U.S., so we’ll go through which ones will work best with your policy.

Amethyst Is Here for You

Here at Amethyst, we care about our patients. It is our priority to make this process as smooth as possible for you. Insurance can be a complex topic, but we like to simplify it. Making sure you get the most out of your policy and benefits is crucial. Give us a call at 888.447.7724 or contact us here, and let us take the first step with you on the road to recovery. 


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