Rehab Centers That Accept Cigna Insurance

Figuring out how you’re going to pay for rehab can be one of the most stressful parts of starting addiction treatment. If you have insurance, the cost of care may be much less than you think.

Cigna is one of the largest insurance providers in the country, and most plans cover at least part of the cost of treatment for substance use disorder. If you have a Cigna insurance plan, understanding what your policy covers and how cost-sharing works can give you a more accurate idea of how much rehab may cost.

Cigna is a top insurance company in the United States, with 16 million covered domestically and more than 185 million customer relationships worldwide. The majority of its policies are employer- and group-sponsored plans, but it also offers individual and family plans on the Health Insurance Marketplace.

Those with Cigna insurance may have:

• Health Maintenance Organization (HMO) plans
• Preferred Provider Organization (PPO) plans
• Exclusive Provider Organization (EPO) plans
• Point of Service (POS) plans

The type of plan you have impacts what type of substance use treatment is covered, whether you have to see an in-network provider and how much you pay out of pocket.

Treatment for substance use disorder is one of the essential health benefits covered by the Affordable Care Act (ACA) and governed by the Mental Health Parity and Addiction Equity Act (MHPAEA). This means that Cigna Marketplace plans must cover substance abuse and behavioral health. Off-Marketplace plans must cover these treatments the same way they would cover traditional medical care.

How much of the treatment cost will be covered depends on your plan and other factors, such as whether the rehab is in network and whether you’ve met your deductible for the year. Your Summary of Benefits explains how cost-sharing for substance use and behavioral health benefits works, and you can call the member service number on the back of your card to verify your benefits for a specific rehab or treatment.

Every person has unique needs when it comes to addiction treatment, and many people end up receiving a variety of services throughout their recovery journeys. Cigna health insurance covers many, but not all, of these services.

Medical detox takes place in an inpatient setting, often at a hospital or medical clinic, and provides 24/7 monitoring and support as you go through withdrawal. Your care team may use medications and other supports to manage withdrawal symptoms and cravings as your body finds a new baseline.

Cigna plans may cover medical detox services for those who have other health complications, have severe substance use disorder or are dependent on certain substances, such as alcohol, opioids or benzodiazepines. For Cigna to cover these services, you may need a face-to-face assessment conducted by a licensed care provider who can submit an authorization request.

Many Cigna plans also cover medication-assisted treatment (MAT). MAT is a service that uses medications approved by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder and alcohol use disorder. MAT for opioids may also be called medications for opioid use disorder (MOUD).

MAT is considered part of substance use disorder treatment, so it falls under the MHPAEA requirements to be covered the same as other medical benefits. Depending on your plan, Cigna may cover all or part of the cost of MAT.

Inpatient rehab provides 24/7 care in a designated facility for a specific length of time, often 30, 60 or 90 days. This higher level of care can result in a higher cost.

The ACA requires Cigna Marketplace plans to cover inpatient rehab as an essential health benefit, and most employer-sponsored plans also offer some coverage for inpatient treatment. You may need to meet your deductible before insurance kicks in, and precertification may be required.

For many people, alcohol and drug addiction often occurs alongside mental health disorders, which is called a dual diagnosis. Dual-diagnosis services treat SUDs and co-occurring mental health disorders at the same time.

How much Cigna plans cover depends largely on whether dual-diagnosis care happens in an inpatient or outpatient setting. Other potential factors include whether the facility is in-network or out-of-network and whether you’ve met your deductible. As with other types of addiction treatment, you’ll need pre-certification before admission.

Outpatient treatment programs for addiction can range from once-a-week services to higher levels of care, such as intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs). How Cigna covers outpatient treatment for substance use disorder depends on the specific services and the level of care.

Standard outpatient services, such as individual counseling and group behavioral therapy, generally don’t require prior authorization. However, depending on your plan type, you may be limited to in-network providers. IOPs and PHPs are considered a higher level of care and may require precertification before you can access coverage.

Counseling and behavioral therapy, such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), are common in many addiction treatment programs. The majority of Cigna health insurance plans cover counseling and behavioral therapy due to requirements under the ACA and MHPAEA.

Most plans have a co-pay requirement for outpatient therapy. Every time you have a session, you pay the co-pay, and the insurance covers the rest. Therapy that happens in an inpatient setting is often covered under the program as a whole.

Choosing continuing care services, such as support groups or sober living facilities, can help you maintain your sobriety after you’ve graduated from rehab. While some services, such as peer support groups, don’t require payment, others do.

Some Cigna plans may cover some continuing care services, such as ongoing outpatient therapy, but they generally don’t cover anything that isn’t medically necessary, such as sober living.

Several factors can affect the amount of coverage Cigna provides for drug and alcohol addiction treatment, including:

• The type of plan you have. If you have an HMO or EPO plan, you’ll be limited to in-network providers if you want to use insurance. PPO and POS plans offer more flexibility.
• Where you live. Your location affects both the types of Cigna plans available to you and the rehabs that are convenient for you to attend.
• The kind of care you need. Higher levels of care are more expensive, but your insurance may also cover a larger percentage to offset your out-of-pocket costs. Outpatient office visits usually only require a copay.
• Specific requirements from your plan, such as prior authorization. If you need prior authorization, a healthcare provider must submit the pre-certification request before admission for coverage to apply.
• How cost-sharing is set up. How much of your bill Cigna covers depends on whether you’ve met your deductible for the year and your copay and coinsurance requirements.

Contacting both Cigna and the rehab you’re considering can help you better understand how these factors apply to your specific situation.

Some Cigna plans, such as PPO and POS plans, provide limited out-of-network benefits. HMO and EPO plans generally cover out-of-network care only in a medical emergency.

Always check your specific plan to determine if you’ll receive coverage for out-of-network rehab programs. If you choose to see an out-of-network provider, your out-of-pocket costs will be higher, even if your plan does offer some coverage.

Depending on where you’re getting your plan, you may have access to a few options through Cigna. Certain plans have higher premiums, while others have higher deductibles. What’s right for you will depend on your health history and anticipated future needs.

Cigna plan options include:

• Preferred Provider Organization (PPO) plans have higher premiums than other plans, but they offer some out-of-network care.
• Health Maintenance Organization (HMO) plans usually have some of the lowest premiums, but they typically don’t offer out-of-network coverage, and you may need a referral to see a specialist.
• Point-of-Service (POS) plans require you to have a primary care physician and may require a referral to a specialist, but they offer limited out-of-network coverage.
• Exclusive Provider Organization (EPO) plans only cover in-network care, but you usually don’t need a referral.
• High-Deductible Health Plans (HDHPs), usually paired with a Healthcare Savings Account (HSA), have high yearly deductibles, but you can contribute pretax dollars to an HSA to use for medical expenses.

If you have a Cigna plan from the Marketplace, it will be one of four tier levels based on coinsurance amounts after you’ve met your deductible:

• Bronze: Your plan will pay 60%, and you’ll pay 40%.
• Silver: Your plan will pay 70%, and you’ll pay 30%.
• Gold: Your plan will pay 80%, and you’ll pay 20%.
• Platinum: Your plan will pay 90%, and you’ll pay 10%.

The higher percentage your plan pays, the more you’ll pay in your premium. Deductibles, co-pays and out-of-pocket maximums vary by plan within each metal level.

Cigna’s insurance coverage for substance use and behavioral health treatment isn’t determined by what kind of substance you use. It’s based on whether you have a medical diagnosis and meet the requirements for medical necessity.

Substance use disorder can refer to many substances, but some of the most common include:

• Alcohol
• Cocaine
• Meth
• Heroin
• Benzodiazepines
• Opioids
• Prescription drugs

Gambling use disorder is also a recognized diagnosis for behavioral health treatment. Other process addictions, such as shopping or sex, aren’t officially recognized by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). For insurance to cover these other behavioral addictions, you’ll need another relevant mental health diagnosis.

The best way to find treatment facilities that accept your Cigna plan is to log in to your Cigna account, click “Find A Doctor,” enter your location and search for “addiction” or “substance abuse.” You’ll be able to see all centers that accept your plan, and you can visit their websites to learn more about care types and treatment philosophies.

If a healthcare provider or loved one recommends a rehab facility or you find one on your own, you can call the center to find out if they accept Cigna and verify your benefits. RehabNet.com also has a list of addiction treatment centers by state, with information on accepted insurance for each facility.

*Note: Cigna is no longer participating in the Health Exchange Marketplace after the 2026 benefits year.

Having a Cigna health insurance policy can help cover the cost of substance abuse treatment and reduce some of the worry about affording care. If you’re ready to take the first step in your journey toward recovery, call our helpline today to find an addiction program covered by Cigna near you.