Cigna is one of the largest insurance providers in the United States, serving more than 170 million people worldwide. In the United States, the company delivers private and employer insurance to 20 million Americans, meaning 1 in 14 Americans has Cigna health insurance. The company also delivers a wide network of hospitals and recovery centers, meaning you’ll have plenty of choice in terms of where to go for your HMO plan. Cigna also provides plenty of coverage for mental health and rehab services across the United States, and as a national provider, can also help you to go to out of state rehab.
Compassion Recovery is an in-network mental health treatment center and rehab center for Cigna Insurance. That means you can attend one of our inpatient or outpatient programs and receive maximum coverage based on your plan. If you’d like to know more, keep reading, or call us at 909-314-1097 for a consultation.
Cigna insurance covers every aspect of physical and behavioral health. That holds true whether you have a plan through your employer or have your own private policy. However, Cigna has a policy that means you’ll be recommended to the minimum level of care first, after which you can escalate care if that doesn’t work. This means you’ll be pushed into an outpatient program first and only moved into an inpatient program if you follow the program and don’t show recovery.
Cigna offers full coverage for substance abuse and substance use disorders. However, it has an evaluation process and recommendation for level of care (LOC).
From this, Cigna will offer a recommendation for treatment with a Level of Care or LOC. That Level of Care will inform you what Cigna will cover as part of its program. Of course, if you have court-ordered or doctor-ordered treatment, you will be able to skip this step.
Cigna also offers follow-up case management services where needed. You can also get personalized coaching and support programs, although these are typically only available through employer-provided insurance programs. Finally, Cigna will work with you to ensure that you move into local and community support programs.`
Cigna’s approach to mental health is very similar to its approach to substance abuse treatment and the two are mostly rolled into a single category in your insurance. Here, you’ll want a referral from your doctor. You’ll also need an evaluation to determine level of care. From there, you’ll be recommended into an inpatient or outpatient program depending on your history of treatment. Here, you’ll get treatment for most kinds of mental health treatment.
Essentially, if your doctor recommends the therapy and the Cigna evaluation shows it to be necessary, you can get any treatment you need with Cigna.
Cigna fully supports and offers coverage for dual diagnosis programs. For example, the dual diagnosis program at Compassion Recovery offers a track that treats both mental health disorders and substance abuse or substance use disorders at the same time. This allows the treatment track to adjust based on need, to treat issues getting in the way of progressing with treatment, and to take a holistic approach, rather than simply trying to solve a single issue such as substance abuse.
Cigna rolls mental health treatment and substance abuse treatment under the same umbrella of therapy, which means it’s easy for you to get into a dual diagnosis track. However, again, you’ll be recommended based on doctor diagnosis, your Cigna evaluation, and the approach of starting with the minimum recommended care first and only stepping that up if it’s necessary.
Cigna uses a somewhat unique approach to mental health treatment and substance use recovery treatment costs. Here, it charges the same rates whether you’re attending an inpatient or an outpatient program. This means you won’t pay extra fees or have higher deductibles or higher maximums for attending an inpatient rehab program with Cigna. However, to enable this, Cigna heavily involves itself in what types of recovery treatment you can go to. It starts every treatment program with an evaluation program and puts you into the lowest possible care for your needs and then steps that up if the initial treatment is not successful. This means that you’ll always start with an outpatient or intensive outpatient or partial hospitalization program and only step up to an inpatient program if you don’t succeed with the initial program.
Cigna uses a standard metal-based system with a Bronze-Platinum level system, your choice of PPO or HMO, and copays and coinsurance.
Bronze – You pay 40%
Silver – You pay 30%
Gold – You pay 20%
Platinum – You pay 10%
Aetna covers dual diagnosis treatment, which means you can easily seek out a program like the one at Compassion that roles everything you need into one program. In addition, because Aetna doesn’t cap the number of days you’ll receive reimbursement for treatment like many competitors, you can stay in the program for as long as you need, without worrying about costs increasing.
In practice, that works out to:
Bronze – $5,500 deductible per person/$11,000 deductible per family. You pay a 50% coinsurance for inpatient or outpatient treatment. Out of network providers are not covered.
Silver – $5,500 deductible per person/$11,000 deductible per family. You pay a 25% coinsurance for inpatient or outpatient treatment. Out of network providers are not covered.
Gold – $500 deductible per person / $1,000 deductible per family. You pay a $65 copayment per visit before deductible for outpatient office visits. You pay 30% coinsurance + deductible for inpatient and outpatient services.
Platinum – $0 deductible for in-network treatment/ $12,500 individual deductible for out-of-network treatment. You pay $20 per office visit for outpatient care and a 10% copayment for inpatient care. You pay a 50% deductible for out-of-network treatment.
In each case, you’ll pay the cost of the deductible first and then Cigna will start paying its portion of the fee. So, if you’re going to a rehab program with a Cigna Bronze plan, you’ll pay the first $5,500 out of pocket, after which you’ll only pay 50%.
Compassion Recovery is fully in network for Cigna Insurance. This means you can attend a Cigna rehab or mental health treatment program to receive maximum coverage from your plan. However, it’s important to keep in mind that you’ll still need a referral from your doctor and an evaluation from Cigna.
Once you have that, you’ll have coverage based on your Level of Care (LOC) recommendation. E.g., that normally means you’ll get coverage for an intensive outpatient program, potentially with an outpatient detox program. However, Compassion can work with your insurance provider to ensure that we recommend the adequate level of care for your needs as you move through the program as well.
Cigna has an evaluation process for mental health and rehab treatment. This means you’ll have to follow the process to get coverage:
Cigna’s process means you’ll have less freedom to choose the specific treatment you want. However, that can offer you more financial freedom, because you’ll get more coverage if you end up needing inpatient treatment.
If you or a loved one needs help, we’re here to help. Contact us today for a free consultation or for help with your insurance.
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