Understanding What Happens After Verification
Excellence Recovery is proud to be an in-network treatment center that accepts Cigna insurance for addiction and mental health services. Our team helps clients use their Cigna coverage to make high-quality care accessible, affordable, and stress-free from the very first step.
Cigna is one of the nation’s largest and most trusted insurance providers, offering extensive behavioral health and substance use treatment benefits. With millions of members worldwide and a strong focus on mental wellness, Cigna helps individuals and families access treatment options that fit their unique needs. Understanding how your Cigna rehab coverage applies can make beginning treatment easier and more affordable.
If you have an active Cigna plan, you may qualify for partial or full coverage of your treatment at Excellence Recovery. Our admissions team will verify your benefits quickly, explain your coverage in clear terms, and help you begin the recovery process without unnecessary delays or hidden costs.
Complete our confidential insurance verification form to learn more about your coverage. Our admissions team will contact you directly with your results and walk you through your next steps toward recovery.
Please note: Excellence Recovery does not accept Medicare or Medicaid.
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Understanding Cigna Insurance Coverage for Addiction and Mental Health Treatment
Cigna’s coverage for addiction and mental health care functions much like the rest of your health insurance benefits. Thanks to the Affordable Care Act, insurance providers are required to offer mental health and substance use treatment benefits that are comparable in scope and cost to other medical services under the same plan. This means that if you’re seeking treatment for depression, anxiety, or substance use disorders, you generally won’t have a separate deductible or entirely different coverage rules from your standard medical care.
While Cigna insurance can greatly reduce the cost of treatment, the exact amount covered will depend on your specific plan and the type of program you select. Coverage levels can vary based on factors like location, medical necessity, and whether the facility is in-network. Choosing a treatment center that accepts Cigna, such as Excellence Recovery, helps ensure your benefits are maximized and your out-of-pocket expenses remain as low as possible.
Some Cigna plans require preauthorization before covering certain types of care, including residential treatment or medication-assisted therapy. In these cases, a healthcare provider must submit documentation showing that treatment is medically necessary. At Excellence Recovery, our admissions team manages this process directly with Cigna on your behalf, so your coverage is verified quickly and your treatment can begin without unnecessary delays.
Understanding IOP and PHP Treatment Levels
Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs) provide structured, clinically supported treatment for individuals recovering from substance use or managing mental health challenges without the need for 24-hour residential care. These programs are ideal for people who:
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Need a higher level of support than standard outpatient therapy but do not require inpatient treatment.
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Are stepping down from a residential program and benefit from continued clinical guidance.
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Require flexible scheduling to maintain work, school, or family responsibilities while pursuing recovery.
Cigna recognizes the value of these treatment levels and often includes coverage for PHP and IOP services as part of its behavioral health benefits. This helps ensure that members have access to the right care at the right time, promoting long-term stability and lasting recovery.
What Does Cigna Typically Cover for PHPs and IOPs?
Cigna’s behavioral health coverage is based on medical necessity, meaning benefits are approved when treatment is considered essential for recovery or mental health stabilization. For individuals seeking care at Excellence Recovery, this often includes:
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Therapy Sessions: Individual, group, and family therapy designed to address substance use, emotional wellness, and long-term healing.
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Medication Management: Oversight by licensed medical professionals to safely manage withdrawal symptoms, medications, and any co-occurring mental health needs.
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Comprehensive Assessments: Initial evaluations and ongoing progress reviews to tailor each treatment plan to your specific goals and needs.
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Relapse Prevention Planning: Education and tools to strengthen coping skills and reduce the risk of relapse after treatment.
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Specialized Therapeutic Interventions: Evidence-based therapies focused on trauma, emotional regulation, and co-occurring disorders for more personalized support.
Preauthorization Requirements
Cigna may require preauthorization before approving coverage for certain levels of care, including Partial Hospitalization (PHP) and Intensive Outpatient (IOP) programs. This process helps confirm that treatment meets the plan’s medical necessity guidelines and prevents unexpected out-of-pocket costs.
Preauthorization usually includes:
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Clinical Documentation Submission: Your treatment provider submits a detailed plan explaining why PHP or IOP care is clinically necessary for your recovery.
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Approval Prior to Admission: After reviewing the documentation, Cigna issues authorization that specifies which services are covered and for what duration.
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Ongoing Progress Reviews: For continued treatment, updated clinical information may be required to confirm that extended care remains appropriate and beneficial.
At Excellence Recovery, our admissions and clinical teams handle this process directly with Cigna to ensure a smooth approval and quick start to your treatment.
Out-of-Pocket Costs for PHPs and IOPs
The cost of PHP or IOP treatment under your Cigna plan depends on your specific coverage details. While every policy is different, most members can expect costs to include:
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Deductibles: The amount you are responsible for paying before your Cigna coverage begins.
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Copays or Coinsurance: After meeting your deductible, you may owe either a set copay per session or a percentage of the treatment cost, depending on your plan.
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Out-of-Pocket Maximums: Once you reach your annual out-of-pocket limit, Cigna typically covers 100% of eligible treatment costs for the remainder of the year.
At Excellence Recovery, our admissions team will review your Cigna plan, explain these costs clearly, and help you understand exactly what your insurance covers before treatment begins.
Steps to Verify Cigna Coverage for PHPs and IOPs
Navigating insurance benefits can feel confusing, but understanding your Cigna coverage is an important first step toward starting treatment. Here’s how to verify your benefits for PHP or IOP care:
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Review Your Policy: Log in to your Cigna member portal to check your behavioral health and substance use treatment benefits.
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Call Cigna Directly: Use the customer service number listed on your insurance card to confirm what levels of care are covered under your plan.
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Contact Excellence Recovery: Our admissions team can verify your benefits on your behalf, explain your coverage in simple terms, and manage any preauthorization needed before treatment begins.
Taking a few minutes to verify your Cigna coverage can help you start your recovery journey with confidence and clarity.
How Do You Get Cigna Addiction Insurance Coverage?
Like many major commercial providers, Cigna offers health insurance plans through employers, the Health Insurance Marketplace, and certain Medicare Advantage programs. Here are the most common ways to obtain Cigna coverage:
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Through Your Employer: Many companies partner with Cigna to provide employer-sponsored health insurance. You can typically enroll during your initial hiring period or during your company’s annual benefits enrollment. With these plans, a portion of your premium is deducted from your paycheck before taxes, and your employer covers the remaining cost.
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Through the Health Insurance Marketplace: Cigna plans are available in many states through the Marketplace. During the yearly open enrollment period, you can compare available plans to find one that fits your health and behavioral care needs.
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Through a Medicare Advantage Plan: If you’re eligible for Medicare, you may choose a Cigna Medicare Advantage plan. These plans include all standard Medicare benefits and may offer additional coverage, such as mental health and addiction treatment services.
Cigna’s employer-sponsored plans often include strong behavioral health coverage, while Marketplace and Medicare Advantage plans may vary in the extent of addiction treatment benefits provided. Always review your plan details to confirm whether programs like PHP or IOP are included.
Understanding Cigna Drug Rehab Copays, Deductibles and Out-of-Pocket Expenses
No matter how you get your Cigna coverage, it’s important to understand potential out-of-pocket expenses as you consider treatment, including drug addiction treatment. Your exact expenses depend on your plan, your treatment providers, and the treatment options you choose. However, even after you find an outpatient alcohol rehab that is in-network with Cigna, you do need to look for these common expenses and understand how they might apply to you:
- Deductible. This is how much you must pay before your insurance starts paying any claims. Your deductible is for the calendar year and includes any covered substance abuse treatment, medical treatment or any other services your plan would normally cover. So, if you had inpatient treatment in the hospital for appendicitis in January, for example, anything you paid for that treatment would go toward your deductible. If you then sought substance abuse treatment in July, you might have already met the deductible. However, if you’re wondering, ‘Does Cigna cover inpatient alcohol rehab?’ and haven’t met your deductible, you’ll have to meet it before insurance coverage pays for any charges.
- Copay or coinsurance. This is how much you pay once you hit your deductible. Every plan has different copay amounts. The copay amounts for outpatient services might also differ from those related to inpatient options. Typically, you may owe a percentage of covered charges (as coinsurance) or a flat fee (as a copay).
- In-network vs. out-of-network providers. Some insurance plans cover more of the charges if you choose in-network providers. When considering healthcare providers for rehab needs, keep this in mind and look for providers that are in the network with your plan. For example, a plan might cover 80% of approved charges after the deductible if addiction treatment providers are in the network, but it may only cover 50% of approved charges if you receive addiction treatment from a provider that’s out of network.
Other factors that can affect the cost of addiction treatment when you have a Cigna insurance plan include:
- The nature of the treatment. For example, inpatient recovery options might cost more than outpatient treatment services overall. That can increase your coinsurance amount.
- The location of the addiction treatment centers you choose. Insurance companies typically do not cover transportation to and from treatment facilities, so it’s important to consider this when selecting from different treatment centers.
- Whether preauthorization or other requirements were met. In some cases, your insurance plan might require preauthorization or prior approval. This means a doctor or another provider orders treatment and sends that information to the insurance company. The insurance company approves the treatment tentatively, and without this approval, it will deny future claims for that treatment. Some Cigna plans do require preauthorizations. If you agree to treatment without the appropriate preauthorization, you might end up owing more than you planned.
Cigna considers PHP and IOP to be cost-effective treatments. Cigna typically covers these programs, and they often have lower copays and deductibles compared to inpatient treatment, making them a preferred option for many individuals. However, if your plan has a high deductible, you may need to cover more upfront before insurance begins to pay. Understanding these nuances can help you make informed decisions about your treatment path.
FAQs About Cigna Insurance for Rehab
If you have additional questions about your Cigna insurance coverage or how it applies to treatment at Excellence Recovery, our admissions team is here to help. We’ll walk you through your benefits, verify coverage, and make sure you understand every step before starting care.
Will Your In-Network Cigna Alcohol and Drug Rehab Policy Pay for Treatment at Excellence Recovery?
The best way to know how your Cigna insurance applies to addiction or mental health treatment is to verify your benefits today.
Excellence Recovery is a trusted, in-network treatment center in Arizona that proudly accepts Cigna insurance. Our team will review your coverage, explain your benefits clearly, and help you begin treatment with confidence. Don’t let concerns about cost delay your recovery — reach out to our admissions team and take the first step toward lasting change today.