Outpatient Treatment With Cigna Rehab Coverage
Residential treatment is the most comprehensive, but it’s not an option for everyone. You may need to enroll in outpatient treatment if you can’t get time off from work to go to a residential treatment center, for example. Outpatient treatment may also be appropriate if you have a lot of support from your family and friends. Your Cigna health insurance plan may pay for outpatient therapy, medications to help you with opioid addiction and other services provided on an outpatient basis.
Inpatient Treatment With Cigna Rehab Coverage
Cigna pays for both inpatient and outpatient treatment, but your out-of-pocket costs will vary based on the details of your plan. According to the National Institute on Drug Abuse, treatment outcomes vary based on the length of the treatment. Residential treatment is appropriate if you need several weeks of intensive treatment before transitioning to outpatient therapy and other services. You may also need residential treatment if you currently live with people who make it difficult to abstain from alcohol, illicit substances or prescription medications.
Determining Medical Necessity
Regardless of whether you want to seek outpatient treatment or stay at a residential treatment facility, your Cigna coverage will only pay for services that are considered medically necessary. Cigna, like other health insurers, relies on the ASAM criteria, a set of objective guidelines for determining if a service is medically necessary based on the patient’s medical and psychological needs. Rather than covering the same set of services for every patient, Cigna uses the ASAM criteria to determine if a specific service is appropriate based on an individual patient’s circumstances.
When determining if a treatment is medically necessary, Cigna representatives check to make sure the treatment is offered based on accepted standards of practice and is clinically appropriate based on the patient’s diagnosis. Cigna doesn’t cover services that are performed primarily for the doctor or patient’s convenience.