When you know you’re ready for addiction treatment, one challenge may be knowing how to pay for treatment. While it is impossible to make generalizations about every person’s circumstances, we can still help. We want to provide you the information you need so that you can make the best decision for yourself. On this page, we want to specifically help you learn about your options if you have Cigna insurance. If you have more questions about insurance and addiction treatment, please call us at 901-403-7925.
Cigna Insurance Plans
Cigna insurance prioritizes its clients’ mental health and health needs. Ultimately, Cigna operates according to its core values. For example, a few of the values include caring deeply about customers, keeping promises, innovating for a better future, and acting with purpose. Further, Cigna serves 74,000 people throughout the United States.
On Cigna Connect Network, your benefits will depend on your level of coverage. For example, the best level of coverage comes with Gold plans. Gold plans often have minimal deduction prices, but they also have high monthly payments. Further, addiction treatment coverage looks different for inpatient and outpatient treatments. For example, some Gold plans may provide outpatient treatment with a low payment, such as $60. However, inpatient treatment would come with 30% coinsurance. Coinsurance is a type of insurance that a share of the payment made against a claim. In this case, the person receiving treatment would pay 30% for that treatment.
Next, average coverage comes with Silver plans. In many Silver plans, clients will pay a combination of coinsurance and deductibles. For example, through a Silver plan, a client might pay a $10 copay for their first visit at an outpatient treatment center. From there, they might pay a 15% coinsurance of all the following appointments. For inpatient treatments, they will likely pay 15% of coinsurance for the entire treatment program.
Finally, Bronze plans offer the lowest coverage. For example, a Bronze plan may have clients paying 50% of coinsurance for both inpatient and outpatient treatment. As you can see, each of the plans offers a different level of coverage. However, regardless of which plan you choose, Cigna only offers services for treatment centers that are within the network. However, all three of these plans offer addiction treatment. Each plan’s mental health, health, and substance abuse sections have information on what they offer. Coinsurance, copays, or deductibles may apply to each service.
Medicare and Medicaid in Tennessee
Several treatment centers in Tennessee will accept Medicare and Medicaid. They are both US federal healthcare plans. Medicare is designed for individuals ages 65 and older. But Medicaid is for people who have disadvantages economically. These plans are put in place for individuals who are unable to use private insurance as coverage.
Information on Medicare
Traditionally Medicare is for people who are 65 years old in age and older. However, younger individuals can use Medicare if they fall into certain categories. Such as a disability or the condition of End-Stage Renal Disease which requires a transplant of a permanently failed kidney. Therefore, if you qualify to use Medicare then you need to decide what service you want to use. It is broken down into four categories:
- Part A: Hospital Insurance
- Part B: Medical Insurance
- Part C: Medicare Advantage (all-in-one coverage)
- Part D: Prescription drug coverage
Each part of the Medicare health plan is broadened down below. We hope to help you understand how these services can benefit you and which one you believe is the best fit.
Medicare Part A
Hospital Medicare Part A insurance will cover the care given to you in skilled nurse facilities. This means your assisted living center will be covered along with any hospice care needed. It is even covered for your family to come and visit you at an inpatient hospital. If you are receiving home healthcare, Medicare Part A can cover that as well based on the situation.
Medicare Part B
This part of the Medicare plan is called medical insurance. Part B will cover the outpatient care needed, along with preventative services, and medical supplies. Even some doctor’s services and visits can be partially covered by this plan.
Medicare Part C
Medicare Advantage Part C is an all in one coverage of previous parts A, B, and usually part D down below. This means if you chose to have Medicare Part C as your insurance plan then you will have coverage over your hospital care along with your medical care and prescription services.
Medicare Part D
The final part and option of Medicare Insurance cover prescription drug medication. This way individuals can still buy their prescriptions but at a reduced and affordable price.
Information on Medicaid
Medicaid serves those who are economically disadvantaged and who would not have the means to have health insurance. This includes millions of individuals such as children, people with disabilities, adults, and women who are pregnant. Medicare is federally funded by the government and then administered throughout the country by the states.
Coverage of Inpatient, Outpatient, and Residential Treatment
Unfortunately, your Medicare provider determines if your addiction treatment is worth covering. Therefore, if you want to consider care such as inpatient or outpatient services check with your provider first to see if they would be covered. But Medicaid would cover aspects of addiction treatment such as these services for alcohol and drug addiction.
Outpatient treatment is where you attend a care facility part-time. This can be a great compromise for those who can not leave their work, school, or home life to attend treatment. Therefore, you can work around your schedule and still attend treatment a couple of hours each weekday. You can receive this care anywhere from three months to a year depending on your addiction and commitment to attending.
There are facilities and clinics that specialize in treatment for inpatient care. This means that patients stay on location and are treated daily for their addiction. The time period lasts differently for each patient, it could be 21 days or it could be a couple months. Regardless, while staying here patients receive tailored treatment that is more expensive than outpatient treatment. However inpatient therapy and treatment has high success rates.
The concept of residential treatment is very similar. The difference is that the stay is longer and the location is different. Residential means that patients with similar drug or alcohol struggles get to live in residence together with trained medical staff. By living together, patients get to leave their previous home lives and focus solely on healing from their addiction. Each residential center either has treatment on-site or the staff takes all the patients to a treatment center. This benefits both aspects of inpatient and outpatient treatment.
How to Find Information
Most centers in Tennessee offer assistance when it comes to paying for treatment. However, even if you have a center who is willing to provide you a sliding fee scale it is better to check with your insurance first. Under your Medicare or Medicaid insurance website there should be a list of substance abuse treatment centers that are covered.
More Information About Cigna Insurance Options
If you live in Tennessee and are covered by Cigna, you will eventually find the treatment for your addiction. It might take time but there is a treatment center covered by your insurance that will be the best fit for you. Cigna offers Gold plans, Silver plans, and Bronze plans. Although each of these plans covers addiction treatment, copayments and coinsurance depend on which plan you have. For example, those with Gold plans likely pay the highest monthly payment, but they have the lowest copay and coinsurance prices. Contrarily, a Bronze plan would require the lowest monthly payment and the highest copays. When deciding which treatment center is right for you, be sure to look into whether your rehab is in-network. Cigna only covers in-network rehab centers. Overall, Cigna provides more coverage for addiction treatment than many other insurance companies do. If you do not think Cigna is the right fit for you, then you can look into the options that Medicare and Medicaid provide.
When it comes to insurance, there are usually additional plans offered inside each type of insurance. The most popular and common options are called the Health Maintenance Organization plan (HMO) and the Preferred Provider Organization plan (PPO). The plans vary in cost and flexibility in choosing providers. For example, HMO has a cheaper monthly premium but you have to pick a provider from their list. PPO allows their clients to choose providers that are in-and-out of network without referrals. But the caveat is that it has a more expensive monthly premium. It all depends on what you want and are comfortable with. Insurance can be a tricky situation, therefore we want to offer our services to you. If you have questions or concerns regarding insurance or PPO and HMO plans, don’t hesitate to call us. We can be reached at 901-403-7925.