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
In several cities in Tennessee, many treatment centers accept both Medicare and Medicaid. In several cities in Tennessee, many treatment centers accept both Medicare and Medicaid. Medicare is the US federal healthcare plan for people who are ages 65 and older. Medicaid, however, is the US federal healthcare plan for those who are economically disadvantaged. Although Medicare and Medicaid aren’t for everyone, these options can help those who aren’t covered through private insurance.
Information on Medicare
Medicare, the federal health insurance program, serves the following people. Medicare serves those who are 65 or older, some younger people who have disabilities, and people who have End-Stage Renal Disease (ESRD). ESRD is permanent kidney failure that requires dialysis or a transplant. Further, Medicare’s services come in four distinct parts. Here are the four parts:
- Hospital Insurance, Medicare Part A
- Medical Insurance, Medicare Part B
- Medicare Advantage, or all-in-one coverage, Medicare Part C
- Prescription drug coverage, Medicare Part D
To help you better understand Medicare, we will further explain these services.
Medicare Part A
Part A is hospital insurance. Therefore, Part A covers care in a skilled nurse facility (such as an assisted living center), hospice care, inpatient hospital visits, and home healthcare in some situations.
Medicare Part B
Part B is medical insurance. Consequently, Part B covers outpatient care, some doctors’ visits, medical supplies, preventative services, and some doctors’ services.
Medicare Part C
Part C is a combination of Part A, Part B, and (most of the time) Part D. This means that those covered by Part C have access to hospital care, medical care, and prescription services.
Medicare Part D
Part D covers prescription drug coverage. This means that those covered by Part D can receive their medications at a lower cost than they normally are.
Information on Medicaid
Millions of people in the US receive healthcare through Medicaid. Primarily, Medicaid serves those who are economically disadvantaged. People with disabilities, pregnant women, children, and adults can all receive coverage from Medicaid. Through Medicaid, people can receive care who would not otherwise have the means to do so. States administer Medicaid, and the program is funded by states and the federal government.
Coverage of Inpatient, Outpatient, and Residential Treatment
Although there are no specific benefit categories for addiction treatment, Medicare covers those types of services when providers deem the services reasonable and necessary. Therefore, Medicare could potentially cover inpatient, outpatient, and residential treatment. Further, Tennessee’s Medicaid also covers addiction treatment for adults with alcohol or drug dependency. Medicaid’s coverage includes outpatient and residential services, among other treatments.
Here is some information about the difference between outpatient, inpatient, and residential treatment. Outpatient treatment is part-time, usually between 10 to 12 hours a week, meaning that the recovering user comes to the facility, but they do not stay in the facility. These programs usually run between three months to one year. Ultimately, outpatient treatment is right for those who have more mild addictions.
Inpatient treatment means the person stays at a facility for a period of time—usually between three weeks and six months. While staying at the facility, they undergo intensive treatment. Inpatient treatment has a higher success rate than outpatient treatment, but it is also more expensive. Further, inpatient treatment interrupts daily life. Ultimately, inpatient treatment is especially effective for those who have undergone serious addictions.
Residential treatment means that patients live in a residence with other patients. Treatment staff transports the patients to the treatment center each day. In this way, they experience the benefits of both inpatient and outpatient treatment. Residential treatment is best for those who want to keep their treatment and living areas separate, but they still want to separate themselves from their toxic environments.
How to Find Information
Substance abuse treatment options are commonly found in behavioral and mental health sections of insurance company websites. If you are looking for a specific facility, check your insurance company’s website to make sure the provider is covered by your plan. Many facilities in Tennessee offer payment assistance and/or offer their services on a sliding fee scale.
More Information About Cigna Insurance Options
If you live in Tennessee and are covered by Cigna, you may find the addiction treatment you need. To review, 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.
Further, those who do not have insurance through Cigna can find help through either Medicare or Medicaid. In summary, Medicare is federal healthcare. Further, Medicare covers those over the age of 65, as well as certain people who have disabilities. Also, Medicare covers those who have ESRD. Therefore, Medicare can be a good option for people who fall into those categories. Additionally, Medicaid is a federal program designed to serve people who are economically challenged. Therefore, people who have severe financial constraints may qualify for Medicaid.
Another element of insurance to be aware of is the types of plans offered. Most insurance companies offer a Health Maintenance Organization (HMO) plan or a Preferred Provider Organization (PPO) plan. HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. However, PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of the network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan. Clearly, you have a lot of options when it comes to deciding which method of payment is right for you. If you would like more information about HMOs, PPOs, or Cigna insurance, please call us today. Contact us at 901-403-7925.