Cigna Insurance Coverage for Drug and Alcohol Rehab

Alcohol is one of the most commonly treated substances in rehab programs. 

Coverage often includes detox, inpatient or outpatient care, and ongoing therapy. 

Because alcohol withdrawal can be dangerous, medically supervised detox is usually considered necessary.

This includes substances like fentanyl, heroin, oxycodone, hydrocodone, and other prescription painkillers. Detox and medication-assisted treatment (MAT) like buprenorphine or Suboxone may also be covered.

Given the current opioid epidemic in Tennessee, many plans support multiple levels of care for opioid use disorder.

Benzodiazepine addiction can be particularly dangerous due to the risk of severe withdrawal symptoms. 

Drugs like Xanax, Ativan, Klonopin, and Valium can lead to severe withdrawal symptoms. Medically supervised detox and long-term therapy are often approved under Cigna.

Substances like Adderall, Ritalin, methamphetamine, and cocaine are also covered, with therapy-based approaches often recommended for these types of addictions.

Many individuals use more than one substance, and Cigna policies recognize this. Treatment plans tailored to multiple substance dependencies are typically included in coverage.

In addition to addiction-specific treatment, Cigna also covers care for co-occurring mental health disorders—an approach known as dual diagnosis treatment. 

Integrated care gives individuals the best shot at long-term recovery by addressing the mental health and substance use components at the same time.

Not every rehab facility is part of Cigna’s official provider network—and that’s where the term “out-of-network” comes into play. 

An out-of-network rehab is simply a treatment center that doesn’t have a contract with your insurance provider. That doesn’t automatically mean you can’t go there. 

In fact, depending on your Cigna plan, you might still get some of the costs covered.

If you have a PPO (Preferred Provider Organization) plan through Cigna, you’ll likely have out-of-network benefits. That means Cigna may reimburse part of your treatment costs even if you choose a rehab facility that isn’t in their network. 

However, you’ll probably have a higher deductible and more out-of-pocket responsibility than you would with an in-network provider.

For those with HMO or EPO plans, out-of-network care is rarely covered unless it’s an emergency. That said, there are sometimes exceptions, especially if you can demonstrate that a particular program offers care that’s not available in-network.

If a treatment center doesn’t have a contract with BCBS TN, it’s then considered out-of-network. 

That doesn’t always mean it’s off-limits—it just affects how much your insurance will pay and what your out-of-pocket costs may be.

Even with insurance, most people still want to know what rehab will actually cost. The answer depends on a few key pieces of your insurance plan:

• The deductible is the amount you pay out-of-pocket before your insurance starts covering treatment. For example, if your deductible is $1,500, you’ll need to cover that amount before your plan contributes.
• Once you meet your deductible, you may be responsible for paying a percentage of the treatment costs, known as co-insurance. A common coinsurance rate is 20%, meaning Cigna pays 80% and you pay 20%.
• Some plans charge a flat fee (copayment) for services, such as $25 per therapy visit.
• Your out-of-pocket maximum is the maximum you’ll pay in a year before insurance covers 100% of services. It offers peace of mind if you need extended care.

Many people end up paying less than they expect, especially when they verify their benefits ahead of time. 

Tulip Hill’s admissions team can help you understand your Cigna coverage and potential costs.

Because sometimes it’s worth it—especially when you’re looking for:

• Trauma-informed treatment that goes beyond the basics
• Veteran-specific programming that understands military culture and mental health
• Smaller, more personalized centers that offer privacy, comfort, and individualized care

Out-of-network options open the door to treatment that might be a better fit for your needs—not just what’s “in the system.” 

Yes. Cigna generally provides coverage for substance use disorder (SUD) treatment, including drug and alcohol rehab.

Coverage is required under laws such as the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA) when the plan is not grandfathered — meaning addiction treatment must be covered similarly to other medical services. 

Depending on the specific plan and medical necessity, Cigna may cover a full continuum of addiction treatment levels, including: 

• Medically supervised detoxification (inpatient or outpatient) 
• Inpatient/residential rehab (live-in treatment programs)
• Partial Hospitalization Programs (PHP) — day treatment while living at home or in sober living 
• Intensive Outpatient Programs (IOP) — frequent therapy sessions allowing patients to maintain daily responsibilities
• Standard outpatient therapy, counseling, and behavioral health services (individual/group therapy)
• Treatment of co-occurring mental health issues along with substance use disorders (dual diagnosis) Often medication-assisted treatment (MAT) or medication support when clinically appropriate. 

Yes — coverage details can vary significantly based on:

• Whether your plan is HMO, PPO, EPO, or other type (employer-based vs. individual).
• Whether you use in-network vs. out-of-network providers — in-network facilities typically result in lower out-of-pocket costs. 
• Your plan’s deductible, copays, coinsurance, and out-of-pocket maximums. 
• Whether the treatment is medically necessary (as determined by a clinician) and prior authorization requirements. 
• The state you live in (since coverage and network availability can vary by state).

Yes — medically supervised detox is commonly covered when it is deemed medically necessary. That means safe withdrawal under medical supervision, sometimes including medications and monitoring. This may trigger requirements like prior authorization, depending on the plan.

Cigna often covers ongoing outpatient care and behavioral health services as part of addiction treatment — including individual and group therapy, counseling, relapse prevention, and other support. 

Many plans treat substance use disorder treatment as part of broader behavioral health, giving access to therapy and mental health support, including treatment for co-occurring mental health conditions.

Often, yes. For inpatient rehab, detox, PHP, IOP, or other higher-level care, prior authorization is typically required. 

Treatment must be medically necessary and appropriately documented for coverage to apply. 

Yes. Cigna generally covers mental health treatment and substance use disorder treatment — meaning integrated or dual-diagnosis treatment (addiction + mental health) is usually covered under the same behavioral health benefits.

Coverage tends to focus on medically necessary, evidence-based addiction treatment. Luxury or “boutique” rehab centers — with luxury amenities, upscale accommodations, or non-standard extras — may not be fully covered, especially if they are out-of-network.

You can verify your coverage by:

1. Calling the member services number on the back of your Cigna insurance card and asking about behavioral health / SUD benefits. 
2. Reviewing your plan’s Summary of Benefits and Coverage (SBC) or policy document. 
3. Contact Tulip Hill Recovery’s Admissions Teams for a free insurance verification and can check benefits for you.

Ask about: required prior authorization, in-network providers, your deductible/co-pays/coinsurance, coverage limits (days, sessions), and whether medications or MAT are covered.