Does Cigna Cover Therapy? Navigating Insurance for Mental Health Treatment

Experts estimate that 1 in 5 adults in the United States is living with a mental illness and 1 million employees are absent from work every day due to stress.

Seeking help from mental health professionals for work and life challenges and mental health conditions can help you manage your emotional well-being. But many people are unsure about health insurance coverage for mental health treatment. Specifically, the question many ask is: Does Cigna cover mental health treatment? Read on to find out.

Does Cigna Cover Mental Health Care?

Yes, most health insurance plans offered by Cigna include coverage for mental health care services.

However, you may be required to pay mental healthcare costs until you meet your plan’s annual deductible (if your plan has a deductible).

After you meet the deductible for your health plan, Cigna will start to cover some of the costs of your mental health treatment, but you may still need to pay your share of costs (copay or co-insurance) as outlined in your plan document.

Also, some mental health services and treatments may require prior approval (pre-authorization) from Cigna Healthcare before they are covered under your plan.

What Types of Mental Health Treatments Does Cigna Cover?

Health insurance plans offered by Cigna Healthcare include mental health benefits such as:

• Access to a network of mental health providers, including psychiatrists, psychologists, counselors, and therapists.
• Mental health services such as consultations, referral services, and outpatient services.
• Case management services.
• Referrals to community support groups, behavioral coaches, and online resources.
• Inpatient and outpatient treatment services for substance use disorders.
• Personalized coaching and support programs.

Residential Treatment Programs

Cigna Healthcare plans typically cover residential treatment programs for substance use disorders and mental health conditions. Residential treatment for substance abuse, also called inpatient rehab, involves staying onsite at a treatment facility in a structured environment with 24/7 care from therapists and doctors.

The extent of coverage by Cigna health insurance plans for inpatient treatment programs depends on the specific insurance plan, geographical location, and your medical needs.

Your healthcare providers may need to request prior authorization for residential (inpatient) addiction treatment. Cigna may or may not authorize treatment for the full recommended length of stay at an inpatient addiction treatment center.

Partial Hospitalization Programs (PHPs)

Cigna Healthcare insurance plans cover partial hospitalization programs (PHPs), also called day treatment. These programs provide intensive outpatient care in a hospital setting to people with substance use disorders and mental health conditions. However, they offer a more flexible approach compared to inpatient care. Patients do not live onsite at a treatment facility and return home each evening. PHPs are ideal for people who need more intensive care than standard outpatient services but don’t require 24/7 supervision or medical care.

The level of coverage and out-of-pocket costs for partial hospitalization programs will depend on your specific Cigna plan.

Intensive Outpatient Programs (IOPs)

Cigna plans include behavioral health coverage for intensive outpatient programs (IOPs). These programs are designed for people with substance abuse issues who have completed a higher level of care, such as inpatient rehab or partial hospitalization programs, and require ongoing but less intensive mental healthcare.

IOPs typically involve going for frequent visits to a treatment center (usually 3-5 days a week) and spending 3-5 hours in treatment at every visit. However, these programs allow you to continue living at home and attending to daily responsibilities while receiving more intensive mental health services compared to standard outpatient programs.

Most Cigna insurance plans cover intensive outpatient programs, including access to individual and group therapy sessions and educational workshops.

Outpatient Therapy

Cigna health insurance typically covers outpatient therapy for mental and behavioral health conditions. This includes individual therapy sessions including cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT), group therapy, family therapy, couples therapy, support groups, and medication management.

The extent of Cigna mental health coverage for outpatient therapy depends on the specific plan (deductible, copays and coinsurance), and whether the therapist is in-network or out-of-network. Routine outpatient care does not, however, include medical treatment to manage complicated withdrawal symptoms as part of a medical detoxification program.

Dual Diagnosis Treatment Programs

Cigna insurance covers dual diagnosis treatment programs that are designed to treat co-occurring substance use disorders and mental health conditions such as depression, anxiety disorders, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, eating disorders, bipolar illness, and other psychiatric illnesses. These disorders can affect each other and simultaneous treatment is vital for successfully managing both conditions.

Dual diagnosis mental health services are offered at specialized addiction treatment centers where healthcare providers have the expertise to treat multiple co-existing mental and behavioral health conditions.

Cigna insurance coverage for dual diagnosis includes treatment for mental health conditions and substance use disorders at the same time.

Is Online Therapy Covered by Cigna Insurance?

Yes, Cigna mental health coverage includes online therapy and virtual care. These services are useful for people with family and work responsibilities who cannot find time to attend in-person therapy sessions. Cigna insurance plans give members access to 24/7 mental health services through:

• 24/7/365 care, including after-hour appointments (nights, weekends, and holidays).
• Online therapy via video calls and phone calls.
• Access to board-certified doctors, pediatricians, psychiatrists, and licensed counselors.
• $0 dedicated virtual urgent care.

You can schedule an online appointment for mental health services in minutes using the myCigna platform. It’s also possible to have a prescription sent directly to your local pharmacy if your mental health professional deems medication management of your condition necessary.

How Much Does Therapy Cost with Cigna Insurance?

The cost of therapy with Cigna insurance plans depends on your specific health plan, deductible, copay and coinsurance as outlined in your plan documents.

On average, Cigna Healthcare members have a copay of $40 per therapy session, but this can range from $20 to $50.

Note: You must pay the entire cost of mental health services before you meet your annual deductible. Once you have met the deductible for your health plan, Cigna will start to cover mental health treatment, but you will have the copay or coinsurance as out-of-pocket costs.

The type of therapy covered by Cigna insurance will depend on your insurance plan, and may include individual therapy sessions, group therapy, couples therapy, and/or family therapy. More intensive treatments, such as residential programs, may be partially covered.

How to Find a Therapist Who Takes Cigna

You can look up in-network licensed therapists, psychologists, counselors, social workers, psychiatrists, nurse practitioners, and substance use treatment facilities on the Cigna Healthcare Provider Directory.

Remember, most hospital care programs and residential programs require pre-approval (prior authorization). Check your coverage details by calling the number at the back of your Cigna ID card.

How Discover Recovery Can Help

If you or your loved ones are struggling with substance use, seeking help is one of the most important steps you can take toward healing. You don’t have to face this challenge alone—there are professionals and resources available to support you every step of the way. At Discover Recovery Treatment Center, we have a team of healthcare professionals who can develop a personalized addiction treatment plan for you. Our administrative staff can help you navigate coverage for behavioral and mental health services and understand if Cigna will cover your treatment.

Do you have a loved one struggling with addiction?

We know how hard that can be. Give us a call to find out what options you have.

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Someone is standing by 24/7 to help you

If you are concerned about being able to afford addiction treatment, you should know that many health insurance providers, including Cigna, offer coverage for mental health services, including substance use disorder treatment. This means that help is more accessible than you might think, from therapy and counseling to inpatient rehabilitation. Don’t wait—reach out for support, call Discover Recovery today, and take the first step toward a healthier, brighter future.

Frequently Asked Questions (FAQs)

How much does Cigna pay for therapy sessions?

How much Cigna pays for therapy sessions depends on the specific Cigna plan you have. Generally, Cigna offers coverage for mental health services, including outpatient therapy sessions, but the amount they pay varies, based on factors like whether the therapist is in-network or out-of-network and the type of plan you hold (HMO, PPO, or EPO).

For in-network therapists, Cigna typically covers a significant portion of the cost after you’ve met your deductible, and you may only be responsible for a co-pay or co-insurance. Co-pays for therapy sessions can range from $20 to $50 per session, depending on your plan. If you see an out-of-network therapist, Cigna may still offer coverage but at a lower rate, meaning you’ll pay a larger portion of the cost.

It’s always best to check your specific plan details or contact Cigna directly to confirm how much they will pay for therapy sessions under your insurance coverage for mental health treatment.

Does Cigna cover online or virtual therapy?

Yes, Cigna typically covers online or virtual therapy, often referred to as telehealth services. This includes mental health services such as therapy and counseling, allowing you to connect with licensed therapists remotely. Many Cigna plans offer the same coverage for virtual therapy as they do for in-person sessions, meaning you might only be responsible for a co-pay or co-insurance depending on your plan.

Cigna has partnerships with various telehealth platforms and providers, so you can often access therapy through their preferred networks. However, it’s important to verify whether your specific plan covers online therapy and if the provider you choose is in-network to ensure you receive the maximum coverage possible.

How do I verify if my therapy is covered by Cigna?

To verify if your therapy is covered by Cigna, follow these steps:

1. Check Your Insurance Plan: Log in to your myCigna account online or through the Cigna mobile app. Review your plan’s summary of benefits, specifically the section on mental health or behavioral health services. This will provide details about coverage for therapy, including co-pays, co-insurance, and whether there’s a deductible.
2. Contact Customer Service: Call the customer service number on your Cigna insurance card to speak with a representative. Ask specifically about your plan’s coverage for therapy, including whether it covers in-person and virtual sessions and if there are any limits on the number of sessions.
3. Find In-Network Providers: Use Cigna’s online directory to find in-network therapists, which can help reduce out-of-pocket costs. Search for therapists offering the type of care you need (e.g., individual, family, or group therapy) and verify they are covered by your plan.
4. Ask Your Therapist: If you already have a therapist, ask if they are in-network with Cigna. If they are out-of-network, you can ask about reimbursement options, though out-of-network coverage may come with higher costs.

What should I do if my therapy claim is denied by Cigna?

If your therapy claim is denied by Cigna, here are the steps you can take to address the issue:

1. Review the Explanation of Benefits (EOB): When Cigna denies a claim, they will send you an Explanation of Benefits (EOB) detailing why the claim was denied. Review the EOB carefully to understand the reason—common reasons include errors in billing codes, issues with coverage limits, or the provider being out-of-network.
2. Contact Cigna for Clarification: Call Cigna’s customer service to get more information about why the claim was denied. Sometimes, claims are denied due to simple errors, like incorrect paperwork or missing information, which can be easily corrected.
3. Check Your Insurance Plan: Review your policy to verify Cigna coverage for therapy. This will help you understand if the denial was due to a misunderstanding of what’s included in your plan (e.g., coverage limits, required pre-authorizations, or network restrictions).
4. Submit an Appeal: If you believe the claim was denied unfairly, you have the right to file an appeal. The Cigna Insurance Company will provide instructions on how to do this, and you’ll need to include documentation such as your therapist’s treatment notes, any correspondence related to the denial, and a letter explaining why you believe the therapy should be covered. The appeals process usually has deadlines, so make sure to submit your appeal within the specified time frame.
5. Work with Your Therapist: Ask your therapist to provide any necessary documentation or clarification that might support your appeal for insurance coverage of mental health treatment. Sometimes a letter from your therapist explaining the medical necessity of the therapy can help with getting a denial overturned.
6. Seek External Review: If your internal appeal with Cigna is denied, you may have the option for an external review by a third party. This process is available through your state’s insurance department or through federal programs like the Affordable Care Act, depending on your policy.

How can I find a Cigna-approved therapist in my area?

To find a Cigna-approved therapist in your area, follow these steps:

1. Log in to Your myCigna Account: Visit the Cigna website or use the Cigna mobile app. Once logged in to your myCigna account, you can access your plan details and use their directory to find in-network providers.
2. Use Cigna’s Online Provider Directory: On the Cigna website, navigate to the “Find a Doctor, Dentist, or Facility” section. Select “Behavioral Health” or “Mental Health” and input your location. You can refine your search by specifying the type of therapy you’re seeking (e.g., individual, family, or couples therapy) and whether you prefer in-person or virtual sessions.
3. Call Cigna’s Customer Service: If you prefer to speak with someone, call the customer service number on your Cigna insurance card. A representative can help you find in-network therapists in your area and give you details about coverage for therapy services.
4. Use Third-Party Platforms: Some websites and apps, like Psychology Today, allow you to search for therapists and filter by insurance. When searching, you can select Cigna as your insurance provider to find therapists who accept your plan.
5. Ask Your Primary Care Doctor: Your primary care physician may have recommendations for Cigna-approved therapists in your area who accept your insurance for mental health treatment. They can often refer you to someone who meets your specific mental health service needs.

Do I need a referral to see a therapist with Cigna insurance?

It depends on your plan, but most Cigna health plans do not require a referral for therapy.

Does Cigna cover couples or family therapy?

Yes, Cigna Insurance Company typically covers couples and family therapy. However, exact coverage and out-of-pocket expenses will depend on your specific plan.

Does Cigna cover group therapy sessions?

Yes, Cigna covers group therapy sessions as part of their mental health benefits.

What is the process for getting therapy approved by Cigna?

Check if your therapist is in-network and contact Cigna for any pre-authorization requirements before starting therapy.

How do I submit a claim for therapy sessions to Cigna?

If your therapist in in-network with Cigna, they will typically submit the claim for you. For out-of-network providers, you can submit a claim through your myCigna account or by mail.

What happens if my therapist no longer accepts Cigna insurance?

If your therapist stops accepting Cigna, you may need to a find a new in-network therapist or pay out-of-network rates.

Are there any exclusions in Cigna’s coverage for therapy?

Cigna covers most mental health services, provided they are medically necessary. However, there may be some exclusions for non-medically necessary services, for example, life coaching.

How can I check the status of my therapy claim with Cigna?

You can check the status of your claim through the myCigna app, on the Cigna website, or by calling customer service.

Does Cigna cover therapy sessions with a psychiatrist or psychologist?

Yes, Cigna covers therapy sessions with both psychiatrists and psychologists. Your out-of-pocket expense for therapy sessions will depend on your plan.

Are there any therapy types not covered by Cigna insurance?

Cigna may not cover certain types of alternative therapies, such as hypnosis. Coverage for therapies like biofeedback varies by plan. Most evidence-based therapies, such as cognitive behavioral therapy (CBT), are generally covered. Check your benefit plan document for coverage details for a specific type of therapy.

Are there limits on the number of therapy sessions Cigna will cover?

Some Cigna plans may have limits on the number of therapy sessions that are covered. Check your plan details.

Can I switch therapists under Cigna insurance coverage?

Yes, you can switch therapists under Cigna insurance coverage provided the new provider is in-network or you’re aware of out-of-network costs.

How does Cigna insurance work with Medicare for therapy coverage?

Cigna offers Medicare Advantage Plans that may include coverage for mental health services. Check your specific plan for details.

How does Cigna’s mental health coverage compare to other insurance providers?

Cigna’s mental health coverage is generally comparable to other major insurance companies. Cigna offers broad coverage for mental health treatment with both in-network and out-of-network providers and in-person and virtual therapy options.

What documents do I need to submit a therapy claim to Cigna?

To submit a therapy claim to Cigna, you’ll need an itemized bill from your therapist, a completed claim form, and possibly proof of payment for out-of-network claims.

How does Cigna handle coverage for therapy in different states or while traveling?

Cigna coverage applies across states, but out-of-network rules may apply when traveling, leading to higher out-of-pocket costs for therapy sessions.

How can I estimate my therapy costs with Cigna before starting treatment?

You can ask your provider to use Cigna’s Cost Estimator Tool or contact customer services to get an estimate of out-of-pocket therapy costs before starting treatment.

Are there any specific mental health conditions that Cigna does not cover for therapy?

Cigna covers most mental health services, but exclusions may apply for treatments not considered medically necessary.