Does Cigna Cover Drug & Alcohol Rehab in Beverly Hills, CA?
Yes, Cigna does cover drug and alcohol rehab in Beverly Hills, CA. Cigna insurance provides comprehensive coverage for substance abuse treatment, including medical detox, inpatient rehabilitation, outpatient programs, therapy, and dual diagnosis care at facilities throughout Beverly Hills and the greater Los Angeles area. Coverage typically includes evidence-based treatments such as individual counseling, group therapy, medication-assisted treatment (MAT), and family therapy sessions. However, the extent of your Cigna rehab coverage depends on your specific plan type, whether the Beverly Hills treatment center is in-network, and if pre-authorization is obtained. Most Cigna plans cover medically necessary addiction treatment services with varying copays, deductibles, and out-of-pocket maximums.
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What Addictions Will Cigna Cover?
Cigna health insurance provides comprehensive coverage for substance use disorder treatment across a wide range of addictions. Whether you’re struggling with alcohol dependency, prescription drug misuse, or illicit substance abuse, Cigna plans typically cover medically necessary addiction treatment services. The key factor in determining coverage eligibility is medical necessity rather than the specific type of substance involved. If a licensed healthcare provider or addiction specialist determines that treatment is clinically needed for your substance use disorder, Cigna will generally cover all or part of the rehab costs, depending on your specific plan type, deductible, copay, and whether you choose an in-network or out-of-network treatment facility.
Addiction and substances that Cigna may cover:
- Alcoholism and alcohol use disorder
- Heroin
- Prescription painkillers (OxyContin, Vicodin, Percocet, Hydrocodone, Morphine)
- Fentanyl and other opiates
- Xanax (Alprazolam)
- Ativan (Lorazepam)
- Klonopin (Clonazepam)
- Valium (Diazepam)
- Cocaine and crack cocaine
- Methamphetamine (Crystal meth)
- Adderall
- Ritalin and other prescription stimulants
- Marijuana/Cannabis
- Sedatives and sleep aids
- Prescription medication abuse
- Polysubstance use (multiple substances)
What Levels of Care & Treatment Will Cigna Cover?
Cigna provides comprehensive coverage for the full continuum of addiction treatment services, from medical detoxification through long-term aftercare support. Coverage varies depending on the plan, but commonly includes medical detox, inpatient rehab, outpatient treatment including partial hospitalization and intensive outpatient programs, medication-assisted treatment, behavioral therapy, and aftercare with relapse prevention. Levels of care covered by Cigna may include:
- Medical Detoxification (Detox) – 24/7 medically supervised withdrawal management for drugs and alcohol with medication support to manage symptoms
- Inpatient/Residential Rehabilitation – Live-in treatment programs with around-the-clock medical and therapeutic care, typically lasting 30-90 days
- Partial Hospitalization Program (PHP) – Intensive day treatment (5-6 days per week, 20-30+ hours) while living at home or in sober living
- Intensive Outpatient Program (IOP) – Structured therapy sessions 3 days per week for 9-20 hours while maintaining work, school, or family responsibilities
- Standard Outpatient Treatment – Weekly individual counseling, group therapy, and ongoing support with lower time commitment
- Medication-Assisted Treatment (MAT) – FDA-approved medications like Suboxone, methadone, naltrexone, and Vivitrol combined with counseling
- Dual Diagnosis Treatment – Integrated care for co-occurring mental health disorders and substance use disorders treated simultaneously
- Behavioral Therapy – Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and other evidence-based therapies
- Family Therapy – Counseling sessions involving family members to support recovery and heal relationships
- Aftercare and Relapse Prevention – Continued support, alumni programs, and ongoing counseling following primary treatment
Sober Living/Transitional Housing – May be covered as part of a comprehensive treatment plan when medically necessary - Telehealth Services – Virtual therapy and counseling sessions for ongoing outpatient care
Many Cigna insurance plans cover a variety of evidence‑based therapies and treatment types for substance use disorders when they are considered medically necessary. These therapies may include:
- Cognitive Behavioral Therapy (CBT) – Structured approach to identify and change negative thought patterns and behaviors that contribute to addiction and mental health issues
- Dialectical Behavior Therapy (DBT) – Skills-based therapy originally developed for borderline personality disorder, focusing on emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness
- Eye Movement Desensitization and Reprocessing (EMDR) – Trauma-focused treatment using bilateral stimulation to process traumatic memories and reduce PTSD symptoms
- Motivational Interviewing (MI) – Client-centered approach that enhances motivation to change addictive behaviors and resolve ambivalence about recovery
- Motivational Enhancement Therapy (MET) – Systematic intervention designed to produce rapid, internally motivated change in addiction behaviors
- Contingency Management – Behavioral intervention using positive reinforcement to encourage sobriety and treatment engagement
- 12-Step Facilitation Therapy – Structured approach to introduce and engage clients in 12-step recovery programs like AA and NA
- Rational Emotive Behavior Therapy (REBT) – Therapy approach that identifies irrational beliefs and replaces them with more rational, helpful thoughts
- Acceptance and Commitment Therapy (ACT) – Mindfulness-based therapy that helps individuals accept difficult emotions while committing to behavior change
- Cognitive Processing Therapy (CPT) – Evidence-based treatment for PTSD that helps individuals challenge and modify unhelpful beliefs related to trauma
- Exposure and Response Prevention (ERP) – Specialized therapy for OCD and anxiety disorders involving gradual exposure to feared situations
- Psychodynamic Therapy – Exploration of unconscious patterns, past experiences, and underlying emotional issues contributing to current behaviors
- Interpersonal Therapy (IPT) – Focus on improving interpersonal relationships and social functioning to reduce symptoms
- Family Therapy – Addresses family dynamics, improves communication, resolves conflicts, and strengthens support systems for recovery
- Group Therapy – Peer-supported therapeutic environment where individuals share experiences and learn from others in recovery
- Relapse Prevention Therapy – Skills training to identify triggers, develop coping strategies, and maintain long-term sobriety
- Trauma-Informed Care – Treatment approach that recognizes and addresses the impact of trauma on addiction and mental health
- Holistic Therapies – May include art therapy, music therapy, yoga therapy, mindfulness meditation, and recreational therapy when integrated into evidence-based treatment programs
Does Cigna Cover Dual Diagnosis Mental Health Treatment?
Yes, Cigna provides comprehensive coverage for dual diagnosis treatment, which addresses co-occurring mental health disorders and substance use disorders simultaneously. 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.
Cigna understands the complexity of these cases and provides comprehensive coverage for co-occurring disorders, recognizing that addressing both issues simultaneously is essential for effective recovery. This comprehensive approach provides unified care plans, coordinated medication management to avoid conflicting prescriptions, simultaneous therapy sessions that tackle both mental health symptoms and addiction triggers, and continuity of care that reduces the risk of relapse and improves long-term outcomes. Coverage for dual diagnosis treatment is available across multiple levels of care including residential treatment, partial hospitalization programs, intensive outpatient programs, and standard outpatient therapy, with the specific coverage depending on your Cigna plan type, medical necessity determination, whether providers are in-network, and pre-authorization requirements.
How Long Will Cigna Insurance Cover?
Cigna insurance typically covers substance use disorder treatment for as long as it is medically necessary according to your individual plan’s guidelines and American Society of Addiction Medicine criteria. The average rehab stay varies depending on the level of care, with medical detox often lasting 3 to 10 days, residential or inpatient programs averaging 28 to 90 days, partial hospitalization programs ranging from 2 to 6 weeks, and intensive outpatient programs lasting 6 to 12 weeks. Standard outpatient treatment can continue for 3 to 6 months or longer, while medication-assisted treatment may be covered for several months to years when medically necessary. Some Cigna plans may require periodic medical necessity reviews and pre-authorization for continued treatment, while others may allow extensions if additional care is clinically justified through progress reports and documentation. Dual diagnosis treatment addressing both addiction and mental health conditions often requires longer coverage periods due to the complexity of treating co-occurring disorders simultaneously. Verifying your individual Cigna policy before admission helps you understand how long coverage will last, what services are included, any out-of-pocket costs, and requirements for continued treatment approval throughout your recovery journey.
Prior Authorization & Medical Necessity for Rehab
Prior authorization is a requirement for most levels of addiction treatment under Cigna insurance, meaning you or your treatment provider must obtain approval from Cigna before starting rehab services to ensure coverage. The prior authorization process typically begins when your chosen treatment facility contacts Cigna’s behavioral health department, which is administered by Evernorth Behavioral Health, to submit a request that includes detailed clinical information about your condition and recommended treatment. This submission includes your diagnosis, substance use history, previous treatment attempts, severity of addiction, co-occurring mental health conditions, current symptoms, risk factors, and the specific level of care being requested such as medical detox, residential treatment, partial hospitalization, or intensive outpatient programs. Cigna reviews this information against their medical necessity criteria, which are based on American Society of Addiction Medicine guidelines that assess six dimensions including acute intoxication and withdrawal potential, biomedical conditions and complications, emotional and behavioral conditions, treatment acceptance and resistance, relapse potential, and recovery environment.
Medical necessity is proved through comprehensive clinical assessments conducted by licensed healthcare providers, including psychiatric evaluations, substance use assessments, medical examinations, and mental health screenings that document the severity of your addiction and why the requested level of care is appropriate. Your treatment provider must demonstrate that you meet specific criteria for the level of care requested, such as showing that outpatient treatment would be insufficient due to severe withdrawal risk, unstable living environment, multiple failed treatment attempts, serious co-occurring disorders, or immediate danger to self or others. The authorization process requires detailed documentation including DSM-5 diagnosis codes, clinical notes describing symptoms and functional impairment, treatment history, drug screening results, and a proposed treatment plan with measurable goals and expected outcomes. For inpatient or residential treatment, providers typically need to show that less intensive options have failed or would be inadequate, that you require 24-hour medical monitoring or structured supervision, or that your home environment poses significant relapse risk or safety concerns.
Once Cigna receives the prior authorization request, they typically respond within 24 to 72 hours for urgent cases or within 15 days for non-urgent requests, either approving treatment for a specific number of days, requesting additional information, or denying the request with an explanation. Initial authorizations are often granted for shorter periods such as 7 to 14 days, after which your treatment team must submit continued stay reviews with progress notes, updated assessments, and justification for why you still meet medical necessity criteria for that level of care. These ongoing reviews document your participation in treatment, progress toward goals, any complications or setbacks, response to interventions, and why stepping down to a lower level of care is not yet appropriate. If Cigna denies authorization or approves fewer days than recommended, you have the right to appeal the decision by submitting additional clinical documentation, peer-to-peer reviews where your doctor speaks directly with Cigna’s medical reviewer, or formal appeals through your plan’s grievance process.
The medical necessity determination process evaluates whether the treatment is appropriate for your diagnosis, whether the intensity and duration of services match your clinical needs, whether the treatment is evidence-based and follows established standards of care, and whether the services can reasonably be expected to improve your condition or prevent deterioration. Working with an experienced treatment facility that understands Cigna’s authorization requirements significantly streamlines this process, as they handle all communication with the insurance company, submit required documentation promptly, advocate for appropriate treatment duration, and manage continued stay reviews throughout your treatment. To facilitate smooth authorization, you should provide complete and honest information during intake assessments, participate actively in all evaluations, authorize release of medical records from previous treatments, and ensure your treatment team has accurate details about your substance use history, mental health conditions, and any complications or risk factors that support medical necessity for the recommended level of care.
How to Use Cigna Insurance for Rehab Coverage in Beverly Hills, CA
Using your Cigna insurance for rehab coverage in Beverly Hills starts with verifying your benefits to understand what addiction treatment services are covered under your specific plan, including deductibles, copays, coinsurance, out-of-pocket maximums, and any limitations or requirements. Contact Cigna’s behavioral health customer service line listed on the back of your insurance card or log into your online member portal to review your Summary of Benefits and Coverage document, which outlines your mental health and substance use disorder benefits. You can also call Beverly Hills treatment facilities directly and ask them to verify your Cigna benefits for you, as most rehab centers offer free, confidential insurance verification services that provide detailed breakdowns of your coverage, estimated out-of-pocket costs, and whether pre-authorization is required before admission.
Once you’ve verified your benefits, choose a Beverly Hills rehab facility that accepts Cigna insurance and is preferably in-network to minimize your out-of-pocket expenses, as in-network providers have negotiated rates with Cigna and typically result in lower copays and coinsurance compared to out-of-network facilities. Research treatment centers in Beverly Hills that specialize in your specific needs, whether that’s alcohol addiction, opioid dependence, dual diagnosis treatment, executive rehab programs, or luxury addiction treatment with upscale amenities. Confirm the facility is licensed by the California Department of Health Care Services and accredited by organizations like The Joint Commission or CARF, which demonstrates they meet quality standards that Cigna recognizes when approving coverage.
Before starting treatment, your chosen Beverly Hills rehab center will submit a prior authorization request to Cigna’s behavioral health department, including your clinical assessment, diagnosis, substance use history, recommended level of care, and treatment plan. This authorization process typically takes 24 to 72 hours for urgent admissions or up to 15 days for non-urgent requests, and approval is based on medical necessity criteria that demonstrate you require the recommended intensity of treatment. Be prepared to complete a comprehensive intake assessment either over the phone or in person, during which clinical staff will ask detailed questions about your substance use patterns, mental health history, previous treatment attempts, medical conditions, living situation, and support system to determine the appropriate level of care and build your case for insurance approval.
During your stay at the Beverly Hills rehab facility, the treatment team will manage ongoing authorization requirements by submitting continued stay reviews to Cigna with progress notes, updated assessments, and documentation showing you continue to meet medical necessity criteria for your current level of care. You’ll be responsible for paying any applicable copays, coinsurance amounts, or deductible portions according to your plan’s cost-sharing requirements, which the facility’s billing department will help you understand and manage throughout treatment. Keep all receipts, explanation of benefits statements, and documentation of payments made, as you may need these for tax purposes or if you reach your out-of-pocket maximum and become eligible for full coverage for the remainder of the plan year.
As you progress through treatment and prepare for discharge, work with your care team to plan for step-down care such as transitioning from residential treatment to partial hospitalization, intensive outpatient, or standard outpatient therapy, ensuring Cigna authorization is obtained for each level of care in your continuing recovery plan. Your Beverly Hills treatment center should provide aftercare planning that includes ongoing therapy, support group recommendations, alumni program participation, and connections to local recovery resources in the Los Angeles area to support long-term sobriety. If you encounter any issues with Cigna denying coverage, limiting authorized days, or requiring step-down to a lower level of care before your treatment team recommends it, work with the facility’s patient advocate or utilization review coordinator to file appeals, request peer-to-peer reviews, or submit additional clinical documentation supporting continued treatment at your current level of care.
To maximize your Cigna insurance benefits for Beverly Hills rehab, maintain open communication with both your insurance company and treatment facility, attend all scheduled therapy sessions and activities to demonstrate treatment engagement, participate fully in assessments and progress evaluations, follow your treatment plan recommendations, and keep your Cigna contact information and member ID readily available throughout the admission and treatment process. Understanding your rights under the Mental Health Parity and Addiction Equity Act ensures that Cigna cannot impose more restrictive limitations on mental health and substance use treatment than they do on medical and surgical benefits, meaning you’re entitled to fair and equitable coverage for your addiction treatment needs in Beverly Hills.
General Info About Cigna Insurance
The Cigna Group is an American multinational managed healthcare and insurance company headquartered in Bloomfield, Connecticut, with a rich history dating back over two centuries. Cigna was formed by the 1982 merger of the Connecticut General Life Insurance Company and INA Corporation, the parent corporation of Insurance Company of North America, which was the first stock insurance company in America. The company name “Cigna” is derived from combining letters from the merging companies, CG and INA. The Insurance Company of North America was founded in 1792 and issued the nation’s first marine insurance policies, while Connecticut General Life Insurance Company was created in 1865. Throughout its history, Cigna expanded through strategic acquisitions and evolved from offering traditional life and property insurance to becoming a comprehensive global health services organization.
Today, Cigna has over 74,000 employees who serve more than 170 million customers throughout the world, making it one of the largest health insurance providers globally. The company ranked number 15 in the 2023 Fortune 500 list of the largest U.S. corporations by total revenue. Cigna operates in more than 30 countries and jurisdictions across North America, Europe, Asia, South America, and Africa, providing diverse health solutions and insurance products to individuals, families, employers, government organizations, and health care providers. In 2018, Cigna acquired Express Scripts in a 67 billion dollar deal, significantly expanding its pharmacy benefit management capabilities. In 2020, the company rebranded its health services portfolio under the name Evernorth, which includes Express Scripts, Accredo, and eviCore, to better organize its comprehensive health services offerings.
Cigna offers several types of health insurance plans designed to meet different needs and budgets. The primary plan types include Health Maintenance Organization plans, Preferred Provider Organization plans, Exclusive Provider Organization plans, Point of Service plans, and High-Deductible Health Plans that can be paired with Health Savings Accounts. HMO plans typically have the lowest monthly premiums but require members to choose a primary care physician who coordinates all care and provides referrals to specialists, with coverage limited to in-network providers except for emergencies. PPO plans offer greater flexibility by allowing members to see any provider without referrals and providing some coverage for out-of-network care, though at higher out-of-pocket costs and monthly premiums. EPO plans fall between HMO and PPO options, requiring members to use in-network providers but not requiring referrals to see specialists, offering lower premiums than PPOs while maintaining more flexibility than HMOs.
For individual and family plans purchased through the Health Insurance Marketplace established by the Affordable Care Act, Cigna offers coverage at four metal tier levels including Bronze, Silver, Gold, and Platinum, with each level paying a different portion of health care bills. Bronze plans have the lowest monthly premiums but highest deductibles and out-of-pocket costs, making them suitable for healthy individuals who rarely need medical care and want to minimize monthly expenses. Silver plans offer moderate premiums and cost-sharing, representing a middle ground between affordability and coverage. Gold plans have higher monthly premiums but lower deductibles and out-of-pocket costs, making them ideal for people who use medical services regularly or have ongoing health conditions. Platinum plans, where available, provide the most comprehensive coverage with the highest premiums but lowest out-of-pocket costs when receiving care. Some Cigna plans also include enhanced benefits such as the Enhanced Diabetes Care program that caps insulin costs at 25 dollars per 30-day supply, 24/7 virtual care through MDLIVE for convenient telehealth access, and the Healthy Rewards program offering discounts on wellness-related products and services.
Cigna provides coverage through employer-sponsored group plans, individual and family marketplace plans, Medicare Advantage plans for seniors, Medicare Supplement insurance, Medicaid managed care plans, international health insurance for expatriates and globally mobile employees, dental insurance including DHMO and DPPO options, vision insurance, disability insurance, life insurance, and supplemental insurance products including accident, critical illness, and hospital indemnity plans. The company’s behavioral health benefits, which cover mental health and substance use disorder treatment, are administered by Evernorth Behavioral Health and include comprehensive coverage for addiction treatment, dual diagnosis care, therapy services, psychiatric care, and medication management as mandated by the Mental Health Parity and Addiction Equity Act and the Affordable Care Act’s essential health benefits requirements.
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You do not have to figure this out alone. If you have Cigna insurance and require addiction treatment, Faith Recovery Center can assist in verifying your benefits and help you establish a plan that works for you. Contact our admissions team for a confidential conversation and a clear path forward.
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