The importance of mental health coverage
People’s mental health is equally as important as their physical health. Having a condition that affects your mental health is not a character flaw or a sign of weakness. Cognitive, affective, and substance-use conditions are very real medical problems that require treatment in order to get better. Furthermore, if an individual has a mental or behavioral condition that goes untreated, it can turn into a cycle of harmful thoughts and behaviours that adversely affect both their mental and physical health. Also, it is often difficult for individuals to recognize the onset of a mental condition because the symptoms may be embedded in their environment or daily habits, which emphasizes the importance of proactive mental health screenings and mental health benefits. Fortunately, Cigna offers clients with some of the best and most encompassing mental health benefits of any health insurance provider currently in the market.
An overview on Cigna Health insurance plans
As a global health service provider, Cigna is dedicated to helping individuals improve their health, well-being, and sense of security. They offer Preferred Provider Organization(PPO) and Health Maintenance Organization (HMO) plans in addition to their popular Open Access Plans (OAP) and Health Savings Accounts (HSA).
With their open access plan, individuals will have the option to select a primary care provider to serve as a personal health advocate, but unlike a PPO plan, it is not required. With their open access plan you will not need referrals to see medical specialists, and you have the option to see out-of-network specialists at an additional cost. Cigna’s Health Savings Accounts are popular amongst families and individuals that are looking to control their insurance dollars. These are great for people who lead healthier lifestyles, and want control over their health insurance costs. HSA’s have higher deductibles, but they are flexible and will follow individuals or families if they were to switch careers.
Cigna mental health benefits
Cigna’s health insurance plans offer mental health benefits. They define mental health services as, “services that are required to treat a disorder that impairs behavior, emotional reaction or thought processes.” This means that they would provide coverage for individual or group psychotherapy, dialectical behavioral therapy or cognitive behavioral therapy for mental disorders like depression, bipolar disorders, and schizophrenia amongst many others. It is imperative for individuals with mental conditions to seek treatment because they may adversely affect their physical health, and their ability to remain employed.
They explicitly mention that, “In determining benefits payable, charges made for treatment of any physiological conditions related to mental health will not be considered to be charges made for mental health treatment.” Meaning that if an individual is seeking coverage for chronic tension or back pain that is the result of their mental condition, they will have to pay out of pocket for that service. However, this highlights the importance of seeking proper mental health treatment because these physical arising from mental conditions may be avoided with proper mental health treatment.
Cigna also defines their coverage for inpatient and outpatient mental health coverage. Cigna’s plans cover services that are provided by a hospital in which an individual is confined for the treatment and evaluation of their mental health. It is important to note that they also provide residential treatment services which are, “services provided by a hospital for the evaluation and treatment of psychological and social functional disturbances that are a result of subacute mental conditions.” Residential treatment centers are not limited to hospitals. They include institutions which specialize in the treatment of psychological conditions, provide structured, psychotherapeutic treatment programs, and are licensed with the laws of the appropriate legally authorized agency as a residential treatment center.
Cigna’s outpatient mental health plan covers services required to treat mental health when services are provided by a qualified practitioner, and they are not limited to a hospital. Services may be provided in an individual or group setting, and outpatient mental health treatment includes intensive outpatient therapy programs. Intensive Outpatient Therapy Programs consist of distinct levels or phases or treatment provided by a properly licensed practitioner. Ardent Counseling is partnered with Cigna and provides services for all cognitive, affective, and behavioral conditions. As a leading mental health facility in the city of Chicago, we operate six days a week, and work in accordance with our clients’ preferences and convenience.
Cigna chemical dependency benefits
Cigna provides individuals with unrivaled coverage for chemical dependency and substance use disorders. Cigna defines chemical dependency as, “a psychological or physical dependence on alcohol or other mind-altering drugs that requires diagnosis, care, and treatment.” Meaning that any prescription drug or illicit substance that generates dependency would be classified as chemical dependency, and that individual would be eligible for treatment. However, they clearly state that, “In determining benefits payable, charges made for treatment of any physiological conditions related to chemical dependency will not be considered to be charges to be made for chemical dependency treatment.” So in other words, if a person encounters a physical health problem or condition as a result of their chemical dependency, it will not be covered under their insurance. This emphasizes the importance of treatment for substance-use disorders because they will inevitably cause physiological issues, and result in individuals paying out-of-pocket for those exact issues. Chemical dependency is fairly common, and individuals are capable of making a full recovery.
Cigna provides coverage for detoxification, inpatient, and outpatient services. In terms of detoxification services Cigna plans covers, “detoxification and related medical ancillary services when required for the diagnosis and treatment of addiction to alcohol and/or drugs.” Furthermore, Medical Management review of the specific situation will determine whether the services will be provided in an inpatient or outpatient setting.
Inpatient treatment is reserve for cases that are more severe, and require individuals to provide coinsurance payments. The Cigna plans cover services provided for rehabilitation while an individual is confined in a hospital. It should be noted that residential treatment services are included and classified as inpatient services. Residential treatment services are those provided by a hospital for evaluation and treatment of psychological and social disturbances that are a result of subacute chemical dependency. Residential treatment is less severe than full inpatient treatment, but both are vital to individuals’ long term physical and mental health.
Outpatient plans cover rehabilitation services required to treat abuse of or addiction to alcohol and/or drugs when services are provided by a licensed professional. Outpatient services may be provided in an individual or group setting, and may include intensive outpatient therapy programs. All of the Ardent Counseling Center facilities are within Cigna’s network, and offer personalized treatment options for individuals struggling with addiction and substance-use disorders. We make a point of assessing our clients needs, and construct treatment and therapy plans around the severity of their condition, and their treatment preferences. It is our goal to help all individuals battling addiction to make full recoveries, and help them develop healthier and more sustainable lifestyles.
Cigna copayments for mental health services & chemical dependency
A copayment is the amount a member and their dependents pay for care at the time of service after their deductible has been met. Cigna provides coverage for both mental health and chemical dependency or substance use disorders. Their coverage for mental health includes network outpatient office visits. Which means that individual or group psychotherapy for mental and behavioral conditions would be covered with a flat rate that is determined by Cigna. On the other hand, if an individual is seeking a screening for a mental health condition, it may be considered preventative care. If it is considered preventive care, Cigna often covers the entire expense of the visit.
Cigna also provides network outpatient coverage for chemical dependency or substance-use disorders. This means that they would treat individual or group psychotherapy and medication prescribed for chemical dependency as they would a physical illness or injury. If you or a loved one are struggling with a substance use disorder, it is imperative to seek assistance in order to prevent the condition from worsening. Chemical dependency is one of the leading causes for unemployment because it inhibits individuals from leading sustainable day-to-day lives. Substance dependency is not a weakness or a character flaw. It is often due to a chemical imbalance within an individual, and requires proper treatment, support, and assistance for an individual to be alleviated from their condition.
Cigna coinsurance for mental health services & chemical dependency
Coinsurance represents the percentage that an individual pays for covered services. On average, Cigna covers 80% of the cost for covered services, meaning that individuals would be responsible for paying the remaining 20% of the cost of the covered service. If an individual chooses to seek a covered service outside of Cigna’s network, they will be responsible for a larger percentage of the cost of care. On average, out-of-network coinsurance payments are around 40% of the cost of care meaning that Cigna would pay for 60% of the cost of care. Cigna provides some of the best coverage for outpatient mental health services, as they cover 100% of the costs for in-network therapy services. Additionally, they will cover approximately 80% of the cost of covered services that are outside of their network area.
They also provide coverage for both inpatient and outpatient chemical dependency services. Because inpatient services are more expensive, individuals are required to pay at least 20% of the total cost of care, and it may require them to reach their out-of-pocket maximum if the hospital stay is long enough. On the other hand, Cigna provides full coverage for outpatient substance use services that are within their network, which makes them the best insurance provider in this field. In network services include individual and group psychotherapy and medication management. They also provide coverage for services that are out of their network area and non-network services at marginally higher prices.
Additional resources:
- https://www.cignahealthbenefits.com/en/about-us
- https://www.cigna.com/iwov-resources/national-second-sale/docs/inventiv/combined-open-enrollment-customer-presentation.pdf
- http://www.healthplanone.com/CIGNA-Illinois.aspx
- https://www.cigna.com/qualified-health-care-expenses