Cigna insurance typically covers treatment across Open Access Plus, LocalPlus, SureFit, and HDHP plans. Cigna plans include behavioral health benefits for substance use and mental health, managed by Evernorth Behavioral Health (formerly Cigna Behavioral Health) using ASAM Criteria 4th Edition. We verify your specific Cigna benefits in 15 minutes.
Accredited Addiction Treatment for Cigna Members in Sicklerville, NJ
Joint Commission accreditation, New Jersey Department of Mental Health and Addiction Services licensing, and clinical care led by Dr. Courtney Scott, MD, Medical Director, back the addiction treatment provided at our Sicklerville facility. Villa Wellness Center works with Cigna plans for adults seeking PHP, IOP, OP, and dual diagnosis care.
WHY PEOPLE TRUST VILLA WELLNESS CENTER
What Cigna Typically Covers for Addiction Treatment
Cigna plans typically cover partial hospitalization (PHP), intensive outpatient (IOP), outpatient counseling and dual diagnosis care for mental health and substance use disorders. Cigna’s behavioral health benefits are administered by Evernorth Behavioral Health, formerly known as Cigna Behavioral Health. Evernorth uses the ASAM Criteria, 4th Edition, for adults 18 and older to determine medical necessity for substance use disorder treatment.
What varies by your specific Cigna plan:
- Deductible amount before coverage begins paying
- Copay or coinsurance percentage after the deductible is met
- Network type (Open Access Plus, LocalPlus, HMO, PPO)
- In-network vs out-of-network cost-sharing structures
- Concurrent-review cadence based on level of care
Levels of Care Covered with Cigna at Villa Wellness Center
Cigna plans cover the full continuum of addiction care, with specific scope and prior-authorization rules varying by plan type. Levels of care your Cigna plan may cover at Villa Wellness Center:
Partial Hospitalization Program (PHP)
Structured daytime treatment with intensive clinical support and no overnight stay
Drug Addiction Treatment
Personalized, evidence-based care to address substance use and support lasting recovery
Intensive outpatient programs (IOP)
If you need clinical support without overnight stays
Dual diagnosis treatment
For co-occurring mental health and substance use disorders
Trauma-focused therapy
If your substance use is tied to past trauma
Evernorth Behavioral Health requires prior authorization for PHP, IOP, and most extended outpatient programs. Outpatient services usually do not require prior authorization for in-network providers.
How to Verify Your Cigna Benefits at Villa Wellness Center
Verifying your Cigna benefits at Villa Wellness Center takes about 15 minutes by phone or one business day through the insurance verification form on verify insurance. Three steps, no commitment required.
- You send us your Cigna plan details. You provide your name, date of birth, Cigna plan name, member ID number, group number if applicable, and policyholder information if you are not the primary subscriber.
- We contact Evernorth Behavioral Health directly. Cigna members have behavioral health benefits managed through Evernorth, Cigna’s behavioral health division. Our admissions team submits the precertification request through CignaforHCP with clinical documentation supporting the recommended level of care.
- Once verification is complete, our team calls you back to explain what your plan covers, whether Villa is in-network or out-of-network with your specific Cigna plan, what your estimated cost would be, and what prior authorizations are needed before treatment begins.
Common Cigna Plan Types and How They Cover treatment
Most Cigna plans cover the same continuum of addiction treatment, but cost-sharing, network rules, and authorization requirements vary by plan type and plan year.
Cigna PPO plans. Standard commercial plans with both in-network and out-of-network benefits. Lower cost-sharing in-network. Evernorth Behavioral Health handles prior authorization for PHP, IOP, and extended outpatient.
Cigna Open Access Plus (OAP). Cigna’s most popular commercial plan type. Allows in-network and out-of-network access without referrals from a primary care physician. Cost-sharing is lower in-network. Same Evernorth authorization process as PPO plans.
Cigna LocalPlus and SureFit. Narrow-network plans with lower premiums and lower in-network cost-sharing, but limited out-of-network coverage. Behavioral health benefits go through Evernorth on the same ASAM Criteria framework as broader Cigna plans.
Cigna High-Deductible Health Plans (HDHP). Paired with a Health Savings Account (HSA). Deductibles run higher and premiums are lower. After the deductible is met, coverage works similarly to a PPO or OAP depending on plan design.
What If Your Cigna Plan Does Not Cover the Service You Need
Four options exist when a Cigna plan denies coverage. Our admissions team works with you on whichever fits your situation.
- Out-of-network reimbursement claims. If your plan has out-of-network benefits, we provide the documentation and you submit for partial reimbursement after treatment.
- Appeal the coverage decision. Evernorth Behavioral Health must process appeals within standard timeframes mandated by federal law, including the right to a peer-to-peer review with an Evernorth medical director.
- Different covered level of care. If a higher level of care is not authorized, we can adjust to a covered level (often IOP or outpatient) that still meets clinical needs.
- Self-pay arrangements. If Cigna is not an option, we discuss what self-pay would look like for your specific situation.
Call (844) 609-3035 before assuming a denial is the end of the conversation.
FAQ's
Frequently Asked Questions
What is Evernorth Behavioral Health and how does it relate to my Cigna plan?
Evernorth Behavioral Health is Cigna’s behavioral health management division, formerly known as Cigna Behavioral Health. The name changed as part of Cigna’s broader Evernorth Health Services rebrand. For Cigna members, Evernorth handles prior authorization, clinical review, and network credentialing for mental health and substance use disorder services.
Does Evernorth still use ASAM Criteria for addiction treatmenddict coverage decisions?
Yes. Evernorth adopted the ASAM Criteria, 4th Edition, on November 2, 2024, for adults 18 and older. This is the most current version of the addiction medicine field’s standard medical-necessity framework. Most other major carriers still use ASAM 3rd Edition.
What if I have Cigna but Villa is out-of-network with my specific plan?
Our admissions team confirms your in-network or out-of-network status during verification and explains what your coverage looks like in either case. Out-of-network coverage usually means higher cost-sharing, but many Cigna PPO and Open Access Plus plans still provide meaningful coverage out-of-network. Single-case agreements may also be available when no in-network alternative exists in your area.
Verify Your Cigna Coverage Today
Submit the form on verify insurance or call (844) 609-3035. We are available 24/7 to verify your Cigna benefits, answer questions about coverage, and help you understand your next step at Villa Wellness Center.