Does Cigna Cover Addiction Treatment?

Yes. Encore Outpatient Services is in-network with Cigna Healthcare/Evernorth for outpatient addiction treatment. Your specific coverage and costs will depend on your plan. 

What Cigna Outpatient Coverage Includes in Arlington, VA

Cigna/Evernorth is in-network for both our Intensive Outpatient Program (IOP) and General Outpatient Program (GOP). Depending on your treatment needs, your benefits can apply whether you need the added structure of IOP or ongoing care through GOP. 

Evaluations, psychiatric evaluations, medication management, and medication-assisted treatment (MAT) are also covered when provided as part of your IOP or GOP care. This allows your treatment plan to include different clinical services based on your individual needs. 

You do not need to know which program or services you need before contacting us. Our clinical team evaluates your needs and recommends an appropriate treatment plan. We can then explain how your Cigna/Evernorth benefits apply to the care recommended for you.

How We Help You Understand Your Cigna/Evernorth Benefits

Before you begin treatment, we review your Cigna/Evernorth benefits and explain how they apply to your care. This includes your expected costs, coverage limitations, and any authorization requirements.

Benefit Verification

We verify your benefits using your member ID number and date of birth. We also need a copy of your insurance card before or on the date of admission.

Understanding Your Costs

Admissions explains your remaining deductible, copay or coinsurance, out-of-pocket responsibility, and any coverage limitations.

Authorization Support

Cigna/Evernorth typically does not require prior authorization. When required, our verification team handles the process, including needed reviews or appeals.

Your Treatment Plan Is Based on Your Clinical Needs

Your insurance coverage does not decide what treatment is right for you. Our clinical team looks at your substance use, mental and physical health, treatment history, current circumstances, and how much support you need.

We use that information to recommend an appropriate level of outpatient care and build your treatment plan. You will not automatically receive every service your insurance may cover. Your care is based on what is clinically appropriate for your needs and treatment goals.

Your treatment plan can also change as you make progress. Our clinical team monitors your progress and can adjust the support or services you receive. Your Cigna/Evernorth benefits determine how covered care is paid for, while your clinical needs guide our recommendations.

Take the Next Step Toward Treatment

If you have Cigna/Evernorth coverage and are considering treatment, our team can help you understand what happens next. You can ask questions about our programs, discuss what is bringing you to treatment, and learn what to expect if you decide to begin care.

When you contact us, you can:

  • Talk with our team about what brings you to treatment
  • Ask questions about our outpatient programs
  • Learn what to expect during the admissions process
  • Discuss any questions or concerns before starting care
  • Get guidance on your next steps toward admission

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Frequently Asked Questions About Cigna/Evernorth

Yes. Cigna/Evernorth is in-network for both IOP and GOP at Encore. Our clinical team recommends the appropriate level based on your symptoms, substance use, treatment history, current circumstances, and need for support.
Yes. MAT is in-network with Cigna/Evernorth when it is included in your IOP or GOP treatment. Our clinical team determines whether MAT is appropriate, while coverage for the specific medication is verified separately under your prescription benefits. 
Yes. Cigna/Evernorth coverage can apply to substance-related services you receive through VASAP at Encore. We verify your individual benefits before treatment to confirm how your plan applies.
We review your benefits again when a change in care affects your coverage. Our clinical team adjusts treatment based on your progress, current symptoms, and need for support rather than keeping you at a level of care solely because it is covered.
We explain the coverage limitation and what it means for your treatment options. Our clinical team still recommends care based on your clinical needs rather than changing the recommendation solely to match what your plan covers.

Let Us Support You On Your Recovery Journey!

Our dedication lies not just in treating symptoms but in addressing the root causes, offering a holistic approach that integrates the best of therapeutic practices with the warmth of community support.