Cigna Behavioral Health
Does Cigna Behavioral Health cover therapy?
Yes, nearly all Cigna Behavioral Health plans cover therapy for mental and behavioral health conditions. However, the extent of coverage depends on your particular plan.
How much your particular plan covers depends on several factors, like if you have/have met a deductible, and whether the service is in-network or out-of-network.
How much does therapy cost with a Cigna Behavioral Health plan?
The cost of sessions depends on A) your plan’s coverage, and B) whether you’re seeing a therapist who’s in or out-of-network.
A) Your plan’s coverage
There are two key two terms that determine your payment amount per therapy session.
- Deductible — The sum total of medical costs you need to pay each year before your insurance coverage begins. (All your medical costs contribute to this, not just therapy costs.)
- Copay — The set fee you pay at every therapy session, after your deductible is met. A copay typically ranges from $15 to $50 per session.
B) In-network vs. out-of-network
In-network: If your therapist is in-network, you will have to pay a copay and/or deductible (see section A). The final cost depends on your specific plan.
- Find out how much each session will cost by looking at your summary of benefits or contacting your health insurance provider directly.
Out-of-network: If you are seeing a therapist out-of-network, then you will have to pay the whole fee the therapist charges up front (or the sliding scale rate, if that is what you have both agreed upon).
- You may be able to get reimbursed a portion of out-of-network costs by using out-of-network benefits.
What types of therapy does Cigna cover?
The modalities that Cigna Behavioral Health covers may include, but are not limited to, the following:
A therapist may use different types of therapy approaches in your sessions.
What types of conditions does Cigna cover?
The mental health conditions that Cigna covers may include:
Note that Cigna Behavioral Health therapists are required to assign you a diagnosis for the above conditions, as well as share the diagnosis with your health insurance, if you are using benefits to pay for therapy.
If you don’t want your insurance company (or your family members, if you have a shared plan) to have access to this information about your mental health, consider out-of-network options instead.
What kinds of therapy does Cigna Behavioral Health not cover?
It is not typical for Cigna Behavioral Health to cover the following:
- Couples counseling (see below for more info + ways to pay for couples counseling)
- Weight loss services
Does Cigna Behavioral Health cover couples therapy?
No. While it depends on your specific plan, it is unlikely that Cigna will cover couples counseling.
That said, even if your insurance doesn't directly cover it, you still have options for getting affordable couples counseling. Here are five ways to pay for couples counseling if it’s not included in your health insurance plan.
Do I need to see my doctor before visiting a Cigna therapist?
Whether you need to get a referral for a therapist from your primary care physician depends on what type of plan you have. Generally speaking, here’s what’s required per plan type:
- HMO: Yes, you are typically required to see your primary care physician for a referral to therapy before your insurance company will provide outpatient coverage.
- POS: Yes, you will likely need to see a primary care physician for a referral to outpatient therapy.
- PPO: No, you typically don’t need to see your primary care physician for a referral before accessing outpatient mental health services.
- EPO: No, you typically don’t need to see your primary care physician for a referral before accessing outpatient mental health services.
If you do not get a referral, you may want to call your member services number directly to check whether pre-authorization is required for coverage.
Does Cigna Behavioral Health cover online therapy?
Yes, Cigna does usually cover video therapy sessions, which you can use in place of an in-person visit to your therapist’s office.
Video sessions are also an option for managing medications without an office visit.