What’s Covered, and What’s Not, by Cigna Behavioral Health
Does Cigna pay for therapy?
Yes, Cigna covers therapy for mental health and substance abuse. Though the course of your therapy will depend on the treatment you and your therapist ultimately establish together, Cigna offers a range of treatment options.
For details of exactly which treatments and conditions are and are not covered, check your individual plan.
What types of conditions does Cigna cover?
The mental health conditions that Cigna covers include:
Adjustment disorder (troubles adjusting to life changes)
Mood disorders, such as bipolar disorder
Does Cigna Behavioral Health cover couples therapy?
While it depends on your plan, it is unlikely that Cigna will cover couples therapy (or marriage counseling, or family therapy) unless someone in sessions has a specific diagnosis.
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.
What should I do if my child needs therapy and I have a Cigna plan?
With a diagnosis, your child should be covered for therapy types including Behavior Therapy for ADHD, Motivational Therapy for Bed-Wetting, and more.
How much does Cigna reimburse for therapy?
Cigna’s reimbursement rates and requirements vary across different plans. Most plans have different rates for therapists who are in-network with Cigna, as opposed to those who are out of network. For more details, check your plan.
Your plan’s reimbursement rates and requirements, ceilings and exclusions are available on your personal webpage.
How much are therapy sessions under a Cigna plan?
What you pay depends on your plan and the provider’s fee. Check your specific plan for information about treatment coverage.
For plans through employers, for example, you may need prior approval from Cigna before you get the service in order to receive coverage under your plan.
What is my copay for therapy with Cigna?
The amount of your copay depends on the details of your specific plan.
Many plans have a copay, a preset amount you pay for covered health services at the time you receive care. Although there are no copays when you use a doctor or facility that is out-of-network, you are responsible for paying a percentage of the total bill, the coinsurance.
This is usually much higher than the in-network copay amount. You can also check out this great resource In Network vs. Out of Network therapists.
What is my deductible for therapy with Cigna?
Your deductible varies, depending on your plan.
To get more information, you can use the plan tracker tool in your Cigna portal for an overview of your deductible (including how much you’ve spent toward your deductible so far, and how much you have left before meeting your deductible amount).
Finding a therapist for Cigna Behavioral Health
How can I find Cigna Behavioral Health therapists?
If you’re in New York City, Boston, Chicago, or Rhode Island, use Zencare.
New York City , you can find Cigna Behavioral Health providers on Zencare. Select Cigna as your insurance company under "Payment Options" to view therapists who are in-network. Alternatively, visit our page of Cigna Behavioral Health Therapists in NYC.
You can also check the list of therapists who have been recommended to us, or ask your primary care physician for a recommendation.
Another option is searching other therapist directories; however, be sure to verify with each therapist that they do in fact take your insurance, as these lists are often out of date.
What happens if I don’t use a Cigna therapist?
If you don’t use a Cigna therapist, you can apply to use out-of-network benefits. The best way to fully understand your out-of-network coverage is to call Cigna directly. The number for member services is typically on the back of your insurance card.
When you call Cigna, be sure to ask:
What is my annual deductible?
Do I have an additional out-of-network deductible?
What is my coinsurance for outpatient mental health?
Do I need a referral from a primary care physician or an in-network therapist to see an out-of-network therapist?
How do I submit out-of-network claims for reimbursement?
Check out our resource on the step-by-step guide to using out-of-network benefits.
Claims & Reimbursements
How long do you have to submit a health insurance claim with Cigna?
The general rule for submitting a claim with Cigna depends on if you used an in-network or out-of-network provider:
If you use an in-network provider, you have 90 days after a treatment session to submit a claim
If you use an out-of-network provider, you have 180 days after a treatment session
How do I complete Cigna claims for therapy?
The first step for completing a Cigna claim for therapy is to download and print the claim form.
You can mail your completed claims forms for mental health and substance use treatment to the following address:
Mental Health and Substance Use Claims
Cigna Behavioral Health, Inc.
Attn: Claims Service Dept.
P.O. Box 188022
Chattanooga, TN 37422
A final note on using health insurance for mental health issues
In order for a therapist to be able to charge an insurance provider for counseling sessions, the insurance companies require the therapist to provide a diagnosis.
For example, if you seek out therapy for stress at work, the therapist has to diagnose you with anxiety disorder. If you’re going through a divorce, it might be adjustment disorder; and for marital issues, depression.
However, getting coverage in this way has some downsides to consider. In some states and cities (like New York City and Boston, for example), therapists are opting to no longer sign up for the insurance panels due to:
Being forced to give a diagnosis
Insurance questioning the necessity of therapy
Possible need to provide the insurance company with proof of the need for therapy
Difficulty in getting paid by the insurance companies
All these should be considered when deciding if you want to use your insurance, or pay out of pocket.
If you do not have health insurance, opt to not use it, or your therapist of choice does not accept insurance, then know that some therapists are able to work with you in regards to their fee. Just ask!