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Cigna Healthcare plans may cover medically necessary treatment for substance use disorders, including outpatient counseling, partial hospitalization, intensive outpatient treatment, co-occurring mental health services, and certain medications used during recovery.
Portland Treatment accepts Cigna and provides structured outpatient addiction treatment at 6 Digital Drive in Biddeford, Maine. Coverage varies between Cigna plans. Your benefits may depend on your employer, provider network, deductible, authorization requirements, and the level of care recommended after a clinical assessment.
Our admissions team can contact Cigna, review your behavioral health benefits, and explain your potential treatment costs before you begin care.
Get your Cigna benefits verified in minutes. No obligation, no pressure — just clarity on what your coverage may include.
Cigna Healthcare is a national health insurance company that provides coverage through employer-sponsored and commercial health plans. Depending on your policy, Cigna behavioral health benefits may help pay for treatment involving alcohol, opioids, fentanyl, prescription medications, stimulants, benzodiazepines, kratom, 7-OH, and other substances.
This matters for two reasons: the phone number for behavioral health questions may differ from the general member services number on the front of your card, and authorization for addiction treatment may be handled by a different team than medical authorization. Our admissions staff works with both.
Not every Cigna member has the same benefits. Some plans require members to use in-network providers, while others offer both in-network and out-of-network coverage. The fastest way to understand your benefits is to have Portland Treatment verify your individual Cigna plan.
Understanding your insurance shouldn’t stand between you and getting help. If your Cigna coverage is active, you may have behavioral health benefits available for addiction treatment — but eligibility and coverage still depend on your plan’s specific terms, your provider network, the clinical assessment, the requested level of care, and any authorization requirements.
At Portland Treatment, we help individuals and families navigate the process before treatment begins. Our admissions team contacts Cigna directly, verifies your specific benefits, and explains what your coverage may include so you can make informed decisions.
All verification conversations are confidential. There is no cost and no obligation to enter treatment.
A clinical assessment identifies the appropriate level of care.
Structured daytime clinical programming for intensive early recovery support.
Structured outpatient treatment allowing continued work, school, or family responsibilities.
Coordinated MAT with trusted prescribing partners: Suboxone, Sublocade, buprenorphine, naltrexone.
Integrated care for co-occurring mental health conditions alongside substance use disorder.
Individual therapy, group therapy, and family counseling as part of comprehensive care.
Note about medical detox: Portland Treatment does not provide medical detox onsite. If clinical assessment indicates you need medically supervised withdrawal management first, we coordinate with trusted detox partners before you begin treatment with us. Your Cigna Healthcare plan may cover detox services at those partner facilities.
Authorization is not a guarantee of payment. Final payment remains subject to active eligibility, plan terms, network status, medical necessity, and the services actually provided.
The amount you may pay for eligible care before Cigna begins paying its share. Some plans carry separate in-network and out-of-network deductibles.
A fixed amount you may pay for an appointment, treatment session, or prescription.
The percentage of an approved treatment cost you may pay after meeting your deductible.
The limit on what you pay for eligible covered services in a plan year. Once met, the plan may cover the full allowed cost of additional covered in-network services.
In-network care usually costs less. Some Cigna plans provide no non-emergency out-of-network coverage; others apply a separate deductible and higher coinsurance.
A service may be included in your benefits but still require documentation showing it is medically necessary for your situation.
Many people are surprised by how straightforward the process actually is. Here’s what our admissions team does.
We take your insurance details and a brief overview of your treatment needs. Takes 5-10 minutes on the phone.
We reach out to Cigna to verify your specific benefits, deductibles, copays, and authorization requirements.
We walk you through what your plan may cover, what your expected costs might be, and next steps if you decide to move forward.
Financial uncertainty is one of the biggest concerns families face when considering treatment. Verification gives you clarity.
Have I met my deductible?
Will I owe a copay?
Is prior authorization required?
Does my plan include out-of-network benefits?
What level of care may be covered?
What total expenses should I expect?
Cigna plans may cover a partial hospitalization program when PHP is included in the member’s behavioral health benefits and considered medically necessary. PHP is structured daytime treatment for people who need more support than traditional outpatient counseling but do not require continuous inpatient or residential care.
A partial hospitalization program may be appropriate when someone has recently completed detox or residential treatment, has experienced repeated relapse, needs frequent therapeutic support, is managing significant cravings, has co-occurring mental health symptoms, needs medication monitoring, has difficulty remaining stable with weekly therapy alone, can remain safe outside program hours, and has a suitable place to live during treatment.
Cigna’s authorization requirements vary by policy. Some plans require approval before PHP begins; others allow treatment to start without advance authorization when specific requirements are met.
Cigna plans may cover an intensive outpatient program when IOP is medically necessary and included in the member’s behavioral health benefits. IOP provides more support than standard outpatient therapy without requiring an overnight stay, which lets clients continue managing work, school, parenting, or family responsibilities.
An intensive outpatient program may include individual therapy, group counseling, substance use education, relapse-prevention planning, coping-skills development, co-occurring mental health treatment, family involvement, medication management, drug and alcohol testing, recovery support, and continuing-care planning.
Cigna may review symptoms, substance use history, previous treatment, current living environment, mental health, and ability to remain safe outside program hours. Prior authorization requirements for IOP depend on the individual policy.
experienced repeated relapse, needs frequent therapeutic support, is managing significant cravings, has co-occurring mental health symptoms, needs medication monitoring, has difficulty remaining stable with weekly therapy alone, can remain safe outside program hours, and has a suitable place to live during treatment.
Cigna’s authorization requirements vary by policy. Some plans require approval before PHP begins; others allow treatment to start without advance authorization when specific requirements are met.
Many Cigna plans include benefits for outpatient substance use disorder treatment. Standard outpatient care is less intensive than PHP or IOP, and may suit someone with stable symptoms or serve as a step-down after completing a more structured program.
Outpatient treatment may involve scheduled individual therapy, group counseling, medication appointments, family sessions, relapse-prevention support, recovery planning, and ongoing clinical monitoring.
Routine outpatient behavioral health care may not require prior authorization under some Cigna plans. Network restrictions, copayments, visit limits, and other plan requirements may still apply.
Cigna plans may cover medications used to treat opioid use disorder or alcohol use disorder when those medications are included in the member’s medical or pharmacy benefits.
Portland Treatment supports MAT continuation. Depending on your plan and clinical needs, medications may include buprenorphine, buprenorphine-naloxone, extended-release buprenorphine, naltrexone, extended-release naltrexone, and medications used to reduce alcohol cravings.
Medication-assisted treatment combines medication with behavioral health services and recovery support. It may help reduce cravings, stabilize withdrawal symptoms, lower the likelihood of returning to use, and improve treatment retention.
Certain medications may require prior authorization, an approved prescriber, an in-network pharmacy, clinical documentation, step therapy, quantity limits, or a copayment.
Cigna employer-sponsored plans may include benefits for both mental health conditions and substance use disorders. Portland Treatment is licensed to treat mental health conditions that occur alongside a substance use disorder.
Many people entering addiction treatment also experience depression, anxiety, post-traumatic stress disorder, bipolar disorder, trauma-related symptoms, sleep problems, or difficulty with emotional regulation. When substance use and mental health symptoms occur together, treating only one condition may leave important triggers or symptoms unresolved.
Integrated care at Portland Treatment may include mental health assessments, individual therapy, group counseling, medication management, trauma-informed care, cognitive behavioral therapy, dialectical behavior therapy, coping-skills development, and relapse-prevention planning.
The plan type on your insurance card affects referrals, provider choice, out-of-network benefits, and cost.
Generally allows use of a national network without a specialist referral. Some plans also offer out-of-network benefits at higher cost.
Generally allows both in-network and out-of-network treatment. In-network usually carries lower deductibles and coinsurance.
Typically requires participating providers except in emergencies. Some plans require a primary care provider or referral.
Generally limits non-emergency coverage to in-network providers but may not require referrals.
Many people in Maine receive Cigna coverage through an employer. Employers select different networks, deductibles, copayments, and behavioral health benefits — which is why two people with Cigna cards may have substantially different addiction treatment coverage.
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Cigna may require prior authorization or precertification for certain addiction and behavioral health services. Requirements depend on your specific policy. Routine outpatient therapy may not require advance authorization under many plans, while higher levels of care may require clinical review.
Services that may require authorization include partial hospitalization, intensive outpatient treatment, certain medications, and specialized behavioral health services. Residential addiction treatment, inpatient psychiatric treatment, and medical detoxification typically require authorization as well — Portland Treatment coordinates referrals for those levels of care rather than providing them onsite.
Cigna may request information about current alcohol or drug use, withdrawal risks, mental health symptoms, medical conditions, previous treatment attempts, recent relapse, ability to remain safe, recovery environment, available support, and the recommended level of care. Portland Treatment can help provide the information needed to request authorization.
Cigna may pay a substantial portion of covered addiction treatment expenses, but insurance does not always pay the entire cost.
Your responsibility may depend on whether Portland Treatment is in network, whether your deductible has been met, your copayment or coinsurance, your remaining out-of-pocket maximum, whether authorization was obtained when required, whether the recommended service is covered, whether the level of care is considered medically necessary, and whether another insurance policy must be billed first.
Some clients owe little because they have already met their deductible or out-of-pocket maximum. Others have a larger financial responsibility. Verification provides a clearer estimate before treatment begins.
Cigna plans may cover medically necessary treatment for alcohol use disorder, including PHP, IOP, outpatient counseling, co-occurring mental health care, medication management, and medications used to support alcohol recovery.
Cigna may cover treatment for substance use disorders involving opioids, fentanyl, heroin, prescription drugs, cocaine, methamphetamine, benzodiazepines, kratom, 7-OH, and other substances. Coverage is generally based on the diagnosed condition, medical necessity, provider network, and recommended level of care rather than the substance alone.
Cigna plans may cover counseling, structured outpatient programs, medication management, and medications used to treat opioid use disorder. Medication coverage and authorization requirements vary by policy.
Cigna may cover partial hospitalization and intensive outpatient treatment when those services are included in the plan and medically necessary. Whether prior authorization is required depends on the member’s individual policy.
Many Cigna plans include behavioral health benefits for mental health and substance use disorders. Portland Treatment provides mental health care for conditions that occur alongside a substance use disorder, including therapy, medication management, and structured outpatient programming.
Some Cigna PPO and Open Access Plus plans include out-of-network benefits. HMO, EPO, and limited-network plans may restrict non-emergency treatment to participating providers. Out-of-network care usually costs more.
Open Access Plus and PPO plans generally do not require specialist referrals. Certain HMO, EPO, individual, or employer-sponsored products may have different rules. Our admissions team can verify whether a referral is required under your plan.
Possibly. Cigna operates national provider networks through many employer-sponsored plans. Network access and out-of-state coverage depend on the plan listed on your insurance card.
Many clients continue working while attending IOP or standard outpatient treatment. Whether this is appropriate depends on your symptoms, safety, schedule, and recommended level of care.
Insurance verification and treatment inquiries are handled confidentially. Your employer does not receive details about your diagnosis or treatment simply because you use an employer-sponsored health plan.
No. Verification helps you understand your benefits and potential costs. It does not obligate you to enroll at Portland Treatment.