Evernorth Insurance Coverage for Drug and Alcohol Rehab
How Does Evernorth Insurance Work?
When considering access to coverage for treatment, you should follow the requirements of your specific plan to schedule and receive assistance. For instance, Evernorth requires members to meet certain medical necessity criteria.5 The utilization management team evaluates your eligibility for coverage based on different factors—such as the terms of your plan, the treatment facility where you wish to receive care, and the appropriateness of the service based on standard guidelines.6
Each service has different criteria, and you’ll need to get preauthorization for many of them including:6
- Admissions to hospitals or facilities that are not emergencies.
- Excluded services or those with limited coverage.
- Some outpatient services and medications.
With Evernorth, copays and deductibles vary, as do out-of-pocket costs for different services, which are dependent to your specific insurance plan. However, Evernorth offers copay assistance programs for high-cost medications.7 Additionally, if you have Evernorth insurance through your employer, mental health and substance use treatment services don’t require a separate deductible. Your specific plan provides you access to benefits, which may include:4
- In-network behavioral health providers.
- Mental health and follow-up case management services.
- Referrals, consultations, and outpatient services.
- Referrals to behavioral coaches, local community support groups, and online resources.
- Confidential therapy.
- Recovery specialists.
- Inpatient and outpatient treatment services.
Like most insurance plans, choosing an Evernorth in-network provider is your best option to guarantee that at least some portion of your treatment will be covered. In-network providers are mental health professionals, specialists, facilities, and hospitals contracted through your insurance to offer healthcare services.
At times, a referral from your primary care physician (PCP) may be required to seek certain treatments. Choosing a provider outside of your network will likely require you to pay high out-of-pocket costs.
Evernorth Employee Assistance Program for Drug and Alcohol Misuse
Evernorth offers an Employee Assistance Program (EAP) that provides the tools and resources to employers and their workforce to help them successfully navigate difficult situations in and out of the workplace. The EAP provides referrals and resources for mental and behavioral health needs, home-life concerns, legal and financial services, job and career support, and manager and workplace concerns. The program helps managers and other employees manage stress, improve their work/life balance, and resolve issues.8
Evernorth, a division of Cigna insurance, offers high-quality healthcare services to individuals and families nationwide.1 Many of the costs for different substance use treatments may be covered with Cigna Evernorth insurance.
What is Evernorth Insurance?
Cigna Corporation launched Evernorth in 2020 to meet the diverse needs of employers, health plans, and government organizations.1
With it, they developed several companies under Evernorth to advance the availability of quality services specific to mental health and substance use disorder treatment. One of those companies, Express Scripts PBM, created the Advanced Opioid Management solution to aid in opioid misuse prevention, manage opioid misuse, and facilitate recovery in individuals suffering from opioid use disorder.2
Another Evernorth solution dedicated to mental healthcare is inMynd, which works to change the stigma of silence and shame that surrounds mental health conditions to get individuals the help they need.3
Evernorth operates as a medical practice division of Cigna HealthCare in different states nationwide.
- Cigna. (2020). Cigna launches Evernorth to accelerate delivery of innovative and flexible health service solutions.
- Evernorth. (2022). Advanced opioid management.
- Express Scripts. (2022). inMynd℠ — Every mind deserves better.
- Cigna. (2022). Mental health and substance use benefits.
- Cigna. (2020). Cigna standards and guidelines/medical necessity criteria.
- Evernorth. (2022). Commitment to quality.
- Evernorth. (2021). Copay assistance strategy reduces financial burdens for plans and patients.
- Evernorth. (2022). Employee assistance program.
Rehabs That May Accept Evernorth Insurance
Frequently Asked Questions
Where can I find information on other insurance providers?
Use the mini sitemap below to read more about other insurance providers
Anthem Health Insurance, Blue Cross Blue Shield, First Health, Sierra Health and Life Insurance, AmeriHealth, AvMed Insurance, Carelon Behavioral Health (formerly Beacon), Cigna, ConnectiCare, EmblemHealth, Harvard Pilgrim, Health Plan of Nevada, Magellan, MagnaCare, Meritain, Oxford, QualCare, UPMC, Behavioral Healthcare Options (BHO), Humana Health, Kaiser Permanente, Kemper Direct, Providence Health Plan, Rocky Mountain HMO, State Farm, TRICARE Health Insurance, Tufts Health Plan, United Healthcare, Medicaid Plans, Sunset of Veterans Choice Program, Zelis
What substance addiction does health insurance coverage include?
Health insurance providers typically cover rehab treatment for most types of substance addiction; including alcohol, suboxone, heroin, cocaine and meth and rehab for drug addiction.
