Cigna Behavioral Health for Therapy | Zencare Guide — Zencare

Cigna Mental Health Coverage

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Does Cigna Insurance cover therapy?

Yes, nearly all Cigna Mental Health plans cover therapy for behavioral and mental health treatment. 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 Insurance Plan for Mental Health?

The cost of sessions depends on A) your plan’s mental health 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 mental health treatment 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 mental health treatment 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).

What types of behavioral health treatment does Cigna cover?

The modalities that Cigna Insurance for Mental Health issues covers may include, but are not limited to, the following:

A therapist may use several types of therapy approaches in your sessions.

What types of conditions does Cigna cover?

The mental health conditions that Cigna health benefits cover may include:

Note that Cigna Mental Health therapists must assign you a diagnosis for the above conditions, as well as share the diagnosis with your health insurance, if you are using mental health 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 treatments, consider out-of-network options instead.

What kinds of behavioral health services are not covered by Cigna?

It is not typical for Cigna Mental Health benefits to cover the following:

  • Couples counseling (See below for more info + ways to pay for couples counseling)
  • Weight loss services
  • Hypnotherapy
  • Aromatherapy

Does Cigna cover couples therapy?

No. While it depends on your specific plan, it is unlikely that Cigna’s behavioral health benefits 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 must typically see your primary care physician for a referral to therapy before your insurance company provides outpatient treatment 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 cover online therapy?

Yes, Cigna’s mental health benefits 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.