Admissions / Insurance
In-network coverage through Cigna and Evernorth Behavioral Health for PHP, IOP, and outpatient behavioral health care. Our admissions team verifies your Cigna benefits at no cost.
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About Cigna
Cigna Healthcare is one of the largest health service organizations in the United States, operating as a division of The Cigna Group alongside Evernorth Health Services. Cigna provides medical, behavioral, pharmacy, and dental coverage to tens of millions of members through employer-sponsored plans, individual marketplace plans, and Medicare Advantage. A defining feature of Cigna's structure is that while Cigna is the health plan and contracting entity, Evernorth Behavioral Health handles behavioral health authorization, utilization management, and clinical review on Cigna's behalf. Many Cigna members are also covered under self-funded employer plans, in which the employer assumes financial responsibility and Cigna serves as administrator.
2 Divisions
Cigna Healthcare + Evernorth Health Services
Cigna Plan Types
Open Access Plus (OAP)
Cigna's most common PPO-style network — members can see in-network specialists without a referral and have reduced (but not eliminated) out-of-network coverage.
HMO (Health Maintenance Organization)
Requires care from in-network providers and often a referral from a primary care physician.
LocalPlus
A regionally focused network available in select states with lower premiums and a more limited provider list.
EPO (Exclusive Provider Organization)
Covers in-network providers only, no referral required.
HDHP (High-Deductible Health Plan)
Lower premiums paired with higher deductibles, often combined with an HSA.
How Cigna Covers Behavioral Health Treatment
Under the Mental Health Parity and Addiction Equity Act of 2008, Cigna is required to provide coverage for mental health and substance use disorder treatment comparable to coverage for medical and surgical care. Cigna plans generally cannot impose stricter limits on behavioral health benefits than they do on other medical benefits.
Coverage decisions are made by Evernorth Behavioral Health based on medical necessity. For substance use disorder care, level-of-care decisions are guided by the ASAM Criteria. Reviewers consider the severity of the condition, prior treatment history, co-occurring disorders, and the appropriate level of care.
Levels of Care Covered
Cigna plans generally provide coverage across our full continuum of care when medically necessary. Our admissions team works directly with Cigna to secure appropriate levels of care for each individual.
Speak With AdmissionsIntensive daytime treatment, typically 5–6 hours per day, 5 days per week, while the individual returns home or to supportive housing in the evenings.
Approximately 9–12 hours of treatment per week, designed for individuals stepping down from higher levels of care or maintaining work, school, or family responsibilities.
Individual therapy, group therapy, medication management, and aftercare planning as part of an ongoing recovery plan.
Addresses substance use alongside mental health conditions such as depression, anxiety, PTSD, and bipolar disorder as part of integrated treatment.
Understanding Out-of-Pocket Costs
Choosing an in-network provider like Mountain View Treatment results in lower deductibles, lower coinsurance rates, and a lower out-of-pocket maximum. For members on self-funded employer plans, the benefit structure is set by the employer — verification confirms the exact terms.
The amount paid out-of-pocket before insurance begins covering services.
A fixed dollar amount paid for specific services, such as a therapy session.
A percentage of the service cost paid after the deductible is met.
The annual cap on total cost-sharing, after which the plan pays 100% of covered services.
Most Cigna plans require pre-authorization for residential treatment, partial hospitalization, and intensive outpatient programs. Mountain View's clinical team submits documentation to Evernorth Behavioral Health to demonstrate that the requested level of care meets medical necessity criteria.
Once treatment begins, Evernorth conducts concurrent reviews at regular intervals to determine whether continued care remains medically necessary. Mountain View's utilization review team manages this process directly with Evernorth, advocating for the appropriate length of stay.
Treatment records are protected under federal law, including HIPAA and 42 CFR Part 2. Cigna and Evernorth receive only the information necessary to process claims and authorize care. Employers, family members not involved in payment, and other third parties do not receive details of treatment without explicit written authorization.
Dependents covered under a family member's Cigna plan, including adult children up to age 26, are entitled to the same confidentiality protections as the policyholder.
No-Cost Benefits Verification
Because coverage varies significantly between fully insured plans, self-funded employer plans, and individual marketplace plans, the most accurate way to understand benefits is through a verification of benefits. Mountain View's admissions team contacts Cigna and Evernorth directly with the member's policy information.
Cigna In-Network
As an in-network provider, Mountain View Treatment offers lower deductibles, reduced coinsurance, and a lower out-of-pocket maximum for Cigna members.
Verification confirms:
There is no cost or obligation associated with a benefits verification.
Common Questions
Coverage depends on the specific plan, the level of care, and where the member is in their deductible and out-of-pocket maximum. Few plans cover 100% of treatment from the first day, but in-network care substantially reduces costs.
No. Evernorth Behavioral Health is Cigna's behavioral health subsidiary. Authorization and clinical reviews for mental health and substance use treatment are handled by Evernorth, but the coverage itself is part of the Cigna plan.
Self-funded plans use Cigna's network and administrative services, but the actual benefit design is set by the employer. Some self-funded plans have different limits or authorization requirements than standard Cigna commercial plans, which is why benefits verification is especially important for these members.
Coverage decisions can be appealed. Mountain View's clinical team assists with appeals by providing documentation supporting medical necessity, and members have the right to external review under the Affordable Care Act.
Medications used in treatment, including those for MAT such as buprenorphine, naltrexone, and methadone, are generally covered under Cigna's pharmacy or medical benefits, depending on how they are administered.
Under the Affordable Care Act, insurers cannot raise premiums or deny coverage based on a history of mental health or substance use treatment.
Financial Concierge
We believe that navigating the financial aspects of recovery should never be a barrier to care. We work intimately with most major PPO insurance providers to maximize your benefits and minimize out-of-pocket expenses.
How The Process Works
Secure Submission
Provide your basic policy info via our 100% HIPAA-compliant portal. Your data is strictly guarded.
Expert Analysis
Our financial advocates liaise directly with your provider to uncover the full extent of your coverage.
Clear Guidance
Within 1-2 hours, we present a completely transparent, commitment-free breakdown of your benefits.