Evernorth Health Insurance Coverage for Addiction Rehab
Discover how Evernorth Health Services supports addiction treatment and behavioral health coverage. Get the care you need today.
Evernorth Health Insurance Coverage for Addiction Rehab
Discover how Evernorth Health Services supports addiction treatment and behavioral health coverage. Get the care you need today.
Evernorth Health Services is a part of Cigna Corporation. The company provides a wide variety of solutions for health plans, employers, labor unions, health systems, and more. The focus is on pharmacy support and behavioral health services along with data driven benefits management.
Certain aspects of healthcare, in particular pharmacy benefits and behavioral health, are fragmented and challenging to understand. It can be hard for insurance plans and other organizations to know how to provide continuity of care with appropriate followup especially for complex health cases. Evernorth helps these plans and organizations provide appropriate care.
Cigna Corp also announced that in 2025 Evernorth will be launching a nationwide outpatient behavioral health practice which will help insurers and healthcare providers address each patient’s mental health and medical needs. You can get care online or in person. This care is already available in six states and D.C.
Does Evernorth Health Cover Addiction Treatment?
Evernorth is a benefits provider and administrator, not an insurance company, so they don’t determine what kind of care you get. However, most insurance plans are required to offer at least some coverage for mental health and substance use due to the Affordable Care Act (ACA). Evernorth can help insurance plans meet those requirements because they offer a wide variety of in person and telehealth addiction rehab and mental healthcare.
Every insurance plan is different, so be sure to talk to the insurance company or your employer’s benefits specialist to get your plan’s details before you start treatment. That way you know what to expect and don’t have any surprises when you’re focused on recovery.
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BEST PLACE EVER. I have tried various other doctors/clinics and none of them even begin to compare to this one. The staff here is absolutely amazing. I can’t even make a single complaint. Dr Son is the best as well. He explains everything and you truly feel like he understands you. I can proudly say this, this place saved my life. If you or someone you know needs help getting off opiates do it right the first time and come here. You won’t be disappointed. If you are specifically struggling with fentanyl please don’t waste your time with other ways. I have tried 6 other methods from lazer therapy to having the earpiece to suboxone. Methadone is the key to our current fentanyl crisis. This clinic makes recovery possible again!
Mason
1 month ago
Entire staff was friendly, helpful and supportive throughout the whole process from reception to nurses to counselors
William Maddux
2 months ago
The nurses at the hurst location and also Samantha the receptionist are all so kind and compassionate!! They all go above and beyond the call of duty. They should all be praised for their hard work and their kindness to their patients!!
I recently completed the 30 day Core Peogram at Elevate Addiction Services in Watsonville. After two relapses following decades of previous sobriety, I knew I could benefit from an intensive inpatient residential program to set me bsck on the right path again. I'm so grateful I found Elevate right away. The 12 Steps originally got me sober, and I have no issues with AA/NA, but Elevate is based on SMART Recovery, which is built on a different foundation from the 12 Step program. I gained new insights through the intensive workbooking and structured group sessions, as well as my time spent with my on-site therapist. There's a big emphasis on Mindfulness at Elevate, so be prepared to meditate and practice breathwork frequently. The rural location is serene, with spectacular views of the Pajaro Valley, and the wildlife is abundant. If you enjoy nature, this is a wonderful, peaceful location. The ranch-style property doesn't look or feel institutional at all. The facilities are a bit worn (it was originally built 50+ years ago as a retirement home for nuns), so if you're looking for a luxury rehab, this probably isn't the place for you. But if you could benefit from delicious meals, CrossFit and yoga, volleyball and pickleball and a well-stocked game, book and DVD library, look no further! Every single employee has gone through the program themselves, so they really understand what you're going through. Many people opt to stay on past their 60-90 day programs to train as staff members. The facilitators are caring, kind and helpful. The folks in the detox center are supportive and gentle. The security staff are strict but reasonable. Monday-Saturday, the schedule is very structured, with plenty of breaks and evening free time, and Sundays are completely free all day and night. You will be expected to do chores and follow rules. After an initial 7 day "blackout" period, clients have access during free time to shared cell phones in a common room, and once a week you have an opportunity to use your personal cell phone/laptop in a more private space. Visits from friends/family are limited, subject to pre-approval and only take place on Fridays from 3-6pm. The structure and rules are in place to help keep you focused on what you came there to do in the first place: get clean and sober! Overall, Elevate offers clients the opportunity to hit "pause" on the chaos of using and drinking, the tools to gain clarity and insight, and the strength and will to go back to living a clean and sober, productive life.
N. D.
1 week ago
Elevate was such a great program, it’s really changed my way of thinking for a positive
Thank you Elevate!!!
michael gonzales
2 weeks ago
It was the best program I could ever ask for going in at 18 I wasn’t courted to do anything the work is straight forward and really helped me to grow and mature thank you so much elevate you made me feel welcomed comforted and made me want to stay
I had the most amazing experience of my life! WWR saved my life in many ways. I tackled multiple addictions and took advantage of every service they offer (which there are many!). The counselors and recovery advocates are incredible. While I now have the tools to go back to the real world, I will miss this place in my soul. I would recommend WWR to anyone needing to face addiction or any other mental challenge.
Marsha Baker
1 month ago
Windmill is set amongst a beautiful scenery of trees and deers, that enables peace of mind and a healing quietness for the spirit. This serene atmosphere grows and shines in the people living there and the ones there providing us support through their smiles and patient caring for each other. I was able to learn again what it felt like to be human, sane, and a part of something. Fellowship being the heart of the strength built, I walked away with a community that stands as an army ready to fight together. You will be empowered. It works if you work it. As the windmill keeps turning, so shall we!
Annemarie
1 month ago
To say I can't give enough stars for Windmill Wellness Ranch would be a true understatement. This place saved my life brought me back my happiness and gave me the tools for a beautiful future. The staff at Windmill have real life experience and top-notch education to help the struggling no matter what you are struggling with. They really pay attention to you and your situation. They do an excellent job placing you, from your roommates,to your process group, your therapist and recovery coach. That being said if you feel it is not working they will work with you to make you feel comfortable. I've never felt like I've truly fit in in my whole life. I've always felt like the oddball out.Here I found my tribe and We are doing this new happy exciting life sober!!!
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This place has done amazing things for me Casey Fisher is the most amazing person she got me back in when needed and the staff is always there when you need someone I've had a chance at a new start cause of them I love this place and would recommend this place if you want a fresh and sober start thanks avenues and I will always appreciate your Support and loving staff ...
Grimm
3 days ago
The staff at Avenues Recovery Center is awesome. They have helped me with not only my addiction, but also being institutionalized. If you are struggling, call Avenues.
Zach Holden
3 days ago
The staffs great!These people really care here! I recommend this place to anyone struggling with addiction!
These people have helped me recover from the worst point in my life to become a much better happier person today. I owe my life and my family to this place. Especially Leia, Cynthia, and Mary. But I want to thank everyone else for being a part of this process.
Daymond Johnson
1 month ago
They Ubered me to the clinic when my car broke down and even they stayed open late because of the bad weather. These people always go the extra meter to take care of me no matter what. Five stars!!!
Gwen R
4 months ago
Everytime I come here the staff are beyond amazing very personable no judgement passed on and extremely helpful always quick and easy Cynthia is still my favorite though ;)
I am truly grateful for Springhill Recovery. Immediately I was made to feel at ease, safe & secure. I quickly realized that I was in competent, caring hands with all of the staff that I met.
I learned so much about myself here! I can see where I need to work on a few things and I now have to tools to do it thanks to the amazing groups here.
I leave here confident in my sobriety & recovery! I will seek connections with others in recovery because I’ve learned that absolutely nobody can do this alone.
Thank you Springhill Recovery for giving me a chance at life again!
Jackie Loewen
1 month ago
Amazing! Take everything they give you! Make connections with your peers! Day by day! Spring Hill is where recovery begins and you will leave with serenity, courage, and so much more.
These are all Angel's walking among us!!
Love the whole team, thanks for showing me a better life!!!!
Freddie Moor
1 month ago
Lantana Recovery is an outstanding facility with caring clinicians and supportive leadership. They truly put patients first and are dedicated to helping them succeed in their recovery.
Katie Zeigler
1 month ago
Where to begin? My life was not worth living. I was depressed, and broken up inside. Lantana Recovery Rehab made it possible for me to get to know myself in a way that, most importantly, was spiritually and physically sound. Something I could not say before, and was looking to change. You get out of the program what you put into it. I got my life back, which was more than I deserved. If you’re looking to be truly honest with yourself, get your life together, and get sober too, this is the place to do it. Shout out to Scott, Ashley, Josh, Jeff, Jen, and Eleanor. Without whom, I most likely wouldn’t be here today. There are many others I have left out, but they are all equally special, when it comes to sobriety and recovery. Thank you all, from the bottom of my heart. My family thanks you, my wife thanks you, and most importantly, I thank you for changing my life!!! Love you guys.
I had little to no hope before coming to Kemah Palms Recovery. I had just spent 8 days at a med-center hospital after a suicide attempt and they wouldn't discharge me unless it was to a rehab. Kemah Palms was actually my 6th rehab in the past year and a half. It was the first one I actually finished. I had left against medical advice at all the others. I was on a tremendous downward spiral with so much momentum that there was no stopping this fall. I was coping with the pressures of a recent divorce and spending the last two plus years fighting for my son's life who had had 4 open heart surgeries and 3 brain surgeries amongst many others. That was in addition to life's other traumas and pressures. I am dual diagnosed and my PTSD is so extreme it doesn't usually allow me to deal with situations of chaos and high stress. The team at Kemah Palms developed a treatment plan just for me and weren't so legalistic with the rules that I couldn't make it through there, but also had enough order that it was a safe environment. Earlier in this review I mentioned this being the first rehab I finished. That begs the question "what was different about Kemah Palms Recovery?" The biggest difference for me were that the people who are with you day in and day out are former recovering addicts themselves and actually care about recovery. They understand this is life and death and come at you from a place of understanding and love. From their director Paul (no one knows more about recovery than this man) to their clinical director Tabitha (compassionate and intuitive) to my counselor Mrs. Day (best in the business and a true overcomer) to all the RA's and I do mean absolutely all of them, they prioritize you as a person and put your recovery first. From Raquel (super sweet and caring) to Michael (now my sponsor and I wouldn't have it any other way) to Cody (a fantastic recovery ally who I can still call and process with today) to Kristen (super caring) to Christian (rooted in faith) to Matt (a caring recovery advocate) to Abbie (authentically cares for you as a person) to Julie (who knows how to keep you grounded) to Ember (heart of gold) to Ashton (strong advocate) Mandy (super love her and no more caring/empathetic person alive) to the nursing staff, Hailey,(actually saved me when I was choking and also grounded in faith) to Carmen (fantastic nurse.) From Ashlynn who was kind and caring during my intial call, to even Jennifer and Stephanie who make sure you're set up for success when you leave by making sure you have living arrangements and appointments set. Basically just everyone from the doctors to even the maintenance staff Andy, Curt, and Cameron, this place is all about recovery and doing what it takes to get you healthy and the best version of you. I must also mention Mrs. Clara the cook. That was some of the best eating I have ever had. I even spoke with the owners several times while I was there and they are absolutely awesome. You'd think a place like this would be profits over people and most rehabs are, but it is super refreshing that this is the exception to that rule where people and their recovery come first. I love this place. I have to mention the equine therapy they have with two awesome horses, (Star and Cassie) and Sparky the recovery dog was there to love on you when you needed a friend. The community and love here and the continued connection has laid the foundations for what my recovery will be for the future. I am now participating in their PHP program and Jason and John are fantastic. They are the counselors running that program and they really challenge your old thought processes. I am approaching 2 months sober at this time, which is huge if you know me, and nothing short of a present day miracle. If you're looking for a place to partner with you and give you the necessary tools for you to be sober and successful I highly recommend this place. Kemah Palms Recovery is more than a rehab, they are love. ❤️
J.C. Herrington
5 months ago
Well considering I’ve been to quite a few rehabs, Kemah Palms has hands down been the best one. All the staff was very welcoming from the moment I walked through the front door. Detox was surprisingly good, Residential had its ups and downs but that’s all about perspective. The counselors were amazing! Told me what I needed to hear not what I wanted to hear. I’ve never felt so confident in recovery. They gave me wonderful tools to use. Taught me away to handle life in a more affective way. I would recommend KPR to anyone looking to change their life.
Elizabeth Faust
5 months ago
I was unsure of how this program would benefit my recovery in the beginning; I did not buy in fully for almost two weeks, but I am so glad I did. I want to thank the amazing staff- RA’s, Counselors, Admin, Groundskeepers, and especially the other clients I befriended along the way for their role in my recovery. I am a better man for it today, and I’m eternally grateful.
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Frequently Asked Questions
What Benefits Does Evernorth Health Provide?
Evernorth has a broad suite of services that help health plans and organizations provide much needed care to their members. Not all insurance plans will have all services.
Their behavioral health services include AI guided care recommendations and licensed clinicians available 24/7/365 by phone or online on demand. They also have an expanded network of providers that includes inpatient and outpatient care along with virtual support. Evernorth provides an Employee Assistance Plan (EAP) that can refer employees to financial and legal assistance along with other resources.
They also have a Behavioral Health Navigator that gives you a live person to help you determine what you need and find a provider. They can even help you schedule an appointment and follow up to ensure you got what you needed. Finally, Evernorth has a program called inMynd that provides digital cognitive behavioral therapy (CBT) and medicaton management.
Evernorth’s CareNav+ is an app that allows members to get care coordination to help them address health issues before they become serious. It includes an AI powered care navigator that gives you proactive recommendations for medical care.
Another Evernorth service that can help with substance use treatment is a partnership with Pelago Health. They provide virtual care and one to one coaching and counseling. Pelago also has on demand CBT and specialized treatment options that can be mailed to your home.
Evernorth Health’s Advanced Opioid Management® program is focused on helping those who are prescribed opioids avoid misusing the medication. You will be educated about the risks of opioids and given drug disposal bags to ensure leftover meds aren’t misused. Patients can also get case management and a connection to a mental health hotline. As part of this program pharmacies can provide Narcan and there may be prior authorization required for some prescriptions and refills.
What Inpatient Addiction Treatment Does Evernorth Health Cover?
While your insurance company may have a contract with Evernorth for addiction treatment services the insurance company will still decide what coverage it ultimately provides.
If you need residential treatment, almost all insurance plans will expect you to get prior approval before you go. Insurance companies ask for prior approval before agreeing to cover residential treatment because they want to know that it’s the right match for the severity of your condition. They usually take several factors into account such as your health status and what substances you’re using as well as what kind of social support you have.
Depending on your clinical condition there are different inpatient services your treating doctor might refer you to.
If you’re physically dependent on a substance that can lead to dangerous withdrawal symptoms you might start with inpatient detox. The drugs that are most commonly detoxed in inpatient settings are alcohol, opioids and sometimes benzodiazepines. The length of stay usually depends on your clinical condition. Most detox admissions last between three and ten days.
If you don’t need medical detox or you’ve completed it your next stop may be residential rehab. This might be the right level of care for you if you’re getting alarmed about how dangerous your drug use is getting — either because of the situations in which you use or the health consequences it’s causing you. Residential rehab separates you from these dangerous conditions by bringing you into a controlled environment. It’s usually very structured with little free time and limits as to what can come into the facility. Days are usually spent in therapeutic groups and activities. The length of stay can vary but is usually several weeks.
What Outpatient Rehab Does Evernorth Health Cover?
Your insurance company may partner with Evernorth to connect you to some of the outpatient services described below.
If your treatment team refers you to partial hospitalization you may find that the experience is very much like residential treatment but with one major difference – you go back to your own home at the end of the day. Partial hospitalization is often used as a step down from residential rehab but you can also get admitted there directly. People who have supportive home environments may be candidates for direct admission to a partial hospitalization program.
Intensive outpatient programs (IOPs) take place for two or three days a week for a few hours. They sometimes offer evening hours. IOPs are often best for people who are still able to keep working or who are trying to get back to having responsibilities.
Standard outpatient therapy is when you find a therapist and perhaps a psychiatric medical provider and see them on a regular basis. How often you see them will be between you and your provider.
Does Evernorth Health Cover Methadone & Suboxone (MAT)?
Methadone and suboxone are both medications that are used to treat opioid use disorder. Sometimes these medications along with others get collectively referred to as MAT. MAT stands for medication assisted treatment. Medications can be used as part of detox or as a maintenance treatment. There are also medication treatments available to help people who are addicted to alcohol.
If you’re using MAT for detox you will normally get medications to help keep away the most harmful withdrawal symptoms. The medications will usually get tapered until you’re no longer physically dependent on the substance from which you’re detoxing.
MAT can also be used for maintenance if you have opioid use disorder. With maintenance therapy your withdrawal is minimized or avoided altogether by continuing to take either methadone or suboxone. You remain dependent on opioids while you’re on these medications but they don’t make you get high so you’re able to live a normal life.
Does Evernorth Health Cover Other Mental Healthcare?
Your insurance company decides what’s included in your mental health coverage. They may use parts of Evernorth’s network to help connect you with care. Most insurance companies offer mental health coverage as a result of the Affordable Care Act but there are some exceptions to the law so it’s important to verify your coverage.
Apart from what’s already been discussed other types of mental health coverage your insurance company may cover through Evernorth include services like crisis management and inpatient psychiatric treatment.
Your insurance company may also cover providers that care for people with co occurring disorders. More and more mental health service providers are integrating addiction treatment into the care they provide. That’s because it’s common for people to have both addiction and mental health challenges at the same time. Since people do better when both illnesses are treated together it’s important to find a provider who can do both.
Does Addiction Treatment Need to Be In Network?
Evernorth doesn’t set the network rules for your insurance company. Although they may provide services, the coverage for these would be subject to your insurance plan details.
Different insurance plans have different rules about whether you can see a care provider that’s outside of your network. However if getting the most out of your insurance coverage is important then you want to look for ways to stay within your network even if out of network care is available. That’s because going out of network will significantly increase your out of pocket costs. These out of pocket costs — like your deductible and copay — can get really expensive when you go out of network.
If you decide to go out of network carefully check the rules as to what your plan allows and how much they will cover.
How to Verify Coverage With Evernorth Health
The most reliable way to verify your benefits is to talk to your insurance company directly. The ways you can do that include calling your insurance company’s customer service line or logging into your online insurance account. You can also use an app if your insurer has one.
You may also be able to verify your coverage for specific Evernorth services by asking Evernorth to confirm your coverage at the time of service.
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By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
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