Although smoking cessation programs and aids are rarely covered under medical plans and are NOT a covered service under CIGNA Behavioral Health's EAP, there are many community resources that can help people who are trying to quit. You can find out more about local programs by calling your health care provider or the state or local health department. Information hotlines also provide quit-smoking materials and referrals:

The American Lung Association
1.800.LUNG.USA (1.800.586.4872)
www.lungusa.org

CancerNet: A service of the National Cancer Institute
1.800.4.CANCER (1.800.422.6237)
www.cancer.gov/cancerinfo/prevention-genetics-causes/prevention

The American Heart Association
1.800.AHA.USA1 (1.800.242.8721) www.women.americanheart.org/self_care/fs_smoking.html

To find out more about what benefits are available through your insurance plan, please call the toll-free number on your insurance ID card.

My state has a law regarding biologically based benefits. What is that?

Some states have passed laws designed to ensure that covered participants who are diagnosed with a critical mental health condition receive the same level of benefits as the participant would expect to receive with a critical physical illness. These critical mental health conditions are most often referred to in state laws as "biologically-based" or "serious" mental illnesses. The law makers, using the same diagnostic references that mental health professionals use, typically define these biologically based mental illnesses as: schizophrenia; schizo-affective disorder; bi-polar disorder; major depressive disorder; panic disorder; paranoia, delusional and psychotic disorders; and obsessive-compulsive disorder. Some states, however, have expanded the list of “biologically based mental illnesses” to include other conditions such as anorexia-nervosa, bulimia and post-traumatic stress disorder. In a few unusual states, the list includes diagnoses related to alcohol and drug abuse. Your state may have a variation of this type of law with its own, unique list of covered mental illnesses whose benefit levels are mandated to be largely similar to the benefit levels for a physical condition.

Because mental illness conditions are diagnosed and treated differently than physical illnesses, the legislative interpretations of this concept, "mental illness benefit levels that are largely similar to those for physical conditions," varies significantly from state to state. Generally speaking, if you have a biologically based benefit law in your state that affects your health plan, you can expect that your plan's cost-sharing provisions (i.e., co-pays, co-insurance and deductibles) for biologically based mental conditions will mirror your plan's cost-sharing provisions for diagnosis and treatment of physical conditions. The intent of most states' laws is that you, as a covered participant, are not faced with a greater financial burden for your mental health care than you are for your physical health care.

To fully understand the terms and conditions of your mental health coverage, you should consult your plan's written description of mental health benefits or call the number on your ID card for a complete and precise description of how, and whether, the laws in your state affect the health plan provided to you by your employer or group.

If I must cancel a scheduled appointment, do I still have to pay the copayment (or cancellation fee)?

Once you have established a business relationship with a CIGNA Behavioral Health contracted behavioral health professional, you are only liable for charges (including deductibles, copayments/co-insurance) if you fail to give at least 24-hour notice of the cancellation.

It is best to notify your behavioral health professional well in advance of any need to cancel, as our contracted professionals have the right to charge you directly for any appointment missed without 24-hour cancellation notification.

Do I have to pay the bill if the services are not covered?

We recommend that you always ask about services you are interested in to make sure they are covered under your specific plan. You can do this by calling the toll-free number on your insurance ID card. We also encourage you to read your benefit plan summary for details of your coverage as you will likely be liable for services that are not covered or ones that require pre-certification of coverage, where none was obtained.

What do I do in the case of an emergency?

If you need emergency services please go to the nearest emergency room or behavioral health facility. We request that you or a representative call us as soon as possible, preferably within 48 hours, so that we can help you determine the benefits available to you under your plan. Your plan benefits will apply to services needed to evaluate or stabilize treatment for a condition that is reasonably considered to be an emergency behavioral health condition. Some plans may have a penalty if you do not call within a certain time frame after admission. Check with your plan if you are not sure what the requirements are.

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