How to verify your Cigna (Commercial) mental health benefits.
Cigna commercial plans cover outpatient mental health at the in-network rate without a referral on essentially every product, but the verification call has a quirk worth knowing about: Cigna's behavioral-health benefits are administered through Evernorth Behavioral Health, a Cigna subsidiary. When you call Cigna member services and ask about therapy or psychiatry, you may be transferred to an Evernorth representative — same network, same copay, just a separate phone tree. This guide assumes the transfer and walks through what to confirm with whichever rep ends up on the line. Positive Reset Eatontown is in-network with Cigna and Evernorth.
The call, in order.
Total time: about 10 minutes for most plans, 24 hours if the rep has to call back.
Call the number on your Cigna card
Start at the main Cigna member services number on the back of your card. The rep will either handle your behavioral-health question directly or transfer you to Evernorth Behavioral Health — both routes reach the same provider directory.
Tell the rep the clinic name and address
Say Positive Reset Eatontown, 615 Hope Rd Suite 3B, Eatontown, NJ. Ask the rep to confirm we are in-network for outpatient mental health under your specific Cigna product. The most common employer plans we see are Cigna Open Access Plus (OAP) and Cigna LocalPlus.
Confirm copay, coinsurance, and deductible
Cigna copays for outpatient mental health typically range from $0 to $40 per visit. If your plan uses coinsurance (common on marketplace plans), ask for the percentage and confirm whether the deductible has been met for the calendar year. Marketplace plans tend to have higher deductibles than employer plans.
Ask about your employer's EAP
Many employer-sponsored Cigna plans bundle a Cigna-managed Employee Assistance Program that gives you three to six no-cost sessions before your regular behavioral-health benefit begins billing. Ask HR or the rep whether your plan includes it. We apply EAP visits first when available, so your benefit isn't drawn down unnecessarily.
Confirm telehealth coverage at parity
Cigna covers telehealth for behavioral health at parity with in-person visits on every commercial product. The rep can confirm for your specific plan. Our telehealth visits are delivered from Eatontown to anywhere in New Jersey.
Ask about TMS prior-authorization timing
If you might need TMS for treatment-resistant depression, ask about the prior-authorization timeline. Evernorth reviews TMS authorizations and typically completes them within five business days once we submit documentation of two or more failed antidepressant trials. Knowing the window helps if you're trying to schedule a start date.
Exactly what to ask the rep.
Copy this list before the call. Each item is the kind of answer that should be on the line with you, not in a follow-up email a week later.
- Is Positive Reset Eatontown in-network for outpatient mental health under my Cigna plan?
- Will my call be transferred to Evernorth Behavioral Health?
- What is the copay or coinsurance per visit?
- Has my deductible been met for this calendar year?
- Does my plan include a Cigna EAP?
- Is telehealth covered at parity?
- What's the TMS prior-authorization timeline?
Plan-specific notes.
Cigna's behavioral-health benefits are administered through Evernorth Behavioral Health, Cigna's national subsidiary — the equivalent role to Carelon for Wellpoint or Optum for UnitedHealthcare. In practice, this matters very little to members at our clinic: the network, copays, and claims process are functionally identical to direct Cigna administration. The one place it does show up is prior authorization for higher-intensity care like TMS, where Evernorth's review window is a fixed business-day count rather than instant.
The most common Cigna products in New Jersey are Cigna Open Access Plus (OAP) PPO — typically employer-sponsored — and Cigna LocalPlus, a narrow-network plan. Marketplace plans through Get Covered NJ may carry higher deductibles than employer plans; verify the deductible status before assuming the copay covers everything.
If your employer offers an Employee Assistance Program through Cigna, those visits run in parallel with your regular behavioral-health benefit at no cost. EAP visits don't count toward any annual session limit. Ask HR if you're not sure whether your plan includes it.
We can run the verification for you.
Call us with your member ID and we’ll do the verification call ourselves — usually 5–10 minutes for most plans, 24 hours for plans that require a callback. You’ll get the copay and coverage answer before you book your first visit.
See the full Cigna coverage page for what we treat and what’s covered.
Other things people ask.
Do you accept Cigna?
Yes. We accept Cigna commercial plans for mental health care, including most employer-sponsored Cigna plans and Cigna marketplace plans. We verify in-network benefits before your first visit so you know what to expect.Do I need a referral from my primary care doctor?
For most plans, no. Commercial plans like Aetna, Cigna, Horizon BCBS, Oxford, and UnitedHealthcare typically don't require a referral for outpatient mental health. Some Medicare Advantage plans do. NJ FamilyCare doesn't require a referral for outpatient therapy or psychiatry. We tell you up front if your specific plan needs one.What if my insurance changes between visits?
Tell us as soon as possible. We re-verify benefits when an insurance plan changes — call (732) 724-1234 with the new card. Coverage of mental health care often continues without interruption, but the copay or coverage level may shift, and we want you to know what to expect for the next visit.How much will therapy cost me?
If you're insured and we're in-network, you typically pay only your plan's copay or coinsurance — usually $0 to $40 per visit. NJ FamilyCare members pay $0. Self-pay rates start at $125 for medication management and $150 for individual therapy. We tell you the exact cost before your first visit, per the No Surprises Act.
Last updated: 2026-05-23