Cigna Coverage for ADHD Testing, Therapy, and Treatment in Dallas, Texas
The diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) is growing in adults, but is still believed to be underdiagnosed. Adult ADHD symptoms are different than those in children but are still disruptive to your home, school, and work responsibilities. The clinicians at BreakThrough by BasePoint understand the normal challenges of young adulthood and how ADHD can make these worse.
BreakThrough by BasePoint has several treatment programs in Texas that take Cigna Health Insurance for in-person treatment in Dallas and virtual therapy sessions throughout the state. Young adults with ADHD have a high rate of co-occurring mental health conditions, such as depression and anxiety. Our mental health professionals are highly skilled at the unique challenges young adults face and work closely with Cigna Health Insurance to help you get the treatment you need.
Attention-Deficit/Hyperactivity Disorder (ADHD): What Is It?
ADHD is a neurodevelopmental disorder characterized by a persistent pattern of inattention, hyperactivity, and impulsivity that interferes with daily functioning and development. People with ADHD may struggle to focus, sit still, stay organized, or follow through on tasks. These symptoms must be present for at least six months and be inappropriate for your developmental level to meet diagnostic criteria.
ADHD is typically identified in childhood, though some people may not receive a diagnosis until adulthood. There are three main presentations: inattentive, hyperactive-impulsive, and combined. While the exact cause is unknown, research suggests a combination of genetics, brain structure differences, and environmental factors contributes to its development.
Studies have also shown that ADHD tends to run in families, indicating a strong hereditary component. Ongoing research is exploring how prenatal exposures and early childhood experiences may influence symptom severity and onset.
Effective management often includes a combination of educational and ADHD support groups, lifestyle changes, behavioral non-pharmacological ADHD interventions, and in some cases, medication. Early diagnosis and treatment can significantly improve long-term outcomes and quality of life.
What Are the Common Signs of ADHD?
ADHD signs can look different depending on your age, environment, and the type of ADHD you have. While everyone can occasionally struggle with focus, ADHD symptoms are more frequent and intense. Recognizing the signs early can help you receive an appropriate evaluation and treatment, so you develop healthy coping strategies. Below are some of the most common signs.
- Inattention: Difficulty staying focused, following instructions, or organizing tasks; may seem forgetful or easily distracted.
- Hyperactivity: Excessive movement or fidgeting, especially in settings where it’s inappropriate; may talk excessively or feel constantly “on the go.”
- Impulsivity: Acting without thinking, interrupting others, or making hasty decisions without considering consequences.
- Disorganization: Trouble keeping track of personal items, schedules, or responsibilities.
- Poor Time Management: Frequently late or underestimating how long tasks will take.
- Difficulty Following Through: Starts tasks but struggles to complete them, even when they’re important.
- Mood Swings or Frustration Tolerance: Easily frustrated, emotionally reactive, or quick to anger.
In 2011, ADHD prevalence in Texas children was 9.4%, and this rose to 10.1% between 2016 and 2019. While commonly associated with children, ADHD can persist in adulthood. One follow-up study found that 29.3% of children with ADHD still had symptoms by age 27, with another study estimating persistence at 62% in women.
Adult ADHD is often underdiagnosed, yet diagnoses in adults are growing four times faster than in children. In Texas and nationally, the rate of adult ADHD diagnosis rose from 6.1% to 10.2% over the past two decades. One study estimated the adult prevalence at 0.96%, more than double the rate from a decade earlier. Adults with ADHD frequently experience comorbid conditions like anxiety, OCD, depression, and sleep disorders, which can complicate accurate diagnosis and access to effective treatment.
BreakThrough by BasePoint Accepts BlueCross BlueShield Cigna Insurance
Our free assessment with a licensed clinician will provide you with a recommendation for the appropriate level of care for young adults struggling with a mental health disorder. We can also check your Cigna ADHD treatment coverage levels.
Call us today to schedule a same-day assessment at (972) 325-2633 or complete our inquiry form.
Breakthrough by BasePoint: Verify Insurance
Who Is Cigna, the Health Insurance Provider?
Cigna is a global health services and managed-care company headquartered in Bloomfield, Connecticut, founded in 1982 through the merger of the Insurance Company of North America and Connecticut General Life Insurance Company. As a publicly traded member of the S&P 500, Cigna rebranded to “The Cigna Group” in February 2023, offering a wide range of insurance and health services.
These products include medical, dental, vision, pharmacy benefits (via Express Scripts), behavioral health, disability, life insurance, supplemental coverage, and specialty products like Medicare Advantage, Medicare Supplement, and Part D drug plans. They employ roughly 73,500 people globally, serving individual and family markets, employers, government clients, and multinational organizations, covering over 1.5 million global providers. They remain among the largest U.S. insurers. Its strategic acquisitions expanded its pharmacy and benefits management capabilities.
Which ADHD Subtypes Are Covered by Cigna?
Structured treatment approaches tailored to ADHD subtypes significantly improve mental health by improving focus, self-regulation, and daily functioning. These programs support skill development and reduce symptom impact. The following are the subtypes of ADHD. However, ADHD happens on a spectrum, so you may have multiple symptoms, but predominantly have symptoms from one subtype.
Predominantly Inattentive Presentation (previously known as attention deficit disorder) is a subtype where you primarily struggle with maintaining attention and organization, without the hallmark symptoms of hyperactivity or impulsivity. Symptoms include frequent daydreaming, forgetfulness, difficulty following instructions, and trouble completing tasks. This can significantly affect academic performance, time management, and daily routines.
Cigna typically covers treatment for the Predominantly Inattentive Presentation when your symptoms meet DSM‑5 criteria. Coverage depends on your Cigna plan, but often includes diagnostic assessments, therapy sessions, medication management, and ongoing follow-up with in-network providers like psychologists or psychiatrists. Services are covered in-person and using online counseling, subject to your plan-specific details. Before receiving treatment, call us. We work closely with Cigna Texas to reduce your financial responsibility for behavioral therapy for ADHD.
Predominantly Hyperactive‑Impulsive Presentation is an ADHD subtype once called hyperactivity disorder, where symptoms of hyperactivity and impulsivity are predominant, while inattention is minimal or absent. You may have signs like excessive fidgeting, restlessness, difficulty remaining seated, constant movement, interrupting others, and acting on impulse without forethought. These behaviors can disrupt daily life, relationships, work, and academic performance.
Cigna ADHD therapy coverage generally includes diagnosis and treatment for the Predominantly Hyperactive‑Impulsive Presentation. The specifics depend on your plan and determine treatment, which can be delivered in-person or virtual therapy sessions. Prior authorization, use of in-network providers, and formulary rules usually apply. It is best to call BreakThrough by BasePoint to understand your insurance copays, deductibles, session limits, or medication management.
Combined Presentation ADHD is characterized by symptoms of inattention and hyperactivity-impulsivity together. You must have at least six inattention symptoms (e.g., forgetfulness, difficulty organizing tasks) and six hyperactivity-impulsivity symptoms (e.g., fidgeting, interrupting others) for a diagnosis. Appropriate treatment addresses the symptoms of ADHD in school, work, and home settings.
Cigna ADHD coverage typically includes treatment for Combined Presentation ADHD, encompassing diagnostic ADHD assessment tools, individual therapy, group behavioral interventions, and medication management delivered in person or through telehealth sessions. Services must be provided by in-network professionals, and plans may require prior authorization to prove medical necessity, step therapy, or adherence to formulary tiers for ADHD prescription drugs.
What ADHD Programs Are Often Covered by Cigna in the Dallas, Texas Area?
Programs offering structured support play a crucial role in improving ADHD-related mental health by teaching practical skills like organization, time management, and emotional regulation. These services complement traditional therapy and medication, helping you build routines and coping strategies that improve daily functioning. The following are examples of treatment options and are not an exhaustive list.
Partial Hospitalization Programs (PHPs) are daytime, intensive rehab programs that provide structured care three to seven days per week, over three to six hours per day. They’re designed to help when you have challenges with moderate-to-severe mental health symptoms, allowing live-at-home flexibility while providing comprehensive therapeutic interventions such as group therapy, individual counseling, skills training, and psychiatric evaluation.
Cigna generally covers PHPs under its behavioral health benefits when a qualified mental health professional finds it medically necessary. These programs don’t require overnight stays but must meet clinical criteria and often require prior authorization, depending on your plan. Coverage typically includes therapy sessions, medication management, and case management. Call us to confirm coverage details like copays, duration limits, and authorization procedures. We can also schedule a free and confidential assessment with treatment recommendations, so you know the level of care needed to treat your symptoms appropriately.
Intensive Outpatient Programs (IOPs) are structured, multi-disciplinary rehab programs that treat ADHD without requiring overnight stays. Participants attend individual, group, and family therapy, plus receive medication management, typically for three to five days per week for three to four hours per day. IOPs allow you to continue daily responsibilities while receiving focused treatment and learning healthy coping strategies.
Cigna plans generally cover IOPs when they are clinically necessary and prescribed by a qualified provider. Coverage usually includes therapy sessions, group skills training, and psychiatric oversight. Prior authorization may be required based on your policy, as dictated by federal parity laws and plan-specific rules. Your copays, deductibles, and prior authorization requirements influence your out-of-pocket expenses. We understand how complex navigating insurance paperwork can be, so we are here to do it for you.
Online ADHD treatment is virtual treatment designed to help you manage ADHD at home over a digital platform. The programs blend counseling, behavioral strategies, and coaching to address symptoms of ADHD and executive function, social skills, and emotional regulation with convenience, flexibility, and reduced travel time while supporting your everyday routines.
Cigna individual insurance and group insurance plans typically cover online ADHD treatment when the services are delivered by licensed, in-network providers and are medically necessary using DSM‑5 ADHD diagnosis criteria. Coverage can include therapy, ADHD assessment tools, and medication management over telehealth platforms. Copays, session limits, and prior authorization requirements vary by plan, but Cigna’s telehealth services coverage in Texas ensures many young adults can access online ADHD services with comparable benefits to in-person care.
Does Cigna Offer Coverage for ADHD Testing for Texas Young Adults?
Yes, Cigna does cover ADHD testing in Texas for young adults under its behavioral health benefits, though specifics depend on your plan. Cigna considers diagnostic assessments conducted by licensed professionals like psychiatrists, psychologists, or PCPs to be medically necessary when the DSM‑5 ADHD diagnosis criteria are used. These evaluations can include interviews, behavioral assessments, and standardized cognitive tests.
Coverage typically includes telehealth and in–person testing options, which may find links between ADHD and academic performance or workplace issues. However, some services are excluded from most Cigna plans. You may also need prior authorization depending on your specific policy, network status, and provider type. You can quickly and easily understand the precise coverage details in your policy by contacting BreakThrough by BasePoint. Our admission specialist will verify your coverage and explain your deductibles, copayments, Cigna provider network, and prior authorization requirements.
Does Cigna Offer Coverage for ADHD Treatment for Young Adults in Dallas, Texas?
Yes, Cigna does cover ADHD treatment in Texas, under its behavioral health and medical benefits, though the extent depends on your specific plan. Treatment services such as medication management, therapy, counseling, and virtual telehealth sessions are typically covered when delivered by professionals in the Cigna provider network and are medically necessary under DSM-5 guidelines.
Cigna’s behavioral health network includes psychiatrists, psychologists, counselors, and therapists who specialize in ADHD care. Treatment can also include prescription ADHD medication options. These are covered through your Cigna prescription drug plan benefit but may require step therapy, prior authorization, and use of preferred brands or generics. You can quickly and easily learn about your coverage specifics, like deductibles, network restrictions, and prior authorization, when you call BreakThrough by BasePoint.
Does Cigna Cover ADHD Therapy and Counseling in Texas?
Yes, Cigna does cover ADHD therapy and counseling in Texas under its behavioral health benefits, typically included in your medical plan with no separate mental health deductible. In-network services such as individual therapy, counseling, and behavioral interventions are covered when prior authorization demonstrates they are medically necessary and provided by licensed mental health professionals.
Cigna ADHD counseling coverage includes in-person and teletherapy sessions. Your deductible and copays depend on the plan you purchased. BreakThrough by BasePoint works with Cigna to provide specialized services for young adults struggling with ADHD and emotional regulation, executive function, and social skills. Cigna member services can answer some questions, but when you call us at 972-325-2633, our admission specialist can accomplish far more in one phone call, including verifying your coverage, estimating your out-of-pocket expenses, and scheduling a free assessment with treatment recommendations.
Will Cigna Cover Psychiatric Care for ADHD in Texas?
Yes, Cigna ADHD coverage includes psychiatric care as benefits provided under employer-sponsored or individual medical plans. However, your coverage for psychiatric care can differ depending on your Cigna coverage option, such as the Cigna preferred provider organization (PPO), Cigna health maintenance organization (HMO), or Cigna high-deductible health plans (HDHPs). Services may include evaluations, ongoing management, and medication prescriptions.
Cigna’s provider network includes licensed psychiatrists who can diagnose ADHD, prescribe medications, and offer therapy that addresses ADHD and comorbid conditions. Your coverage may include in-person visits or online counseling sessions, without a separate behavioral health deductible under many plans. Psychiatric treatment may require in-network providers, prior authorization, and medical necessity criteria before beginning care. Call us today to learn more about our programs that meet the unique needs of young adults and to verify your Cigna Texas coverage.
Will Cigna Cover ADHD Medication in Texas?
Cigna ADHD coverage includes prescription medication in the Cigna prescription drug plan benefits, but coverage often depends on your plan. Most stimulant and non-stimulant ADHD medications are covered when prescribed, when your symptoms meet DSM‑5 ADHD diagnosis criteria. Medications require prior authorization, step therapy, or may have limits, but they help with ADHD management in the workplace or school.
For instance, generic alternatives must typically be tried first, and if they’re ineffective or not tolerated, brand-name options can be approved. ADHD drugs are assigned to different tiers in Cigna’s Texas formulary, which affects your copays. For example, higher-tier medications may cost more. We can quickly and easily determine which specific ADHD medications are covered, the tier level, and any authorization requirements. Call us today to learn more about how medications and treatment go well beyond adult ADHD self-help strategies and verify your coverage.
ADHD Treatment Facilities in Texas that Accept Cigna Insurance Plans
BreakThrough by BasePoint has several facilities in Texas that work with and accept Cigna coverage for ADHD testing, therapy, and treatment. We provide in-person care in Dallas and virtual therapy throughout Texas. When you call us at 972-325-2633 or contact us, our admission specialist will answer your questions, verify your insurance coverage, and explain your Cigna ADHD therapy coverage.
- Arlington, TX: 3900 Arlington Highlands Blvd Suite 237B Arlington, TX 76018
- Forney, TX: 713 W Broad St Suite 100 Forney, TX 75126
- Frisco, TX: 8275 Judges Way, Suite 100F, Frisco, TX 75036
- McKinney, TX: Virtual Mental Health Treatment
Arlington, Texas, is an active city nestled between Dallas and Fort Worth, known for its world-class sports venues, entertainment districts, and family-friendly attractions. Home to the Dallas Cowboys' AT&T Stadium and Six Flags Over Texas, Arlington blends suburban charm with big-city amenities, making it a dynamic destination for residents and visitors alike.
- BreakThrough by BasePoint - Arlington, Texas: 3900 Arlington Highlands Blvd, Suite 237B, Arlington, TX 76018, United States
Forney, Texas, lies just east of Dallas, offering a welcoming blend of rural charm and suburban convenience. Known for its historic downtown, local festivals, and family-owned shops and eateries, Forney also benefits from easy access to major highways and nearby amenities. It’s an appealing choice for those seeking a quieter pace, close to the city.
- BreakThrough by BasePoint – Forney, Texas: 713 W Broad St, Suite 100, Forney, TX 75126, United States
McKinney, Texas, combines historic small-town charm with modern amenities and a thriving arts scene. Its picturesque downtown features preserved architecture, unique boutiques, and cozy cafés. With parks, green spaces, and community events like farmers markets and festivals, McKinney offers a welcoming atmosphere that balances cultural richness and vibrant suburban living.
- BreakThrough by BasePoint - McKinney, Texas: 4733 Medical Center Drive, McKinney, TX 75069, United States
Frisco, Texas, stands out as a dynamic and fast-growing suburb known for its top-tier sports facilities, innovative retail destinations, and family-oriented lifestyle. It boasts premier venues like the Ford Center at The Star and Toyota Stadium, alongside dining and entertainment districts. With abundant parks, community events, and excellent schools, Frisco offers a lively yet welcoming environment.
- BreakThrough by BasePoint - 8275 Judges Way, Suite 100F, Frisco, TX 75036
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How Much Is ADHD Treatment Without Cigna Coverage in Texas?
Without Cigna coverage in Texas, ADHD treatment costs can vary significantly. A diagnostic evaluation typically ranges from $300 for a basic psychiatric evaluation to as much as $3,000 for comprehensive testing, including cognitive assessments. Individual therapy sessions in Texas generally cost between $100 and $300 per hour. Additionally, ADHD medications can run around $200 monthly before insurance.
Overall, complete ADHD treatment includes the initial evaluation, ongoing therapy, and medication. These costs can add up and may feel overwhelming. However, when you call BreakThrough by BasePoint, we help you find various cost-effective financial solutions so you can access high-quality ADHD research and treatments that improve your relationships and quality of life.
How to Check My Cigna Coverage at BreakThrough by Basepoint
The easiest way to check your Cigna Texas plan for ADHD therapy and counseling is to call BreakThrough by BasePoint at 972-325-2633. Our admission specialist can verify your insurance coverage and work closely with Cigna through the prior authorization process to help you receive the quality mental health treatment you benefit from.
The treatment you receive begins with a free and confidential assessment with treatment recommendations, so you understand the level of care needed to address your symptoms. We offer help for young adults struggling with adult ADHD symptoms and provide advice for parenting a child with ADHD. Our highly skilled clinicians understand the challenges of dealing with ADHD and social skills, emotional regulation, and executive function. We address these and more in our unique program, specialized in addressing the life stage demands of young adults.
The first step to getting Aetna insurance to pay for your virtual mental health therapy in Texas is to verify your plan details and understand what virtual counseling services are covered. Start by contacting BreakThrough by BasePoint at 972-325-2633. Our admission specialist will review your policies and benefits for mental health services, including online treatment and remote psychotherapy.
They will also determine if prior authorization is required before you begin treatment and if we are in network with your Aetna plan. Our admission specialist can handle specifics of verifying coverage, estimate your potential out-of-pocket expenses, and offer a free assessment with treatment recommendations so you have the necessary information you need to make an informed decision about receiving virtual mental health services at BreakThrough by BasePoint.
- Attention-deficit/hyperactivity disorder (ADHD) is more commonly diagnosed in children, but can continue into adulthood. Depending on the source, the rate of ADHD diagnosis in children and adolescents ranges from 3–5% of all children and adolescents to 10.1% of childhood ADHD from 2016 to 2019.
- One study estimates a prevalence of 0.96% of adults have ADHD, which is more than double from 10 years before. ADHD diagnosis in adults is growing four times faster than in children and is still thought to be underdiagnosed in adults.
- Statistics in 2023 showed the rate of diagnosis of adult ADHD has increased in the last two decades from 6.1% to 10.2% and ranks in the top ten of online mental health searches.
- Adults with ADHD have very high rates of comorbid conditions, such as obsessive-compulsive disorders, depression, anxiety, eating, and sleeping disorders. These overlapping symptoms make it challenging to make an accurate diagnosis and receive appropriate treatment.
- A follow-up study of children with ADHD found that by age 27, 29.3% still had adult symptoms of ADHD, and the rate of persistence was similar for males and females. Other studies found the rate of persistence was higher, 62% in one study of females.