Cigna
How to appeal a denial from this carrier, with deadlines, portals, and common denial patterns.
Cigna denials follow a predictable pattern — and most of them are appealable. We track the specific reasons Cigna most commonly cites, what's worked to overturn them, and which federal and state protections apply. If you're appealing a Cigna denial, this is your starting line.
Appeal process
Internal appeal to Cigna must be filed within 180 days of the denial notice. Cigna has 30 days to decide standard appeals, 72 hours for urgent. After internal exhaustion, external review by an Independent Review Organization is available for non-grandfathered plans under ACA §2719.
Common Cigna denial patterns
- Mental health parity violations
- Step therapy
- Specialty drug prior auth
- OON balance billing disputes
Portals
- Member portal: https://my.cigna.com
- Provider portal: https://cignaforhcp.cigna.com
Cigna-specific notes
Sold its Medicaid Advantage book to HCSC in 2023. Express Scripts (PBM) is Cigna-owned. Frequent class-action litigation around mental health parity.
Common Cigna plans
- Open Access Plus
- Cigna LocalPlus
- Cigna Connect
- Cigna PPO
- Cigna EPO
- Cigna SureFit
- Cigna OAP
- Cigna HealthSpring
Frequently asked questions
How do I appeal a Cigna denial?
File an internal appeal in writing within 180 days of the denial. Cigna has 30 days to decide standard appeals (72 hours for urgent). After internal exhaustion, request external review by an Independent Review Organization (IRO) — federal law requires this for non-grandfathered plans (ACA §2719).
What are the most common Cigna denial patterns?
Mental health parity violations; Step therapy; Specialty drug prior auth; OON balance billing disputes.
What's specific to Cigna?
Sold its Medicaid Advantage book to HCSC in 2023. Express Scripts (PBM) is Cigna-owned. Frequent class-action litigation around mental health parity.
Which federal regulations apply to Cigna appeals?
Depends on plan type: ERISA §503 + ACA §2719 for commercial/employer plans, 42 CFR Part 422 Subpart M for Medicare Advantage, 42 CFR Part 438 Subpart F for Medicaid managed care.
Other National commercial
Appeal a Cigna denial
Upload your denial — DenialHelp drafts a physician-ready appeal letter in five minutes with the right clinical guideline and federal regulation cited.
Get started →Contact: hello@denialhelp.com