Cigna Healthcare — Denial Rates & Appeal Data
Compare against every insurer we track: denial rates ranked within reporting cohorts.
PUBLISHER-REPORTED FIGURES · CIGNA HEALTHCARE PUBLIC DISCLOSURE
Federally-facilitated Exchange (FFE) Individual & Family Plan disclosure only (source title: "CMS - IFP FFE") — not Cigna employer/commercial coverage and not Medicare Advantage. Cigna reports 27% standard denials, 22% expedited denials, 16% of appeals reversed, and mean decision times of 3.95 and 1.53 days. Coverage Rights converts those times to 94.8 and 36.7 hours for consistent display. Request volumes were not published.
SOURCE: CIGNA HEALTHCARE CMS-0057-F DISCLOSURE, CY2025 · VIEW SOURCE ↗ · METHODOLOGY
What these numbers mean for your denial
Cigna Healthcare reported a 27% prior-authorization denial rate for the Federally-facilitated Exchange Individual and Family Plans (CMS - IFP FFE) in 2025. In the publisher-reported Federally-facilitated Exchange Individual and Family Plans (CMS - IFP FFE) appeal scope, 16% were reversed — a substantial share of challenged denials did not survive review. Cigna Healthcare published the displayed denial and appeal rates in its CMS-0057-F disclosure; decision-time cards identify any Coverage Rights unit conversions.
The practical takeaway is narrower: an initial denial can change on review. These aggregate rates describe past decisions within the stated reporting scope; they do not predict the result of an individual appeal.
Your appeal deadline depends on your plan type
Cigna Healthcare runs several kinds of plans, and the appeal rules follow the plan, not the insurer. Find the ladder and the deadlines for yours:
Common questions
What is Cigna Healthcare's prior authorization denial rate?
Cigna Healthcare reported a 27% prior-authorization denial rate for the Federally-facilitated Exchange Individual and Family Plans (CMS - IFP FFE) reporting scope in 2025, using the public disclosure required by federal rule CMS-0057-F. Within the publisher-reported Federally-facilitated Exchange Individual and Family Plans (CMS - IFP FFE) appeal scope, 16% were overturned.
How do I appeal a Cigna Healthcare denial?
Start with the appeal instructions in Cigna Healthcare's denial notice. An independent external, fair-hearing, or Medicare review may be available after the required internal review, but eligibility depends on the coverage program, plan funding, denial type, regulating jurisdiction, and whether the notice says internal review is exhausted. Use the pathway tool before choosing the next reviewer.
Where do these numbers come from?
Cigna Healthcare published the underlying figures in its CMS-0057-F disclosure for 2025; the methodology note identifies the exact reporting scope and any Coverage Rights unit conversions, and the page links to the source.