Guides · Last reviewed October 20, 2026

How to appeal a Cigna claim denial

Cigna gives most customers 180 calendar days from the denial to file an internal appeal. If it's denied, federal rules let you ask for an independent external review whose decision is binding on the insurer.

Why it's worth appealing

Across ACA Marketplace insurers, about 19% of in-network claims were denied in 2024, yet patients appealed fewer than 1% of those denials. When people did appeal, roughly one in three internal appeals ended with the denial overturned.

Step 1: Read your denial letter and EOB

Find the claim number, your member ID, the exact reason for the denial, and the appeal deadline. For a clinical denial (medical necessity, level of care, or no prior authorization), note the specific Cigna policy named in the letter — you'll answer it point by point.

Step 2: Know your deadline (usually 180 days)

For most plans you have 180 calendar days from the date of the denial notice to file an internal appeal. Some employer plans set shorter windows (as little as 60 days), and Medicare plans are different, so check your plan documents or the denial letter.

Step 3: Build your case

Include a copy of the claim and your Explanation of Benefits (EOB) or Explanation of Payment (EOP). For a clinical denial, add a short narrative of what happened plus supporting records and a letter of medical necessity from your doctor.

Step 4: Submit the appeal to Cigna

• Send a written appeal to the address on your denial letter — certified mail is safest so you have proof of the date.
• If available for your plan, you can also start an appeal at mycigna.com.
• State clearly why you believe the decision is wrong and should be changed.

Cigna generally decides within 30 days for care you haven't received yet and 60 days for care you already got; urgent (expedited) appeals are decided within 72 hours. Keep copies of everything.

Step 5: Request an external review if denied

If the internal appeal is denied, you can request an independent external review, generally within 4 months of the final denial. An outside organization decides, and its decision is binding on Cigna. The federal external review process is free.

Where to get free help

• Job-based plan that's self-insured: U.S. Department of Labor, EBSA — 1-866-444-3272.
• Job-based plan that's fully insured: HHS Health Insurance Assistance Team — 1-888-393-2789.
• Medicare: 1-800-MEDICARE, or see our Medicare appeal guide.

For the general step-by-step that applies to any insurer, see our guide to appealing a health insurance denial.

Common questions

Sources

• Cigna: Appeals and Disputes
• HealthCare.gov: Internal appeals
• HealthCare.gov: External review
• KFF: Claims denials and appeals in ACA Marketplace plans in 2024

Billmira is a self-help information tool, not a law firm, and this isn't legal or medical advice. Billmira is not affiliated with or endorsed by Cigna. Rules change and plans differ; check the official sources above and your own documents.