CignaDenied Your Medication? Here's How to Fight Back

About Cigna

Cigna, through its PBM Express Scripts, is known for strict step therapy requirements and narrow formularies. Express Scripts has faced criticism for high denial rates, particularly for specialty and oncology medications. Peer-to-peer reviews can be effective here.

Commonly Denied Medications

These are among the most frequently denied medications across all insurers. If Cignadenied one of these, you're not alone — and there are proven appeal strategies.

How to Appeal a Cigna Denial

1. 1

   Get the denial in writing

   Request the specific clinical criteria and reviewer credentials.

2. 2

   Ask your doctor for a peer-to-peer review

   A direct call between your doctor and Cigna's medical director often resolves denials quickly.

3. 3

   File an internal appeal

   Include a letter of medical necessity, clinical evidence, and your treatment history.

4. 4

   Request an external review if needed

   An independent reviewer examines your case. Their decision is binding on Cigna.