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Behavioral Health Denial

Cigna Denied Your Mental Health Treatment?

According to federal data, Cigna Healthcare (The Cigna Group) denies approximately 18.5% of claims. When patients appeal, about 52% are overturned. Your mental health treatment denial may have grounds for a successful appeal.Sources: KFF ACA Marketplace Transparency Data, HHS OIG Reports, state insurance department filings. Rates are aggregate averages — individual results vary by plan type, denial reason, and documentation.

18.5%
Denial Rate
52%
Appeal Success
30-60 days
Typical Timeline
$3,000–$20,000
Typical Claim

Based on published government and industry research. Individual results vary based on denial type, insurer, and documentation.

Why Cigna Denies Mental Health Treatment

Session limits or visit caps

Not medically necessary per reviewer assessment

Provider not in-network

Diagnosis not covered under plan

Cigna's Common Denial Tactics

Mass auto-denials (300,000 claims in 2 months at 1.2 seconds each)

Requiring step therapy for medications your doctor already tried

Denying claims as "experimental" despite FDA approval

How to Win Your Mental Health Treatment Appeal

Cite MHPAEA — mental health must be covered at parity with medical/surgical

Document treatment necessity from psychiatrist or psychologist

Show that denial applies stricter criteria than comparable medical treatment

File with DOL if ERISA plan violates parity requirements

Laws That Protect You

Mental Health Parity and Addiction Equity Act (MHPAEA)

ACA Essential Health Benefits — Mental health is required

State mental health parity laws

Tips for Appealing to Cigna

Reference the ProPublica investigation into automated denials

Gather evidence of prior failed treatments to counter step therapy requirements

Obtain peer-reviewed studies supporting FDA-approved treatments

Ready to Review Your Mental Health Treatment Denial?

Upload your denial letter and get a clear analysis in minutes. We'll identify potential weaknesses in Cigna's reasoning and outline your appeal options.

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This information is for educational and informational purposes only. It does not constitute legal or medical advice. Statistics cited are from publicly available sources including KFF, HHS OIG, and state insurance department data. Individual results may vary. Consult a qualified professional before taking action on your specific situation.

Cigna Denied Your Mental Health Treatment? Here's How to Appeal | Lysco