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Guides · Cigna · appeals · Updated July 2026

How to appeal a Cigna mental health or therapy denial

Cigna denials of therapy, intensive outpatient, or residential behavioral care are frequently appealable under federal parity law, which requires mental health coverage to be no more restrictive than medical coverage.

Why Cigna denies this

Cigna (via Evernorth behavioral) commonly denies higher levels of care as not medically necessary using level-of-care guidelines. When those guidelines are stricter than for comparable medical care, it raises a parity issue.

What wins the appeal

Request the medical-necessity criteria used and the comparative parity analysis. Provide your clinician's letter justifying the level of care. File the appeal plus a parity complaint with your state commissioner or the Department of Labor for employer plans.

Your deadline

Depends on your plan type: 180 days for most employer and marketplace plans, 120 for Original Medicare, ~90 for Medicaid, and only 65 for Medicare Advantage. Set it before you do anything else.

Don't fight it alone — and don't miss the deadline

AppealClock translates your denial, drafts your appeal letter, and watches every deadline so you can't miss it. Free, no account, your medical details never leave your device.

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Common questions

Can Cigna limit my therapy sessions?
Not more strictly than it limits comparable medical care. If session limits or authorization requirements are tougher for mental health, that may violate federal parity law.

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