Entities — Insurers
Cigna
A global health services company and health insurer. Owner of Express Scripts, one of the three dominant Pharmacy Benefit Managers in the United States.
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Denial Data — Cigna
| Measure | 2023 | 2024 |
|---|---|---|
| ACA claim denial rate | 21% | 21% |
| ACA claims denied | 3.78M of 18.2M | 3.72M of 17.4M |
| MA prior auth denial rate | 7.7% | — |
| MA denials appealed | 18.0% | — |
| MA appeals overturned | 86.0% | — |
Cigna denied about one in five in-network Marketplace claims in both years. KFF does not list Cigna separately in its 2024 Medicare Advantage data.
ACA = in-network claims on HealthCare.gov Marketplace plans. MA = Medicare Advantage prior authorization requests. Source: federal CMS data analyzed by KFF.
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