To ensure timely access to care, Cigna HealthCare* Medicare Advantage is adopting Centers for Medicare & Medicaid Services guidelines, effective Jan. 1, 2026. Learn what’s changing.

To ensure timely access to medical care, we’re adopting Centers for Medicare & Medicaid Services guidelines for turn-around time standards for prior authorization for our Medicare members, effective Jan. 1, 2026.

What’s changing: We’re reducing response times to up to seven calendar days for nonurgent preservice and concurrent prior authorization and admission notification. The previous response time was up to 14 calendar days.

We may extend the response time up to an additional 14 days when:

• A member or provider requests an extension, or
• We request additional clinical information for prior authorization processing

If the response time is extended, we’ll send notification letters to you and members explaining the delay in prior authorization determination. The notices will include information on a member’s right to file an expedited grievance if the member disagrees with the extension.

For more information, refer to CMS’ appointment wait time FAQs.

*Cigna Healthcare Medicare Advantage is becoming HealthSpring^SM. Our new benefit plans will be rolled out under the HealthSpring name during the 2025 annual enrollment period. Starting in January 2026, you will begin seeing patients with HealthSpring benefit coverage. Learn more