Instead, Cigna sent van Terheyden a letter explaining that it would not pay for the $350 test because it was not “medically necessary. ... But Cigna does not expect many appeals.

On March 13, weeks after being contacted by KFF Health News, England said, a Cigna representative contacted her and offered assistance with her final appeal, the one reviewed by a third-party.

Rep. Cathy McMorris Rodgers, a Republican from Washington who chairs the committee, noted that policyholders under Cigna’s Medicare Advantage plans appeal about one in five denials for requests ...