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HCSC / HealthSpring: Medicare Advantage denial & appeal rates

Health Care Service Corporation · 2.5% of MA enrollment

2025 prior-authorization metrics, as posted by HCSC / HealthSpring

HealthSpring plans (the former Cigna book, ~697,000 members)
Standard requests denied
5%
Approved after appeal
81%

15 Medicare Advantage contracts. Average decision time 0.80 days.

Blue Cross and Blue Shield of IL, MT, NM, OK and TX (~200,000 members)
Standard requests denied
12%
Approved after appeal
80%

11 Medicare Advantage contracts. Average decision time 1.66 days.

HCSC posts two separate reports and they disagree sharply — 5% of standard requests denied on the HealthSpring side against 12% on the Blue-branded side. Neither report publishes the number of requests behind its percentages, so there is no honest way to combine them into one HCSC figure. Which number applies to you depends on which plan you are actually in: check the brand on your card.

These numbers aren’t comparable to the six largest insurers’ pages.

Medicare’s published comparison of insurers only names parent companies with a million or more Medicare Advantage members, so HCSC / HealthSpring isn’t in it. The figures above are HCSC / HealthSpring’s own 2025 filing, which covers a different year and counts denials a different way. Treat them as what this insurer reports about itself — not as a like-for-like ranking against the larger insurers.

Whatever the rate, the pattern that matters is the same everywhere: ~81% of appealed MA prior-authorization denials are overturned, and only about 1 in 9 denials is ever appealed. A denial is rarely the final word — and HCSC / HealthSpring’s own filing shows most of the denials its members appealed were approved in the end.

HCSC / HealthSpring’s posted coverage policies

Insurers must post the medical policies they use to decide coverage. These are the ones most relevant to lab, imaging, and facility denials — quote the matching policy in your appeal.

Service categoryPolicyUpdated
Home healthHome Health Care Authorization Bundles
DME (general)Durable Medical Equipment (DME) Reference List (DME101.000)Revised 7/21/2026
Spine surgery / fusionArtificial Intervertebral Disc - Cervical (SUR712.028)Revised 5/7/2026
Epidural / facet injectionsLysis of Epidural Adhesions (SUR712.024)
Cataract surgeryAqueous Shunts and Stents for Glaucoma (SUR713.034)
Anti-VEGF / intravitreal (Eylea/Avastin)Ranibizumab Injections, Implants and Biosimilars (OTH903.041)Revised 7/21/2026
Behavioral health / inpatient psychEsketamine Nasal Spray for Treatment-Resistant Depression (RX501.105)Revised 5/7/2026
Skin substitutes / CTPsBioengineered Skin and Soft Tissue Substitutes (SUR704.012)Revised 8/18/2026
Oncology / chemotherapy drugsOncology Medications (RX502.061)Revised 7/21/2026
Knee / hip arthroplastyUnicondylar Interpositional Spacer for Unicompartmental Arthritis of the Knee (SUR705.024)Revised 5/7/2026
Genetic / molecular testingLaboratory Testing Investigational Services (MED207.164)Revised 8/18/2026

HCSC / HealthSpring’s CMS prior-authorization metrics posting →

Denied by HCSC / HealthSpring? Don’t pay a bill you may not owe.

Appeals win far more often than people expect. See how the deadlines and the process work, or fast-track a rehab/nursing discharge.

Insurer / contract level. Medicare does not publish per-plan denial rates. Rates are calendar-year 2025 prior-authorization metrics posted by HCSC / HealthSpring under the CMS Interoperability and Prior Authorization rule (CMS-0057-F). "Approved after appeal" is the share of appealed denials that were later approved — not a share of all denials. Data as of September 2026. Notes: Holds the Medicare Advantage book Cigna sold to HCSC (sale closed March 19, 2025). Cigna no longer offers Medicare Advantage; for the 2026 plan year these plans are branded HealthSpring, except in Illinois, Montana, New Mexico, Oklahoma and Texas where they run under Blue Cross and Blue Shield. Informational only — not medical, legal, or billing advice.