Cigna decides coverage for Immunologicals - Dupixent (dupilumab) under policy IP0453. The most effective appeal shows, point by point, that you meet Cigna's own criteria below.
Cigna considers Immunologicals - Dupixent (dupilumab) medically necessary when the following criteria (from IP0453) are met:
Frame your appeal around the specific criterion you satisfy. Quote the IP0453 language above, then show — with your physician's records and clinical evidence — exactly how your situation meets it. Demand that Cigna either approve the claim or identify the precise criterion they believe you fail. CareCost Appeals assembles this automatically: it cites the policy, pulls verified clinical evidence, and applies your state and federal appeal rights.
Source: Cigna medical policy IP0453 — view the published policy.