aid: cigna
name: Cigna
description: >-
  Cigna Healthcare is a leading global health services company offering
  medical, dental, behavioral, and pharmacy plans for individuals, families,
  and employers. The Cigna Developer Portal exposes CMS-mandated FHIR APIs
  for Patient Access, Provider Directory, Drug Formulary, and Provider Access,
  along with member and provider service APIs that enable third-party
  applications, electronic health record systems, and partners to access
  member health data with consent and look up Cigna network providers and
  formulary information.
image: https://kinlane-productions.s3.amazonaws.com/apis-json/apis-json-logo.jpg
url: >-
  https://raw.githubusercontent.com/api-evangelist/cigna/refs/heads/main/apis.yml
type: Index
access: 3rd-Party
position: Consumer
tags:
  - CMS Interoperability
  - Da Vinci
  - Drug Formulary
  - FHIR
  - Health Insurance
  - Healthcare
  - Patient Access
  - Provider Directory
  - SMART on FHIR
created: '2025-02-21'
modified: '2026-04-23'
specificationVersion: '0.20'
apis:
  - aid: cigna:patient-access-api
    name: Cigna Patient Access API
    description: >-
      FHIR R4 API that allows authorized third-party applications to access
      a Cigna member's claims, encounters, clinical data, coverage, and
      pharmacy information after the member completes SMART on FHIR
      authorization. Conforms to the CMS Interoperability and Patient Access
      final rule and the HL7 Da Vinci PDex implementation guide.
    image: https://kinlane-productions.s3.amazonaws.com/apis-json/apis-json-logo.jpg
    humanURL: >-
      https://developer.cigna.com/docs/service-apis/patient-access/implementation-guide
    baseURL: https://fhir.cigna.com/PatientAccess/v1
    tags:
      - CMS Interoperability
      - FHIR
      - Patient Access
      - SMART on FHIR
    properties:
      - type: Documentation
        url: >-
          https://developer.cigna.com/docs/service-apis/patient-access/implementation-guide
      - type: OpenAPI
        url: openapi/cigna-patient-access-api-openapi.yml
  - aid: cigna:provider-directory-api
    name: Cigna Provider Directory API
    description: >-
      Public FHIR-based Provider Directory API listing Cigna's contracted
      network providers, organizations, locations, healthcare services, and
      practitioner roles. Conforms to the HL7 Da Vinci PDex Plan Network
      implementation guide and the CMS Provider Directory API requirements.
    image: https://kinlane-productions.s3.amazonaws.com/apis-json/apis-json-logo.jpg
    humanURL: >-
      https://developer.cigna.com/docs/service-apis/provider-directory/implementation-guide
    baseURL: https://fhir.cigna.com/ProviderDirectory/v1
    tags:
      - CMS Interoperability
      - FHIR
      - Provider Directory
      - Public API
    properties:
      - type: Documentation
        url: >-
          https://developer.cigna.com/docs/service-apis/provider-directory/implementation-guide
      - type: OpenAPI
        url: openapi/cigna-provider-directory-api-openapi.yml
  - aid: cigna:drug-formulary-api
    name: Cigna Drug Formulary API
    description: >-
      Public FHIR-based Drug Formulary API exposing Cigna's covered drug
      lists, formulary tiers, prior authorization requirements, step therapy,
      and quantity limits. Implements the HL7 Da Vinci PDex US Drug Formulary
      implementation guide required by the CMS Interoperability and Patient
      Access rule.
    image: https://kinlane-productions.s3.amazonaws.com/apis-json/apis-json-logo.jpg
    humanURL: https://developer.cigna.com/docs/service-apis
    baseURL: https://fhir.cigna.com/DrugFormulary/v1
    tags:
      - CMS Interoperability
      - Drug Formulary
      - FHIR
      - Public API
    properties:
      - type: Documentation
        url: https://developer.cigna.com/docs/service-apis
      - type: OpenAPI
        url: openapi/cigna-drug-formulary-api-openapi.yml
  - aid: cigna:provider-access-api
    name: Cigna Provider Access API
    description: >-
      FHIR API that allows in-network providers, with appropriate
      authorization, to retrieve a Cigna member's clinical and claims data to
      support care coordination. Implements the HL7 Da Vinci PDex Provider
      Access implementation guide and conforms to the CMS Interoperability
      and Prior Authorization final rule.
    image: https://kinlane-productions.s3.amazonaws.com/apis-json/apis-json-logo.jpg
    humanURL: https://developer.cigna.com/docs/service-apis
    baseURL: https://fhir.cigna.com/ProviderAccess/v1
    tags:
      - CMS Interoperability
      - FHIR
      - Provider Access
    properties:
      - type: Documentation
        url: https://developer.cigna.com/docs/service-apis
      - type: OpenAPI
        url: openapi/cigna-provider-access-api-openapi.yml
common:
  - type: Website
    url: https://www.cigna.com/
  - type: DeveloperPortal
    url: https://developer.cigna.com/
  - type: Portal
    url: https://developer.cigna.com/
  - type: Documentation
    url: https://developer.cigna.com/docs/service-apis
  - type: Support
    url: https://developer.cigna.com/support
  - type: TermsOfService
    url: https://www.cigna.com/legal/terms-of-use
  - type: PrivacyPolicy
    url: https://www.cigna.com/legal/privacy
  - type: JSONLDContext
    url: json-ld/cigna-context.jsonld
  - type: JSONSchema
    url: json-schema/cigna-patient-schema.json
  - type: Spectral
    url: spectral/cigna-spectral.yml
  - type: NaftikoCapabilities
    url: naftiko/cigna-capabilities.yml
maintainers:
  - FN: Kin Lane
    email: kin@apievangelist.com