Compare insurer records · never mix unlike measures
See which insurers say no more often.
These are two different questions. A claim denial means the insurer refused to pay after care happened. A permission-before-care denial means the insurer said no before care happened. We rank them separately and label the year, market, and source beside every table.
Marketplace claim denials, all nineteen large parents
Share of in-network claims denied in 2024 among parent companies with more than five million HealthCare.gov claims. The Marketplace average was 19 percent. Click a column heading to sort.
| 1 | Oscar Health | 14 | 7,728,613 | 1,924,512 | 25% | # |
| 2 | Molina Healthcare | 6 | 6,278,416 | 1,408,843 | 22% | # |
| 3 | GuideWell (Florida Blue) | 1 | 68,858,890 | 15,397,985 | 22% | # |
| 4 | Harris Health | 1 | 6,776,421 | 1,449,319 | 21% | # |
| 5 | Cigna | 7 | 17,434,556 | 3,717,198 | 21% | # |
| 6 | BCBS of Tennessee | 1 | 6,270,421 | 1,323,501 | 21% | # |
| 7 | BCBS of North Carolina | 1 | 16,183,703 | 3,116,071 | 19% | # |
| 8 | UnitedHealth Group | 19 | 37,134,878 | 7,137,191 | 19% | # |
| 9 | BCBS of Alabama | 1 | 10,704,172 | 2,038,603 | 19% | # |
| 10 | IHC Group | 1 | 8,402,145 | 1,571,221 | 19% | # |
| 11 | Centene (Ambetter) | 20 | 93,134,551 | 17,226,764 | 18% | # |
| 12 | Health Care Service Corp. | 3 | 68,390,522 | 12,556,963 | 18% | # |
| 13 | CareSource | 5 | 8,845,681 | 1,588,363 | 18% | # |
| 14 | BCBS of Louisiana | 1 | 6,465,640 | 1,140,936 | 18% | # |
| 15 | BCBS of Michigan | 1 | 5,206,241 | 866,555 | 17% | # |
| 16 | Arkansas BCBS | 1 | 6,568,033 | 1,041,647 | 16% | # |
| 17 | BCBS of South Carolina | 1 | 11,796,220 | 1,827,005 | 15% | # |
| 18 | Scott & White | 1 | 8,274,564 | 1,205,777 | 15% | # |
| 19 | Elevance Health | 7 | 14,691,239 | 1,224,517 | 8% | # |
Source · KFF analysis of the CMS Transparency in Coverage PUF (2024 plan year)
- Published
- Mar. 24, 2026
- Capture note
- HealthCare.gov states only; CMS does not audit insurer submissions.
- Public lineage
- Original source linked below. A public immutable archive and provenance ID are not yet published.
Underlying CMS file · CMS Transparency in Coverage Public Use File (PY2026 file, PY2024 data)
- Published
- Sep. 26, 2025
- Public lineage
- Original source linked below. A public immutable archive and provenance ID are not yet published.
Medicare Advantage, by insurer
How often each major insurer received a prior-authorization request, said no, and changed its answer after an appeal in 2024. Across the market, 7.7% of requests were denied, 11.5% of denials were appealed, and80.7% of appealed denials were reversed. A blank cell means the source did not publish that figure.
| Insurer | Requests per enrollee | Requests denied | Denials appealed | Appeals reversed |
|---|---|---|---|---|
| UnitedHealth Group | 1 | 12.8% | — | — |
| Centene | 2.9 | 12.3% | — | 95.5% |
| Humana | 2.2 | 5.8% | — | — |
| Elevance Health | 3 | 4.2% | — | — |
| CVS Health (Aetna) | — | — | 19.9% | — |
| Kaiser Permanente | 0.6 | — | 1.6% | 51% |
A high request rate with a low denial rate can still produce many denials. These are public averages, not a prediction about your plan.
Source · KFF analysis of CMS Medicare Advantage data (2024)
- Published
- Jan. 28, 2026
- Capture note
- Insurer-reported to CMS; unaudited.
- Public lineage
- Original source linked below. A public immutable archive and provenance ID are not yet published.