Denial Facts

Health insurance denial rates by insurer

209 insurers across 32 states, ranked by the share of in-network claims they denied. National average: 16%. The last column is the one that should be bigger.

InsurerStateDenial rateClaims deniedExternal reviews
AvMed, Inc.Florida50.2%654,725
Celtic Insurance CompanyNorth Carolina41.8%1,193
AmeriHealth Caritas North Carolina, Inc.North Carolina37.9%310
BridgeSpan Health CompanyUtah37.6%710
UnitedHealthcare of Arizona, Inc.Arizona35.8%490,97216
UnitedHealthcare Insurance CompanyAlabama35.5%113,673
UnitedHealthcare of Illinois, Inc.Illinois35.1%62,212
Aetna Health Inc. (a TX corp.)Texas34.1%98,052
UnitedHealthcare Insurance CompanyLouisiana33.7%14,442
US HEALTH AND LIFE INSURANCE COMPANYIndiana33.5%3,685
UnitedHealthcare Community Plan, Inc.Michigan33.1%25,778
US Health and Life Insurance CompanyKansas32.7%5,720
UnitedHealthcare of Florida, Inc.Florida32.5%358,239
UnitedHealthcare of Georgia, Inc.Georgia31.6%94,241
UnitedHealthcare Insurance CompanyTennessee31%195,488
UnitedHealthcare of Oklahoma, Inc.Oklahoma30.2%21,668
UnitedHealthcare of Texas, Inc.Texas30.1%615,24615
UnitedHealthcare of North Carolina, IncNorth Carolina29.9%491,960
Sendero Health Plans, Inc.Texas29.1%83,908
Anthem Ins Companies Inc(Anthem BCBS)Indiana27.8%52,045
Molina Healthcare of Illinois, Inc.Illinois27.5%389
Compcare Health Serv Ins Co(Anthem BCBS)Wisconsin26.9%68,701
Medica Community Health PlanArizona26.2%8,4170
Moda Health Plan, Inc.Texas25.7%4,377
Blue Cross and Blue Shield of AlabamaAlabama25.4%3,214,36054
Cigna Health and Life Insurance CompanyMississippi25.2%125,555
Cigna HealthCare of Illinois, Inc.Illinois24.3%97,334
Premera Blue Cross Blue Shield of AlaskaAlaska24.1%166,188
Anthem Blue Cross and Blue ShieldGeorgia23.7%904,058
Hawaii Medical Service AssociationHawaii23.2%147,935
Celtic Insurance CompanyOklahoma22.9%27,634
Summa Insurance Company, Inc.Ohio22.7%44,158
Molina Healthcare of Ohio, Inc.Ohio22.5%137,57415
Community Insurance Company(Anthem BCBS)Ohio22.3%325,920
Buckeye Community Health PlanOhio22.2%504,400
Healthy Alliance Life Co(Anthem BCBS)Missouri22%354,979
Medica Insurance CompanyOklahoma22%87,492
CareSource Georgia Co.Georgia21.8%361,615
Blue Cross and Blue Shield of South CarolinaSouth Carolina21.6%2,127,42867
Cigna Health and Life Insurance CompanyUtah21.3%18,141
Medica Central Health PlanIllinois21.2%6,512
Medica Insurance CompanyKansas21.1%24,5100
Harvard Pilgrim Health Care of NENew Hampshire20.9%31,314
University of Utah Health Insurance PlansUtah20.9%112,07615
Blue Cross and Blue Shield of Kansas CityKansas20.5%25,771
Medica Central Insurance CompanyMissouri20.5%47,452
CareSource West Virginia Co.West Virginia20.3%87,511
Blue Cross and Blue Shield of Kansas CityMissouri20%40,451
Aetna Health Inc. (a GA corp.)Georgia19.9%37,611
CareSource Ohio, Inc.Ohio19.9%444,66025
Matthew Thornton Hlth Plan(Anthem BCBS)New Hampshire19.7%246,037
Blue Cross Blue Shield of TexasTexas19.6%2,666,19669
Cigna Health and Life Insurance CompanyFlorida19.5%611,58018
Molina Healthcare of Florida, IncFlorida19.5%36,734
AultCare Insurance CompanyOhio19.2%42,971
Blue Cross and Blue Shield of NCNorth Carolina18.9%3,337,68547
Celtic Insurance CompanyIllinois18.7%273,732
CareSource Indiana, Inc.Indiana18.7%645,75732
University of Michigan Health PlanMichigan18.4%60,035
Superior Health PlanTexas18.2%407,80585
Cigna Health and Life Insurance CompanyTennessee17.9%884,13713
Banner Health and Aetna Health Plan Inc.Arizona17.8%26,374
Cox Health Systems Insurance CompanyMissouri17.8%1,005
Absolute Total Care, IncSouth Carolina17.8%269,843
Cigna HealthCare of Georgia, Inc.Georgia17.7%144,773
Blue Care Network of MichiganMichigan17.7%600,03443
Meridian Health Plan of Michigan, Inc.Michigan17.5%129,724
Molina Healthcare of Texas, Inc.Texas17.4%83,57470
Sunshine State Health PlanFlorida17.3%420,671
Celtic Insurance CompanyNew Hampshire17.3%154,238
BlueCross BlueShield of TennesseeTennessee17.2%634,727
Medica Insurance CompanyMissouri17.1%114,2960
Ambetter of North Carolina Inc.North Carolina17%190,418
Aetna Health Inc. (a PA corp.)North Carolina16.8%134,490
Primewell Health Services of Mississippi, Inc.Mississippi16.7%4,269
Aetna Life Insurance CompanyMissouri16.7%28,555
MOLINA HEALTHCARE OF SOUTH CAROLINA, INCSouth Carolina16.7%17,230
Medica Insurance CompanyNebraska16.5%294,260
Celtic Insurance CompanyTennessee16.5%320,566
Common Ground Healthcare CooperativeWisconsin16.5%465,910
Cigna HealthCare of North Carolina, Inc.North Carolina16.3%121,708
Oscar Health Plan, Inc.Illinois16.2%7,597
Molina Healthcare of UtahUtah16.2%7,988
Wellmark Health Plan of Iowa, Inc.Iowa16%306,763
HMO Louisiana, Inc.Louisiana15.9%574,165116
Oscar Health Plan of North Carolina, IncNorth Carolina15.8%1,749
Medica Health PlansNorth Dakota15.8%8,6560
Blue Cross Blue Shield of IllinoisIllinois15.2%2,230,11141
Molina Healthcare of Michigan, Inc.Michigan15.2%20,06318
HMO Partners, Inc.Arkansas15.1%229,049
USAble Mutual Insurance CompanyArkansas15.1%791,69917
Celtic Insurance CompanyFlorida15%1,913,915
Molina Healthcare of Mississippi, IncMississippi15%18,934
Moda Health Plan, Inc.Oregon15%150,74415
Community Health Choice, Inc.Texas15%586,36916
Blue Cross Blue Shield of OklahomaOklahoma14.9%1,144,63415
Oscar Insurance CompanyTennessee14.9%16,916
Regence BlueCross BlueShield of UtahUtah14.7%47,527
SelectHealth, Inc.Utah14.7%1,366,76625
Celtic Insurance CompanyKansas14.6%385,81831
Oscar Insurance CompanyOklahoma14.5%16,348
Network Health PlanWisconsin14.5%35,043
Celtic Insurance CompanyIndiana14.3%405,54133
Medica Insurance CompanyIowa14.3%111,015
Health Options, Inc.Florida14.2%4,109,57152
Celtic Insurance CompanyMissouri14.2%851,07426
Paramount Insurance CompanyOhio14.2%15,017
BridgeSpan Health CompanyOregon14.1%2,305
Celtic Insurance CompanyTexas14.1%1,763,710660
Ambetter of Magnolia Inc.Mississippi13.9%910,311
Health First Commercial Plans, Inc.Florida13.8%99,831
Nebraska Total Care, Inc.Nebraska13.8%71,525
Quartz Health Benefit Plans CorporationWisconsin13.8%86,327
Ambetter of Peach State Inc.Georgia13.7%2,410,742
Blue Cross Blue Shield of Michigan Mutual Insurance CompanyMichigan13.7%177,49845
Blue Cross and Blue Shield of MontanaMontana13.6%122,466
Blue Cross and Blue Shield of Kansas, Inc.Kansas13.5%242,99321
Scott and White Health PlanTexas13.4%325,28113
Oscar Buckeye State Insurance Corp.Ohio13.3%52,812
Cigna HealthCare of Arizona, IncArizona13.2%23,780
Health Net of Arizona, Inc.Arizona13.2%270,924
Highmark BCBSD Inc.Delaware13.2%127,999
Molina Healthcare of Wisconsin, Inc.Wisconsin13.2%13,822
Celtic Insurance CompanyArkansas13.1%742,861
Florida Health Care Plan, Inc.Florida13%308,978
Aspirus Health Plan, Inc.Wisconsin13%61,292
Oscar Insurance CompanyIowa12.8%20,570
Oscar Insurance CompanyKansas12.6%7,102
Louisiana Health Service & Indemnity CompanyLouisiana12.6%41,584
Oscar Insurance CompanyNebraska12.6%14,715
QCA Health Plan, Inc.Arkansas12.5%273,034
QualChoice Life & Health Insurance Company, Inc.Arkansas12.5%276,111
Oscar Health Plan of GeorgiaGeorgia12.5%244,361
Medica Community Health PlanWisconsin12.3%54,8130
Blue Cross and Blue Shield of FloridaFlorida12.1%2,167,15878
Oscar Insurance CompanyMissouri12.1%17,164
Oscar Insurance Company of FloridaFlorida11.7%2,902,781105
Health Alliance Medical Plans, Inc.Illinois11.7%167,43217
Oscar Insurance CompanyTexas11.7%498,53533
Oscar Health Plan, Inc.Arizona11.6%54,197
Regence BlueCross BlueShield of OregonOregon11.6%42,02641
Dean Health PlanWisconsin11.6%127,692
MercyCare HMO, Inc.Illinois11.4%5,948
Blue Cross Blue Shield of North DakotaNorth Dakota11.2%77,379
Oscar Insurance Corporation of OhioOhio11.1%65,413
Blue Cross Blue Shield of WyomingWyoming10.9%89,175
Oscar Insurance CompanyMichigan10.8%3,016
Quartz Health Benefit Plans CorporationIllinois10.6%7,481
Medical Health Insuring Corp. of OhioOhio10.4%192,87412
Kaiser Foundation Health Plan of GeorgiaGeorgia10.3%822
MercyCare HMO, Inc.Wisconsin10.1%22,765
CommunityCare HMO Inc.Oklahoma9.8%18,554
Highmark Blue Cross Blue Shield West VirginiaWest Virginia9.8%52,289
Montana Health CooperativeWyoming9.8%13,268
Chorus Community Health PlansWisconsin9.2%16,82612
Security Health Plan of Wisconsin, Inc.Wisconsin8.9%65,095
Blue Cross and Blue Shield of Arizona, Inc.Arizona8.7%85,26244
Alliant Health PlansGeorgia8.1%36,98723
CHRISTUS Health Plan LouisianaLouisiana7.8%1,615
Kaiser Foundation Healthplan of the NWOregon7.3%1,164
Group Health Cooperative of South Central WisconsinWisconsin7.3%15,174
McLaren Health Plan CommunityMichigan7.2%9,983
Capital Health PlanFlorida7.1%15,920
CHRISTUS Health PlanTexas6.9%17,943
Priority HealthMichigan6.6%197,73042
HealthPartners Insurance CompanyWisconsin6.4%19,972
Kaiser Foundation Health Plan, Inc.Hawaii5%561
Sanford Health PlanSouth Dakota4.9%41,849
Sanford Health PlanNorth Dakota4.6%25,790
PacificSource Health PlansMontana3.7%15,27213
Providence Health PlanOregon3.6%18,702152
Avera Health Plans, Inc.South Dakota3.1%13,424
PacificSource Health PlansOregon3%24,60236
Montana Health CooperativeMontana2.2%2,005

Source: CMS Transparency in Coverage Public Use File (PY2024 release, PY2022 claims), data.healthcare.gov — US Government public domain.

This page presents federal statistics and a general description of appeal rights created by federal law. It is not legal, medical, or insurance advice, and no outcome is guaranteed. Your denial letter and plan documents govern your specific case. Free help is available from your state's Consumer Assistance Program and from the federal Marketplace at HealthCare.gov.