Oscar denied your claim in Michigan. Here is your deadline.
Put in the date on your Oscar Insurance Company notice and get both federal deadlines as calendar dates.
Free, for an Oscar Insurance Company denial in Michigan, and it runs entirely in your browser. The date, the plan type and the state you pick are never sent to us and never stored.
Oscar Insurance Company denied 14,778 of 54,216 in-network claims in Michigan; every one of those denials had these same two dates on it. Across Michigan as a whole the insurers in this file denied 17.4% of in-network claims, 2,371,866 of them, and 2,671 were appealed.
Oscar Insurance Company denied 27.3% of in-network claims in Michigan, 14,778 claims out of 54,216.
Insurance got denied, what to do next?
Those 14,778 denials are 0.6% of every in-network denial recorded in Michigan in this release, which makes Oscar Insurance Company the 7th largest source of denials of the 7 insurers reporting there. Spread across its 9 plans in the state that is about 1,642 denials per plan. 596 internal appeals were filed against those 14,778 denials. Every one of those denials carried the same two dates the tool at the top of this page works out.
Two dates matter more than anything else on this page, and they run the same in Michigan as everywhere else. You have 180 days from the date on your denial notice to file the internal appeal, and then 4 months from the final internal denial to ask for an independent external review. If waiting would seriously jeopardize your health you can ask for both to be expedited, decided in about 72 hours. Both timeframes are federal, not your insurer's choice, 29 CFR 2560.503-1 (PDF) and 45 CFR 147.136 (PDF), in plain English at HealthCare.gov, and your own denial letter states the ones that govern your plan. The PDFs are the same sections on govinfo.gov, which serves them without a challenge page, so an automated reader can check these two dates as easily as you can.
You are not alone, and here is the measured version of that sentence: 14,778 in-network claims were denied by Oscar Insurance Company in Michigan in a single plan year. A denial rate is a fact about an insurer's book of business. It is not a judgment about you, and it is not the last word on your claim.
- Of the 7 insurers reporting a denial rate in Michigan, Oscar Insurance Company is the second highest at 27.3%. The highest in the state is 27.7% and the lowest is 7.9%.
- That is 8.6 percentage points above the 18.7% national average across this dataset, and 9.9 points above the Michigan average of 17.4%.
- Behind the percentage: 54,216 in-network claims were processed under 9 plans in Michigan, and 14,778 of them came back denied.
- For every 10,000 claims Oscar Insurance Company denied, about 403 came back as an internal appeal. The other 9,597 stopped at the letter.
- Of the internal appeals it did receive, Oscar Insurance Company overturned 30.7%, 183 claims that started life as a no.
- 46 of those denials went on to independent external review, the stage whose decision the plan is required by law to accept. Nationally 32.8% of external reviews are overturned.
- Its most-recorded denial reason is administrative reason at 56.7% of its categorized denials, against 22.5% nationally, a heavier share than the country as a whole. That is the denial mix, not an outcome rate.
- In Michigan, Oscar Insurance Company reported 27.3%, and the same company files in 8 other states in this file, where the rate is not the same in any of them: 28.1% in Arizona, 26.1% in Kansas, 25.5% in Texas, down to 21.7% in Nebraska. Which state the plan was bought in moves the odds more than the brand on the card does.
- Oscar Insurance Company accounts for 0.6% of every in-network claim denied in Michigan in this file.
- By raw volume it is the 143th largest source of denials among the 158 insurer-state records in the file that report one.
- Put another way: one independent external review was filed for every 321 claims Oscar Insurance Company denied in Michigan.
- After that, its second-most-recorded reason is provider out of network, 3,578 claims, 20.9% of its categorized denials.
- Third on its own list is benefit limit reached, 1,810 claims, 10.6% of what Oscar Insurance Company categorized in Michigan. Between them the top three account for 88.2% of its categorized denials.
- Where Oscar Insurance Company differs most from the national mix is administrative reason: 56.7% of its categorized denials in Michigan against 22.5% across the file.
- Read the other way round: 39,438 of those 54,216 in-network claims were paid, 72.7% of everything Oscar Insurance Company processed in Michigan.
- Spread across the 9 plans it reports in Michigan, that is about 1,642 denied claims per plan, on about 6,024 claims processed per plan.
- Its reason columns add up to 17,104 categorized rows against 14,778 denials, 115.7% of them, and every reason share on this page is a share of that first figure rather than of the second.
- Its smallest recorded category in Michigan is experimental or investigational, 25 claims, 0.1% of what Oscar Insurance Company categorized there.
- Against the file as a whole, this one record is 0% of the 84,502,749 in-network claim denials reported by every issuer in it.
- Find the reason code on your denial letter. The reason Oscar Insurance Company records most often in Michigan is administrative reason, but yours may be one of the other 8, copy the exact wording and code off your own letter tonight, because that sentence is what your appeal has to answer.
- Ask Oscar Insurance Company in Michigan for the clinical criteria they judged you against. Under 29 CFR 2560.503-1 they have to hand you the claim file and the policy they applied, free, on request, and you cannot argue with a checklist you have never read.
- Put both deadlines on your calendar before you go to bed. 180 days from the date on the letter for the internal appeal, 4 months from the final internal denial for external review. The free calculator on this page turns your date into the two calendar dates in about ten seconds. Oscar Insurance Company overturned 30.7% of the internal appeals it did receive, 183 claims, so the stage you are about to start is not decorative.
None of those three steps costs anything. Anyone charging you to do them is selling you something you can do yourself in twenty minutes.
How that compares
| Denial rate | Rate | Difference |
|---|---|---|
| Oscar Insurance Company | 27.3% | , |
| Michigan average | 17.4% | +9.9 pts |
| National average (this dataset) | 18.7% | +8.6 pts |
Oscar Insurance Company denies 8.6 percentage points more of its in-network claims than the national average across this dataset. A denial rate is a property of the insurer's book of business, coding practice, plan design, the population it covers, not evidence about the merits of any one claim, including yours.
What happened to appeals
| Stage | Filed | Overturned |
|---|---|---|
| Internal appeal (to Oscar Insurance Company) | 596 | 30.7% |
| External review (independent) | 46 | 23.91% |
The gap nobody escalated
14,778 claims denied. 596 internal appeals filed. 46 reached independent external review. Nationally 32.8% of external reviews are overturned and the decision binds the plan.
That is arithmetic from the reported figures, not a prediction: nobody can say what those specific denials would have done at review, because they never got there. What the numbers do establish is that the binding stage was almost entirely unused here.
What that record means for your own Oscar Insurance Company letter, and by when. Oscar Insurance Company overturned 30.7% of the 596 internal appeals its Michigan members filed against 14,778 denials, and 46 of those Michigan denials went on to the independent stage whose decision binds the plan, Oscar Insurance Company's own rows in the plan-year 2026 release of the CMS Transparency in Coverage file, read September 5, 2026 (data.healthcare.gov). Whichever way that lands, nobody files the appeal for you, and the filing runs on a clock set by which plan you hold: an employer or Marketplace plan gives you at least 180 days from the denial notice to file the internal appeal (29 CFR 2560.503-1(h)(3)(i), carried onto individual-market coverage by 45 CFR 147.136(b)(3)(i)), while Medicare Advantage gives you 60 calendar days after you receive its notice (42 CFR 422.582(b)) and Medicaid managed care the same 60 calendar days from the date on the notice (42 CFR 438.402(c)(2)(ii)), both stages free, and the three steps above are the whole of what to do tonight, so take the date printed on your Oscar Insurance Company notice and file well inside whichever of those windows is yours. The free steps are above; the $29 kit is the same clock with the letters pre-filled for Oscar Insurance Company in Michigan. One payment. No subscription. No cut of your claim.
Oscar Insurance Company inside Michigan
Your denial did not happen in a national average. It happened in a state market, alongside 7 other insurers reporting into the same federal file, and these are that market's own figures.
- Across the whole of Michigan, the 8 insurers reporting in this file processed 13,652,457 in-network claims and denied 2,371,866 of them, a state denial rate of 17.4%. Oscar Insurance Company is one of those 8.
- That puts Michigan 20th of 30 states by denial rate, 1.3 points below the 18.7% national average, before you get to what Oscar Insurance Company did inside it.
- Michigan recorded 2,671 internal appeals against those denials: one appeal for every 888 claims the state's insurers refused. Oscar Insurance Company's own ratio is one for every 25.
- Independent external review was reached 189 times in the whole of Michigan, once for every 12,550 denials, against one in 14,369 nationally. 46 of those Michigan filings came from Oscar Insurance Company's denials.
- Of the Michigan external reviews that were filed, 11 were overturned, 5.8%. That percentage is measured on 189 reviews, which is why the count beside it matters more than the rate does when you are deciding whether to file against Oscar Insurance Company.
- The reason Michigan's insurers record most often is service excluded from the plan, 569,264 claims, 33.4% of the state's categorized denials. Oscar Insurance Company records administrative reason most often instead, which is the argument your letter will need to answer.
- The other insurers a Michigan reader could have bought from run from 27.7% (Meridian Health Plan of Michigan, Inc.) to 7.9% (Priority Health). Oscar Insurance Company at 27.3% sits between the two.
- Put the two together and Oscar Insurance Company is responsible for 0.6% of every in-network claim denied in Michigan in this release, from 0.4% of the claims the state's insurers processed.
- Every Michigan figure in this section is that state's own row in the same federal file Oscar Insurance Company's numbers above come from, CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain, and the full Michigan page is free at /states/michigan.
What Oscar Insurance Company denies most
The most common denial reason recorded for Oscar Insurance Company plans in Michigan is administrative reason. How that denial is beaten →
| Denial reason | Claims | Share | National share |
|---|---|---|---|
| Administrative reason | 9,700 | 56.7% | 22.5% |
| Provider out of network | 3,578 | 20.9% | 9.8% |
| Benefit limit reached | 1,810 | 10.6% | 4.2% |
| Referral required | 1,246 | 7.3% | 8.4% |
| Member not covered | 433 | 2.5% | 6.6% |
| Other reasons | 179 | 1% | 32.3% |
| Service excluded from the plan | 133 | 0.8% | 11.6% |
| Experimental or investigational | 25 | 0.1% | 0.1% |
The last column is each reason's share of all categorized denials nationally, so you can see where Oscar Insurance Company's mix in Michigan differs from everyone else's. This is denial mix, not overturn rate by reason, the federal file does not report appeal outcomes broken down by denial reason, and we do not imply otherwise.
Put the date from your notice in and get the two calendar dates, with the days remaining.
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The three steps at the top of this page are the whole of what you have to do tonight. The longer version, what the internal appeal has to contain, how the independent stage works, and how to ask for expedited handling when waiting would seriously jeopardize your health, is published free here. For what it is worth on this page specifically: Oscar Insurance Company overturned 30.7% of the internal appeals it received.
Questions
Is Oscar Insurance Company's denial rate in Michigan high?
27.3% against a national average of 18.7% across the plans in this dataset. It is above average. A denial rate describes the insurer, not the merits of your claim.
How many people appealed an Oscar Insurance Company denial in Michigan, and how many won?
596 internal appeals were filed against 14,778 denials, and 30.7% of them were overturned (183 claims). 46 went on to independent external review.
How does Oscar Insurance Company compare with other insurers in Michigan?
Of the 7 insurers in Michigan with a reported denial rate, Oscar Insurance Company ranks 2 highest at 27.3%. The highest in Michigan is Meridian Health Plan of Michigan, Inc. at 27.7%; the lowest is Priority Health at 7.9%.
What does Oscar Insurance Company deny most often in Michigan?
Administrative reason, 9,700 claims, 56.7% of this issuer's categorized denials, against 22.5% nationally. This is the denial-reason mix; the federal file does not report overturn rates by reason.
How long do I have to appeal an Oscar Insurance Company denial in Michigan?
Generally 180 days from the date on the denial notice to file the internal appeal, then generally four months from the final internal denial to request independent external review. Expedited review, decided in about 72 hours, is available where delay would seriously jeopardize your health. Those timeframes are federal, so they are identical for every insurer reporting in Michigan, Oscar Insurance Company included, what varies by state is who runs the independent review at the end. Your own denial letter states the deadlines that govern your plan; that letter is the authority.
Does appealing an Oscar Insurance Company denial in Michigan cost anything?
The internal appeal to Oscar Insurance Company is free. External review is free under the HHS-administered federal process; where an issuer uses a contracted independent review organization or a state process, any fee is capped at $25 per review. Nobody in Michigan can be charged more than that to file one.
Can Oscar Insurance Company ignore an external review decision in Michigan?
No, and that is the whole point of the stage. External review decisions are binding on the plan by law, which is what makes the 46 external reviews recorded against 14,778 Oscar Insurance Company denials in Michigan the striking number on this page.
Oscar Insurance Company sits at 27.3% in Michigan against 18.7% nationally, and that is the whole of what this page can honestly tell you about your own claim. I am not going to tell you that you will win. This page prints the insurer's own reported numbers whichever way they fall. If what it says does not match the letter in your hand, write to me and I will correct the page.
, Andrew at Axion Labs · hello@getaxionlabs.comEverything you need for your Oscar Insurance Company appeal in Michigan: your two deadlines, the argument that fits your denial reason, the letters, the clinician brief, and the external review request. One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com.
The Oscar Insurance Company figures on this page, the 27.3% denial rate, the 14,778 denials and the 46 external reviews, are this issuer’s own reported rows in that file.
Counts: CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain. Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov. Expedited review is decided in about 72 hours under both sections.
Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136).