Crossfoot
02 · Explorer

Prior authorization denial rates, plan by plan

Every plan that published a CY2025 filing. Search for an insurer or a plan by name, narrow by state or market, and the charts and the weighted rate below recompute as you go.

Reset
54 of 536
filings in view
935K
standard requests
16.0%
volume-weighted denial rate
2
with validation findings

The weighted rate is computed over filings in view that published both a request total and a denial count; the request figure beside it counts every filing in view.

Distribution of denial rates
filings per 10-point band
32
18
4
0–10%
10–20%
20–30%
30–40%
40–50%
50–65%
Denial rate vs. request volume
log volume, 1K → 500K · orange marks carry findings
1K10K100K500K
Request volume by market, current filter
Medicaid Managed Care 872K 13 filings
Medicare-Medicaid Plan 61K 3 filings
CHIP Managed Care 2K 1 filings
Medicare Advantage 0 37 filings

Filings

Download CSV · JSON
Sort
Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
CVS Health / Aetna Aetna Better Health of New Jersey Medicaid Managed Care NJ 56K 27.6% — CVS Health / Aetna Aetna Better Health of Maryland Medicaid Managed Care MD 16K 23.2% — CVS Health / Aetna Aetna Better Health of Florida Medicaid Managed Care FL 43K 22.4% — CVS Health / Aetna Aetna Better Health of Michigan Medicaid Managed Care MI 18K 22.1% — CVS Health / Aetna Aetna Better Health of Kentucky Medicaid Managed Care KY 123K 19.5% — CVS Health / Aetna Aetna Better Health of West Virginia Medicaid Managed Care WV 83K 19.3% — CVS Health / Aetna Aetna Better Health Kids (Pennsylvania CHIP) CHIP Managed Care PA 2K 18.0% 2 CVS Health / Aetna Aetna Better Health of Virginia Medicaid Managed Care VA 108K 17.2% — CVS Health / Aetna Aetna Medicare Advantage - contract H5309 Medicare Advantage — — 16.3% — CVS Health / Aetna Aetna Better Health of Illinois Medicaid Managed Care IL 111K 15.6% — CVS Health / Aetna Aetna Better Health of Louisiana Medicaid Managed Care LA 80K 15.2% — CVS Health / Aetna Aetna Better Health of Ohio (OhioRISE) Medicaid Managed Care OH 76K 14.1% — CVS Health / Aetna Aetna Medicare Advantage - contract H8332 Medicare Advantage — — 13.2% — CVS Health / Aetna Aetna Medicare Advantage - contract H4523 Medicare Advantage — — 12.7% — CVS Health / Aetna Aetna Medicare Advantage - contract H3219 Medicare Advantage — — 11.5% — CVS Health / Aetna Aetna Medicare Advantage - contract H4711 Medicare Advantage — — 11.3% — CVS Health / Aetna Aetna Medicare Advantage - contract H3288 Medicare Advantage — — 10.9% — CVS Health / Aetna Aetna Better Health of Oklahoma Medicaid Managed Care OK 64K 10.8% — CVS Health / Aetna Aetna Medicare Advantage - contract H4835 Medicare Advantage — — 10.7% — CVS Health / Aetna Aetna Medicare Advantage - contract H3928 Medicare Advantage — — 10.4% — CVS Health / Aetna Aetna Medicare Advantage - contract H3239 Medicare Advantage — — 10.4% — CVS Health / Aetna Aetna Medicare Advantage - contract H1609 Medicare Advantage — — 10.4% — CVS Health / Aetna Aetna Better Health of New York Medicaid Managed Care NY 53K 10.0% — CVS Health / Aetna Aetna Medicare Advantage - contract H1692 Medicare Advantage — — 9.6% — CVS Health / Aetna Aetna Medicare Advantage - contract H3931 Medicare Advantage — — 9.5% — CVS Health / Aetna Aetna Medicare Advantage - contract H5325 Medicare Advantage — — 8.7% — CVS Health / Aetna Aetna Medicare Advantage - contract H2293 Medicare Advantage — — 8.3% — CVS Health / Aetna Aetna Medicare Advantage - contract H1608 Medicare Advantage — — 8.2% — CVS Health / Aetna Aetna Medicare Advantage - contract H5521 Medicare Advantage — — 7.9% — CVS Health / Aetna Aetna Medicare Advantage - contract H7149 Medicare Advantage — — 7.8% — CVS Health / Aetna Aetna Better Health of Texas Medicaid Managed Care TX 41K 7.7% — CVS Health / Aetna Aetna Medicare Advantage - contract H0628 Medicare Advantage — — 7.7% — CVS Health / Aetna Aetna Medicare Advantage - contract H1109 Medicare Advantage — — 7.7% — CVS Health / Aetna Aetna Medicare Advantage - contract H5302 Medicare Advantage — — 7.4% — CVS Health / Aetna Aetna Medicare Advantage - contract H3312 Medicare Advantage — — 7.3% — CVS Health / Aetna Aetna Medicare Advantage - contract H3748 Medicare Advantage — — 7.3% — CVS Health / Aetna Aetna Medicare Advantage - contract H8597 Medicare Advantage — — 7.3% — CVS Health / Aetna Aetna Medicare Advantage - contract H2056 Medicare Advantage — — 7.2% — CVS Health / Aetna Aetna Medicare Advantage - contract H3146 Medicare Advantage — — 7.1% — CVS Health / Aetna Aetna Medicare Advantage - contract H5593 Medicare Advantage — — 7.0% — CVS Health / Aetna Aetna Medicare Advantage - contract H5522 Medicare Advantage — — 7.0% — CVS Health / Aetna Aetna Medicare Advantage - contract H2663 Medicare Advantage — — 6.8% — CVS Health / Aetna Aetna Medicare Advantage - contract H5337 Medicare Advantage — — 6.6% — CVS Health / Aetna Aetna Better Health Premier Plan (Medicare-Medicaid) Medicare-Medicaid Plan IL — 6.6% — CVS Health / Aetna Aetna Medicare Advantage - contract H3959 Medicare Advantage — — 6.1% — CVS Health / Aetna Aetna Medicare Advantage - contract H7301 Medicare Advantage — — 6.0% — CVS Health / Aetna Aetna Medicare Advantage - contract H1206 Medicare Advantage — — 6.0% — CVS Health / Aetna Aetna Better Health Premier Plan Michigan Medicare-Medicaid Plan MI — 5.9% — CVS Health / Aetna Aetna Medicare Advantage - contract H5793 Medicare Advantage — — 5.8% — CVS Health / Aetna Aetna Medicare Advantage - contract H3597 Medicare Advantage — — 5.5% — CVS Health / Aetna Aetna MyCare Ohio Medicare-Medicaid Plan OH 61K 3.6% — CVS Health / Aetna Aetna Medicare Advantage - contract H0523 Medicare Advantage — — 2.4% — CVS Health / Aetna Aetna Medicare Advantage - contract H4982 Medicare Advantage — — 2.0% — CVS Health / Aetna Aetna Medicare Advantage - contract H0562 Medicare Advantage — — 0.0% 1