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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.

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3 of 536
filings in view
26K
standard requests
15.4%
volume-weighted denial rate
0
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
3
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
Medicare Advantage 26K 3 filings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Johns Hopkins Medicine Johns Hopkins Advantage MD (HMO) - Contract H1225 Medicare Advantage MD 13K 16.1% — Johns Hopkins Medicine Johns Hopkins Advantage MD (VA HMO) - Contract H1339 Medicare Advantage VA 13 15.4% — Johns Hopkins Medicine Johns Hopkins Advantage MD (PPO) - Contract H3890 Medicare Advantage MD 12K 14.7% —