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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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18 of 536
filings in view
952K
standard requests
9.9%
volume-weighted denial rate
1
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
12
5
1
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 844K 11 filings
Medicaid Managed Care 104K 5 filings
Marketplace QHP 2K 1 filings
CHIP Managed Care 1K 1 filings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Kaiser Permanente Kaiser Foundation Health Plan of the Northwest - Oregon Medicaid Medicaid Managed Care OR 13K 20.4% — Kaiser Permanente Kaiser Permanente Southern California Medicare Advantage CA 144K 19.5% — Kaiser Permanente Kaiser Foundation Health Plan of the Northwest Medicare Advantage OR 62K 12.6% — Kaiser Permanente Kaiser Permanente Northern California (H8794) Medicare Advantage CA 40K 11.3% — Kaiser Permanente Kaiser Permanente Southern California (H8794) Medicare Advantage CA 34K 11.0% — Kaiser Permanente Kaiser Permanente Northern California Medicare Advantage CA 145K 10.5% — Kaiser Permanente Kaiser Foundation Health Plan of Colorado Medicare Advantage CO 69K 9.6% — Kaiser Permanente Kaiser Foundation Health Plan of Colorado - CHIP CHIP Managed Care CO 1K 9.4% — Kaiser Permanente Kaiser Permanente Northern California - Medi-Cal Medicaid Managed Care CA 25K 9.0% — Kaiser Permanente Kaiser Foundation Health Plan of Colorado (H3138) Medicare Advantage CO 876 8.5% — Kaiser Permanente Kaiser Mid-Atlantic States - Maryland Medicaid Medicaid Managed Care MD — 7.1% — Kaiser Permanente Kaiser Permanente Hawaii Medicare Advantage HI 22K 7.1% — Kaiser Permanente Kaiser Permanente Southern California - Medi-Cal Medicaid Managed Care CA 57K 6.4% — Kaiser Permanente Kaiser Foundation Health Plan of Washington Medicare Advantage WA 185K 6.1% — Kaiser Permanente Kaiser Foundation Health Plan of the Mid-Atlantic States Medicare Advantage MD 90K 5.5% 1 Kaiser Permanente Kaiser Foundation Health Plan (Hawaii QHP) Marketplace QHP HI 2K 4.8% — Kaiser Permanente Kaiser Foundation Health Plan of Georgia Medicare Advantage GA 52K 3.1% — Kaiser Permanente Kaiser Permanente Hawaii - Medicaid Medicaid Managed Care HI 10K 2.6% —